The Relationship Between Sleep and Alzheimer’s Disease Andrea C. Gambardella, MAIOP; Grace R. Denault, B.A; Lucille C. Gambardella, PhD, APN-BC,CNE Academy of Sleep and Wellness, Middletown, DE Introduction Scope of the Problem Conclusions Sleep is an essential element for overall good health. Older adults who have poor sleep patterns are more likely to be depressed, have attention and memory problems, experience cognitive difficulties, have a great number of falls, and an overall poorer quality of life. All of this is further complicated if the older adult also has Alzheimer’s Disease. Brain changes in the Alzheimer client disrupts the sleep/wake cycle. Since AD affects an estimated 4.5 million Americans; the sleep concerns of this population and the management by their caregivers is a major community health concern. Circadian rhythms are disrupted in AD AD patients lose ability to stay asleep as the disease progresses Sleep problems increase agitation in the AD population “Sundowning” complicates sleep and care management (20%) Evidence inconclusive on what occurs first: Alzheimer’s Disease or disorders of sleep in AD population International studies indicate that AD clients can be assisted in returning to a more normal sleep pattern New evidence indicates that AD does not destroy the biological clock Community education on sleep and AD can diminish caregiver stress and improve the status of the AD client Build up of plaque causing disruption in suprachiasmatic nucleus Initiation of process Projected effect on Circadian rhythms and maintenance of regular sleep patterns Increases confusion Restless insomnia Sundowner syndrome Daytime sleepiness No biological sense of time Purpose The purpose of this community education initiative is to facilitate addressing these sleep issues as an integral part of the holistic health plan for AD clients. Sleep patterns do change as the disease progresses, so ongoing monitoring of needs and maintenance of meeting comfort and rest requirements is a challenge.. The pieces fit through evidence-based care References: American Academy of Sleep Medicine. Sleep and growing older. Sleep Education News. August 7, 2013. Hoffman, Sandra. Sleep in the older adult: implications for nurses. Geriatric Nursing. 2013:24 (4) Redeker, Nancy, & McEnay, Geoffrey (2015) Sleep disorders and sleep promotion in nursing practice. New York: Springer Publishing Company Roh, JH, et.al. (2012) Discussion of the sleep-wake cycle and diurnal fluctuation of B-amyloid in mice with Alzheimer’s Disease. Science Translational Medicine, September 5, 2012. Vitiello, Michael & Monjan, Andrew ((2017). Alzheimer’s Disease and Sleep. National Sleep Foundation AD clients have difficulty falling asleep AD clients wake up numerous times during the night creating safety problems for them and exhaustion for caregivers AD clients are sleepy during the day resulting in a very poor sleep-wake cycle Goals Community Interventions Contact Information The goals for the community education outreach are to: Raise awareness of the relationship between sleep and Alzheimer’s Disease Provide information related to brain changes that create sleep problems in the Alzheimer’s client Share community resources accessible to caregivers who provide safe, quality treatment options to this AD population Community interventions focus on coping for the client and caregivers: Create an ideal sleep environment Keep as close as possible to a normal sleep/wake schedule Get in bright light soon after waking Utilize light to diminish sundowner effects Encourage exercise to the extent possible Andrea C. Gambardella, MAIOP, VP for Business Development Delaware Sleep Disorder Centers, LLC, Wilmington, DE 19803 302-993-6768 Agambardella@delsleep.com Grace R. Denault, BA, RPSGT, RST; Coordinator of Sleep Education Academy of Sleep and Wellness, Middletown, DE 19709 302-313-5003 gdenault@delsleep.com Lucille C. Gambardella, PhD, APN-BC, Consultant Academy of Sleep and Wellness Lewes, DE 19958. 302-270-7955 gambarlu@Comcast.net