Dementia and Sleep

When a person with dementia has a bad night’s sleep, they are more likely to sleep during the day, in their chair. This increases the likelihood of slouching, sliding, falls, and poorer nutritional and fluid intake¹.

Incorrect seating or inappropriate chairs can significantly affect the health of a resident with dementia. Poor posture, such as slouching and sliding, can constrict the chest cavity and abdomen, leading to serious health issues, including:

• Difficulty in the diaphragm contracting
• Inability to fill lungs on inhalation, potentially causing fluid to pool
• Difficulty taking a breath and causing distress
• Excess energy expenditure on breathing and fatiguing abdominal muscles
• Increased risk of lung infections.
• Obstruction of the oesophagus and heightening the risk of aspiration and choking.
• Obstruction of the gastrointestinal tract, causing constipation, reflux, and pain.
• Constriction of bladder or urinary tracts preventing efficient emptying of urine and increasing the risk of UTIs, bladder or kidney infections.^2,3,4

People with dementia who experience sleep changes are at risk of reduced alertness, fatigue, insomnia, psychosis, and behavioural changes. As if that weren't difficult enough, brainstem loss also impairs the autonomic nervous system, which presents another obstacle for our residents. These impairments to the autonomic nervous system can cause

• Irregular heart rhythm and respiration
• Difficulties with temperature and blood pressure regulation
• Digestive issues, including loss of appetite^4,5,6

Given the connection with dementia and sleep, it's crucial to ensure that people with dementia are seated in chairs which supports optimum posture and facilitated physical functioning. At Seating Matters, our chairs are clinically designed with the needs of the person living with dementia in mind. Our chairs provide pressure relief, postural support and many more benefits. To learn more about our range of seating options designed to support dementia needs, visit our website.

References

1. Webster, L., Powell, K., Costafreda, S.G. and Livingston, G., 2020. The impact of sleep disturbances on care home residents with dementia: the SIESTA qualitative study. International Psychogeriatrics, 32(7), pp.839-847.

2. Osborne, L.J., Gowran, R.J. and Casey, J., (2023) ‘Evidence for 24-hour posture management: A scoping review’, British Journal of Occupational Therapy, 86(3), pp.176-187.

3. Heslop, P., Sinclair Blair, P., Fleming, P.J., and Hoghton, M. (2013) The Confidential Inquiry into Premature Deaths of People with Learning Disabilities, University of Bristol; UK.

4. Katz, S., Arish, N.A., Zaltzman, Y. and Marcus, E. (2018) ‘The effect of body position on pulmonary function: a systematic review’, BMC Pulmonary medicine, 159, https://doi.org/10.1186/s12890...

5. Tobaldini, E., Nobili, L., Strada, S., Casali, K.R., Braghiroli, A. and Montano, N., 2013. Heart rate variability in normal and pathological sleep. Frontiers in physiology, 4, p.294

6. Orr, W.C. and Raad, S., 2021. Autonomic Regulation of Sleep-Related Gastrointestinal Function. Autonomic Nervous System and Sleep: Order and Disorder, pp.333-339.

7. Zoccoli, G. and Amici, R., 2020. Sleep and autonomic nervous system. Current Opinion in Physiology, 15, pp.128-133.