Why do alzheimer’s patients sleep?
Alzheimer’s disease is a degenerative neurological disease which affects memory. It is especially seen in geriatric (old) age group. Alzheimer’s disease is characterized by loss of neurons and synapses in the brain. A positive family history and old age are the most important risk factors for this disease. Environmental factors along with genetic insult may worsen Alzheimer’s disease.
The initial chemical injury to the brain is an increasing amount of soluble amyloid fibrils called oligomers. Accumulation of oligomers eventually leads to neuritic plaques (dense patches). The disease is associated with a reduction in levels of proteins and neurotransmitters in the brain, especially acetylcholine.
Dementia is the most common and the most important sign of Alzheimer’s disease. It starts off with absent mindedness and forgetfulness. The daily chores are affected too but most of the patients take it to be a routine outcome due to increasing age. Some people who have the insight that something unusual is occurring, beyond what can be attributed to old age, take note of the change and approach a doctor. Patients forget the headlines of the news paper they just read or they keep their keys at a wrong place. The positions of things which are used regularly are forgotten. Next is forgetting names of streets, places, home address, and people also. They need to maintain a diary or notes or alarms for constant reminders. Persons tend to behave oddly and need to be taken care of at every step.
The sleep pattern also gets altered eventually. More the dementia more is the sleep cycle is altered. These persons cannot stay awake for more than an hour nor do they stay asleep for more than an hour during night time. This causes restlessness. Since these patients do not sleep well at night they tend to have increased narcolepsy (episodes of sleeping during the day time). This reversal of sleep cycle causes more drowsiness and lethargy. The drowsiness is to such an extent that they will have short naps anytime during the day. Also, the care taker or the loved ones are highly disturbed as patients will stay awake and move about at night. Aimlessly moving about at night may cause some accident putting the patients in danger. Later stages have more difficulty in language due to decreased word fluency and lessening vocabulary. Reading and writing skills are progressively lost. Sense of time and direction orientation is lost and so the patients keep wandering about and feeling lost. Wandering is also seen because they start losing memory of long dated events as well as recent events. This behavior eventually makes them detached from family. Eventually, they become either aggressive or totally passive. There is irritability which is seen more in the evening. People may become abusive or violent due to irritability.
As a part of the treatment, the patients are given drugs to calm them down or induce more sleep but progressive memory loss is inevitable. The condition keeps deteriorating day by day. Patients should be awakened early in the morning and exposed to bright sunlight which will decrease the sleeping episodes through the day. One by one, all the daily chores should be completed. Also, viewing television at night should be prohibited as it will lead to delay in sleeping time. Once the cycle comes to near normal, patients tend to feel better.
Summary: The increasing dementia causes changes in the brain leading to increased levels of sleep. Thus, Alzheimer’s disease patients tend to sleep more than ordinary people do, which tends to reversal of sleep cycle.
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