Almost all people with Lewy body dementia (LBD) will have had some kind of sleep disorder before they develop dementia symptoms. And, of course, the sleep issues continue after dementia shows up.

The two most prominent sleep-related problems appear to be at odds with each other: rapid eye movement (REM) sleep behavior disorder (RBD) disturbs sleep and excessive daytime sleeping (EDS) causes too much sleep. However, both are easily within the realm of elements common to LBD: vivid-but-not-real experiences and a general slowing down of all body functions. The literature occasionally mentions insomnia as a symptom, but caregivers seldom do. Usually, interrupted nighttime sleep is caused by the active dreams of RBD or the irritations of restless leg syndrome (RLS), another sleep disorder common with Lewy body dementia.

Maintaining good sleeping habits promotes better sleep for people in general and serves to decrease LBD-related sleep disturbances.

  • Try a fixed routine that includes: A comfortable bedroom and bed; a regular bedtime with a comforting bedtime routine; regular exercise, but not right before bedtime; and little food and no coffee several hours before bedtime.
  • Limit alcohol and especially do not give any at bedtime.
  • Arrange with the physician to give your loved one the largest doses of drugs that may cause drowsiness, such as medications against acting out, just before bedtime and drugs for alertness, such as modafinil (Provigil), in the morning.
  • Review possible stressors, and eliminate as many as possible from your loved one’s routine.
  • Most sleep aids are contraindicated, meaning it is inadvisable to use them because of an underlying condition, in this case, LBD.