Routines are Boring...And Healthy

When a new resident moves into one of our assisted living homes, they often don’t have a set routine. They may stay up late one night and sleep late into the next day. Other nights they are up all night snacking. Then maybe napping during the day.

This kind of schedule plays havoc with someone’s circadian rhythm - especially if that person has dementia.

Pretty soon that person may show signs of sundowning syndrome. If you haven’t heard of sundowning, it’s not fun. Especially for caregivers.

People with dementia will often start becoming confused or agitated late in the afternoon or early evening. They will be wired and wide awake just when a caregiver wants them to start winding down to start preparing for bed.

The agitation can last late into the night - which results in both the caregiver and the elderly person becoming exhausted.

A lack of good quality sleep is a risk factor for dementia. So you can imagine that ongoing poor sleep is not helping things once someone has been diagnosed.

Dr Matt Walker, a sleep scientist who wrote the best selling book Why We Sleep, has a formula for a good night’s sleep. And it has a lot to do with establishing a good routine.

It goes by the acronym QQRT.

• Quantity

• Quality

• Regularity

• Timing

Quantity is the most common measurement of sleep. We all have heard you’re supposed to sleep for 7-9 hours each night. Sometimes easier said than done.

Quality is important. You can sleep 9 hours in a night but if you wake up every 15 minutes, it won’t matter how long you sleep.

Regularity refers to going to bed at the same time and waking up at the same time every day. Lots of people don’t sleep much during the week and then try to catch up on the weekends. Or they party Friday and Saturday night, go to bed very late, and then sleep late. Not a good idea long term.

Timing refers to sleeping at the right time according to your circadian rhythm. Just as when you fly to another time zone, you can train your circadian rhythm. Light therapy can really help. Exposure to bright light - especially sunlight - when you wake up can help set your circadian rhythm for the day.

Conversely dimming lights an hour before bed (and staying away from bright screens) can help people fall asleep faster and have a better duration and quality of sleep through the night.

We try to have our residents go outside in the morning when they wake up and dim things down before bedtime. The waking and going to bed times don’t vary too much each day. The result is that our caregivers rarely have issues with sundowning. Many of our residents sleep well through the night, except for the bathroom breaks.

Many of us are not in our late teens and 20’s anymore. The partying days are over. We lament that we’ve settled into a routine.

Don’t think of the routine as a bad thing. Sleep is so important for your overall health. Keeping a regular routine is a good thing.