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How much sleep is too much?


Question: My mom has Alzheimers and all she wants to do is sleep. She goes to an adult day care program twice a week but when she is home she sleeps 18 to 20 hours a day. I've talked with her physician and have been told not to worry. What are your thoughts?

Dr. Amy: People with Alzheimer’s disease often develop altered sleep patterns—either sleeping a lot or getting off their sleep cycle. We do not completely understand why. Some studies have found that changes in sleep occur in patients who are in the later stages  of the disease, but this is not always the case. You might ask your doctor to double check your mother to make sure that depression or some other underlying condition is not affecting her health. But based on reports from other caregivers, it does seem that sleeping a lot is fairly common.

Here is a list of tips developed by the Alzheimer's Association, to help caregivers establish a regular sleep cycle. A lot of these seem to be aimed at people whose loved one is sleeping during the day and up at night, but you may find some of these helpful:

  • Maintain regular times for meals and for going to bed and getting up
  • Seek morning sunlight exposure
  • Encourage regular daily exercise, but no later than four hours before bedtime
  • Avoid alcohol, caffeine and nicotine
  • Treat any pain
  • If the person is taking a cholinesterase inhibitor (tacrine, donepezil, rivastigmine or galantamine), avoid giving the medicine before bed
  • Make sure the bedroom temperature is comfortable
  • Provide nightlights and security objects
  • If the person awakens, discourage staying in bed while awake; use the bed only for sleep
  • Discourage watching television during periods of wakefulness
I also encourage you to talk to the day care before you see the doctor, and ask how your mom behaves while there. Does she sleep a lot there too?
If there is a big difference between day care and home, this is something to talk to the doctor about.
Good luck!

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