A good night’s sleep is one of the most basic things we need for our own health and well-being as caregivers—but it’s often the most elusive. Below are some tools and tips specifically to help caregivers sleep better.
If your sleep is routinely disrupted by the person you are caring for, by stress and worry, or by a condition such as obstructive sleep apnea or insomnia, it’s important to take the time to get help. Unfortunately, sleeping poorly increases your risk for all kinds of health problems, including high blood pressure, heart disease, diabetes, obesity, stroke, and dementia. I know several caregivers who have been hospitalized recently with serious conditions, and I suspect that sleep deprivation played a role in their falling ill. If you feel exhausted, please make your own sleep a priority and seek help.
14 tips to get the sleep you need as a caregiver:
1. Connect with others who understand the stresses of caregiving
If you feel alone as a caregiver (and we all do sometimes), you may sleep more soundly if you find more people you can talk to who understand what you’re going through. On this blog I often recommend that people call their county Offices for the Aging for free caregiver counseling or to find a caregiver support group, invaluable ways to get ideas and reassurance when you are feeling frustrated and worried. If you cannot meet with other caregivers in person, you can chat with caregivers online (on Facebook groups for caregivers, or in caregiver chat groups on websites such as the Caregiver Action Network). If you can afford the fee ($50-$100 an hour), I recommend finding a geriatric care manager to guide you through the stressful decisions you will make as a caregiver. Also try calling counselors at local associations that deal with your loved one’s particular diagnosis (for example, your local Alzheimer’s Association).
2. Ask your Office for the Aging about respite services
3. Try to prevent wandering at night
If your loved one is living with Alzheimer’s disease or another form of dementia, and you cannot sleep soundly at night because you worry that they will wander out the door and get lost, visit this Alzheimer’s Association web page for ideas about how to make your home more secure, and how to use available services and devices to help locate your loved one if they do manage to leave your home by themselves. If your loved one wanders from room to room at night and needs supervision for their own safety, consider hiring a home care aide so you can sleep. (More info about home care agencies here.)
4. Get checked for possible sleep disorders
Sleep disorders are surprisingly common, and often go undiagnosed. For example, if you snore, frequently wake up with a headache, or feel exhausted all day despite being in bed for 8 hours or more, you may have obstructive sleep apnea, where you stop breathing many times an hour. Don’t assume that your exhaustion is simply a matter of being over-stretched as a caregiver. In my case, I always felt tired despite a reasonable number of hours in bed, and was diagnosed with severe sleep apnea at age 46. My evaluation at a sleep clinic showed that I would stop breathing up to 20 times an hour. By using a CPAP machine I now stop breathing only 5 times an hour or less, which is normal. I suspect that my mother, who developed symptoms of cognitive impairment in her mid 60s, had undiagnosed sleep apnea.
If you have insomnia, or suspect another type of sleep disorder, talk to your doctor. She may recommend medication or a referral to a sleep clinic. Sleep clinic evaluations require an overnight stay, but investing this time in yourself will pay off for years to come.
5. Try to be more active
You already know this, but getting your heart rate up, and maybe some fresh air at the same time, can help you sleep better. Walking briskly is great exercise—even just 5 to 10 minutes a couple times a day. Exercising close to bedtime, however, may keep you awake.
6. Try this simple relaxation technique
You don’t have to commit to a daily meditation routine to benefit from relaxation techniques. Sit for a few minutes, close your eyes, and focus your mind on your breathing—in, out, in, out, at a normal rate, not necessarily “deep” breathing—and on your chest rising and falling. Thoughts and worries will inevitably intrude, but simply say to yourself “Boy, I’m thinking a lot about such and such” and return to concentrating on your breathing.
7. Avoid caffeine late in the day
We all know that caffeine is incredibly seductive in the afternoon and evening. Try to resist its siren song—not only in coffee, but in tea, chocolate, and soda. If you can, take a short, brisk walk instead.
8. Nap when your loved one naps
Like a new mother, try to lie down and rest whenever your loved one naps. You need your rest more than a loaded dishwasher.
9. Keep a regular bedtime
To regulate your internal clock, try to go to bed and get up at the same time every day.
10. Give yourself time to digest your last meal before bedtime
Eating a meal or a large snack close to bedtime may keep you awake.
11. Reduce “blue light” before bedtime
The blue light in electronic screens (TVs, computers, tablets, smart phones) and energy-efficient lighting can reduce the amount of melatonin your body secretes in the evenings, preventing you from feeling sleepy. Avoid looking at electronic screens two to three hours before bedtime. Also make sure that your bedroom is completely dark (cover any glow from an alarm clock or smoke alarm, for example), and that during the day you expose yourself to plenty of natural light.
12. Try an adult day service center
If your loved one attends an adult day service center for a few hours a day, they may be more ready to sleep at night. Adult day service centers (also called “adult day care”) are open to any adult who needs supervision or assistance because of a physical disability, frailty, or cognitive impairment. Some programs are more oriented toward people with Alzheimer’s disease and other dementias. (Read more about adult day service programs here, and more about a rare nighttime program for people with dementia in this article.) Your local Office for the Aging should be able to connect you with an adult day program, and transportation services.
13. Expand your “circle” of support
In addition to hiring home health care aides to come in and help you, consider asking a friend or family member to take the lead in coordinating more support for you as the primary caregiver. In this article I describe three online tools you, a family member, or friend can use to expand your network of support.
14. Consider an elder care facility
There is no shame in considering a facility for your loved one if you are so exhausted from caregiving that your health is being affected (or for any other reason, for that matter). There are many excellent assisted living facilities, “memory care” facilities for people with dementia, and nursing homes. If your loved one has dementia, consider a “memory care” assisted living facility that will be “secure” to prevent wandering, and that will offer a higher level of care, such as incontinence care and specialized activities, than conventional assisted living. (If you anticipate needing to apply for Medicaid for your loved one, as I did for my mother, seek advice from a good elder care attorney.) Also, if you are lucky, there may be nursing homes in your area that are part of the Eden Alternative registry or Green House Project program, which provide top-notch but affordable person-centered care.
Once your loved one is settled in a facility, your role as caregiver remains just as essential, but in a new way—as their advocate, and their companion. While you speak up for them and coordinate their care, you can also enjoy their company in a different way, free to enjoy just “being” with them rather than “doing” things for them around the clock. And then you can go home and get the rest you need.
How are you doing with sleep? What have you found that has helped you get more rest as a caregiver?