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Promoting a good night’s sleep
Sleep disturbance is common in older people
It can be helpful to try and identify the trigger for disturbed sleep. Look out for one or more of the following:
- Changes to the environment – staff changes, altering furniture/decor, changing rooms/usual environment, altering of routine etc may adversely affect the sleep routine of the person
- Climate – check whether the environment and bedding provide appropriate warmth and comfort
- Noise and light – a person may not sleep as deeply and may have disrupted sleep due to excessive noise/stimulation, both internal and external to the building
- Sleep apnoea, periodic limb movement disorder or restless leg syndrome may be contributing factors in disturbed sleep
- Be aware of their nutritional needs
- Pain – may be caused through acute or chronic illnesses. Pain may be caused through trauma that has not been identified due to the person’s inability to communicate. Is there a history of falls?
- Medication – consider whether insomnia is due to medication e.g. may be causing restless legs or cramps. The person may wake up because diuretics result in the need to urinate.
- Impaction and/or dehydration – constipation and/or dehydration can seriously affect the behaviour of older people and their ability to sleep
- Cognitive impairment – Although not everyone with dementia, for example, will suffer from sleep disturbance, a significant number will experience disruption to the ‘normal’ day/night sleep cycle
- Mental illness – does the person have a history of psychiatric illness? Insomnia or early morning wakening may be symptoms of illness such as depression, anxiety or psychosis
- Recent loss – grief/bereavement, loss of independence, may all add to a person’s anxiety
- Past life events – sleep disturbance may be related to a memory of a significant life event being triggered e.g. an item on the TV or significant anniversary may trigger the memory and emotions of a traumatic event such as bereavement.
Further information is available from the NHS website and from Carers UK. If you are concerned about your sleep quality or the sleep quality of someone else, you can also speak to your GP.
If you would like more information call our Carer Support Line on 01463 723560 or email us on carers@connectingcarers.org.uk.
Ways to promote sleep
Avoid over-stimulation prior to bedtime e.g. caffeine intake.
Participate in light physical activity during the day.
Ensure comfortable positioning and adequate pain relief.
Ensure the bedroom is quiet, reassuring and relaxing. Close your eyes and identify the sounds (creaking doors, buzzers) that can add up to an over-stimulated environment.
Make sure the environment is not too ‘busy’ with, for example, bright colours or too much clutter.
Provide adequate lighting to reduce confusion & disorientation.
Ensure the way to the toilet is well lit and easy to access.
Ways to manage disrupted sleep
Check for signs of infection e.g. check temperature.
Identify what woke them and remedy the cause e.g. is the bed uncomfortable?
The amount of sleep needed normally decreases with age. Light activity through the day will help stimulate healthy sleep.
If the person is upset, communicate with them in an uncomplicated way to validate their feelings and gently reassure them.
Check how much sleep the person has had. Pressuring them to stay in bed if they have had enough sleep may cause resistance, frustration or even a catastrophic reaction. Let them sit or wander safely, or offer them a warm drink.
If you would like more information call our Carer Support Line on 01463 723560 or email us on carers@connectingcarers.org.uk.
What is sleep hygiene?
Sleep hygiene is a variety of different practices and changes to the environment that are necessary to have good quality night-time sleep and full day-time alertness.
Why is it important to practise good sleep hygiene?
Obtaining healthy sleep is important for both physical and mental health. It can also improve productivity and overall quality of life. Everyone, from children to older adults, can benefit from practising good sleep habits.
You are probably already very aware of what you can do to improve the quality of your own sleep but don’t always manage to do it. Complete the Sleep Diary (link below) for a week to see how you are doing before you take the Sleep Quiz (also below). Then, have a look at what your patterns are and try to implement some of our good sleep suggestions. You can always take the quiz again to see how you are improving.
Developing Good Sleep Practice
- Keep a regular bedtime for you or your child and wake at a regular hour each morning, so that the body clock is strengthened.
- Do not have prolonged naps in the late afternoon. If you or your child still needs to sleep, schedule the nap for early afternoon.
- Avoid stimulating activity in the hour before bedtime, including TV, tablets, phones and consoles.
- Avoid drinks of cola, chocolate, tea and coffee i.e. caffeine and additives before bedtime. Instead have a warm milk drink.
- Make sure that you or your child does not go to bed hungry, but do not give a child aged more than six months old feeds/drinks during the night.
- Make sure that the bedroom is quiet and dark.
- Keep room temperature to a comfortable level. High temperatures disturb sleep.
- Keep room clear of distractions and electronics such as TVs or consoles.
- Environmental noise should be kept to a minimum (no loud TV, conversation, music).
- Help your child to learn to fall asleep alone in their own bed, without your presence.
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