tired womanA 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

If you can get a respite volunteer into your home a few hours a week, you can use that time to take a much-needed nap. (Find your Office for the Aging here.)

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?

6 Comments

  1. Kelly

    Wonderful, helpful post with great information. It really touched a nerve! I was just lying in bed willing my brain to stop spinning with the To Dos and What Ifs and Maybe We Cans to let my poor tired body get some rest.

    I am going to borrow this little corner of cyberspace to pour out my frazzled & fraying heart. It hope it helps some (me and maybe others?).

    I am an at a distance caregiver – my dad had prostate cancer and a stroke 7 years ago, but managed to remain independent on his own (with lots of intermittent help from my sister and me) until this summer, when he started a string of hospitalizations that ultimately landed him in a skilled nursing facility for rehabilitation. While in SNF, he contracted a string of urinary tract infections that terribly inhibited his rehab and regaining his strength. We’ve been on a rollercoaster, and just when I thought we were gaining ground in December (he seemed stronger, UTI free, so much so that we transferred him to a transitional Assisted Living arrangement to facilitate a hopeful transfer across our state to be nearer to my sister and her family) he took another downturn, and landed in the hospital again. He was again deemed too weak to go home or back to AL, so now he is back in a SNF. And he only went 29 days toward the 60-day reset of the 100 day Medicare A window. The facility we want to get him into near my sister won’t take him for AL, and even though they have SNF in the same facility the majority of residents transfer from AL to SNF – you really need to get in when you just need AL. We should have moved him before all the hospitalizations started, but hindsight is 20/20… and since he thought he was doing fine on his own, he would never have consented to us moving him.

    The thing that breaks my heart MOST is when I talk to him on the phone and he says to me, with absolutely no rancor in his voice but just quiet defeat, “Why won’t you let me go home?” We’ve screamed at each other about this a time or two, him furious that I won’t just pick him up and drive him home, me trying to explain the reasons why “the experts” don’t think he’s strong enough or will be safe. The quiet question shatters my heart into a zillion pieces whenever he asks it. However, I realized something very important – somewhere down deep, he must believe that there is the remotest glimmer of hope that one day he WILL go back to the home he loves so much. He has to keep this hope alive to keep the flames of his fighting spirit enkindled. And you know what? I’ve realized that I can totally bear the burden of being the “bad guy” in this regard for him. It breaks my heart whenever he asks me the question, but I can bear it for him so he can maintain his fighting spirit.

    Extreme Stress? Incessant Worry? Sleeplessness? You bet. I have deep faith, but feel in the dark most of the time. The emotional toll not being able to be there for him 24/7 weighs on me heavily, and I find that if I’m not doing something for him (trying to figure out how to apply for VA benefits for aid & attendance, getting documents ready for Medicaid because his meager bank account is vanishing quickly in a poof of smoke!) I am worrying about him. Is he working hard in therapy? Is he giving up? Is he brewing another UTI? How is his blood sugar? Are the CNAs helping him with one-person transfers with assistance, or are they just throwing him in the bed like a sack of potatoes because that’s more efficient? Is his dignity being preserved? Can I get a priest to him quickly enough in the middle of the night if he codes again?

    You might wonder how these burdens on my heart apply to sleep.

    I was diagnosed nearly a year ago with severe obstructive apnea at the age of 45 (my sleep efficiency during my sleep study was about 48 – 50%!!). My body felt like lead most days, and I managed somehow to slog through, but just barely. All the demands of my life plus worrying about how my dad was from afar made things worse. Life with a CPAP is much better. I find that I’m still exhausted, but not to the degree that I can barely lift my fork to eat at the table. I think other issues are at play – like constant strain and worry, trying to be present where God has me and needs me right now with most of my heart hundreds of miles away sitting on my dad’s bedside table. I find that my worries follow me to bed, and try as I might to give them to God and rest my weary head it is hard. But I keep moving forward with great love, lots of hope and the burning desire to affirm my dad, love him intensely and do whatever I can to help him live safely, comfortably and in dignity.

    Taking care of yourself – making sure you eat well, exercise and sleep soundly, not to mention meeting your emotional and spiritual needs – is crucially important…because it enables you to be able to give more to your parent or loved one who needs you. Sadly, it is often advice we easily and readily give to others, though, yet do not take for ourselves. Analyzing why we don’t is a post for another day.

    I’m grateful to be able to put this out there. Being able to put what is tugging on my heart down “on paper” is really helpful – because I know that others who read this understand the pulling and stretching the heart endures when being a caregiver, whether 2 feet away or 2,000 miles.

    God bless you.

  2. Kelly

    I posted a lengthy comment here yesterday, which has unfortunately disappeared {? – I apologize if unburdening my weary heart offended somehow, didn’t intend to} – I thought of something else I’d like to share related to sleep.

    I am also a CPAP user, but I still find that I am exhausted and I have been trying to find ways to improve my quality of sleep so that I can manage all that I have on my shoulders.

    I often find that I am up later than I want to be in the evenings {problem #1, I know} trying to squeeze in work that I couldn’t get done during the day, usually on the computer. The blue light glare from the screen often kept me stimulated to the point that it made it difficult to go to sleep when I finally laid down my weary head.

    I stumbled upon an application for my desktop computer {it may be for handheld devices also} called f.lux – once you download it and lock in your timezone, it regulates the light emission on your monitor so that when the sun sets in your location, the screen dims. I was amazed how tired my eyes got the very first evening I used it. It’s freeware, and it works beautifully. There is even the option of temporarily disabling it if you need to work on something with color in it.

    • Kelly

      Sorry – my browser for some reason wasn’t showing the comment I posted. I refreshed the page – everything is there now! I apologize for my tech inadequacies!

  3. Martha Stettinius

    Hi Kelly. Thank you for sharing this! So many people can empathize with you, definitely. And I apologize for any delay approving the comment and getting it posted; sometimes I put the laptop away in the evening and don’t get back online until the next afternoon. I’m glad you’re feeling a bit better with a CPAP machine. I know that feeling of “lead’ that you talk about. I’m amazed that for so many years I thought that that degree of exhaustion was normal. Anyway, I’m sure people tell you that your dad is lucky to have you looking out for him, and that you need to continue to take care of yourself, but I’ll repeat it here. Being a long-distance caregiver can be more stressful in some ways that being closer. Maybe hook up with a support group at your Office for the Aging, or talk to an individual counselor there. I appreciate your thoughts here and wish you all the best. Thank you.

  4. Nancy Bushman

    Hello my friend! I want to say that this post is amazing, nicely written and included approximately all vital info. I would like to see more posts like this. Thanks!

  5. Kim campbell

    Hi everyone. my name kim I need help finding a adult day care ctr.for my mother and my area89131 that’s affordable and a night care ctr.I need sleep and a break……

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