Takeaways

Tip 1: Practice Good Sleep Hygiene

• Keep consistent sleep and wake times 
• Watch your caffeine intake 
• Limit evening substances 
• Time your exercise right 
• Manage fluid intake 

Tip 2: Limit Daytime Naps

• If you must nap: Keep it to less than 30 minutes and before 3 p.m.
• Quiet rest is okay: Sue used to sit quietly with her eyes shut for 5-10 minutes with a phone timer—this relaxation time is fine and helpful for decompressing during the day.

For care receivers: As the disease progresses, they may want to sleep more during the day. Sometimes after diagnosis, they stop doing activities and tend to sit around and sleep. Here’s what helps:

• Keep them engaged
• Let them help
• Use familiar activities

Tip 3: Make Your Bedroom Like a Cave

• Cool
• Dark
• Quiet

Tip 4: Schedule Worry Time Earlier in the Day

• Schedule dedicated worry time 
• Deal with it before bed 
• If worries arise at night 
• For quick notes 
• For major concerns 

Tip 5: Keep Your Bedroom for the Three S’s

Make the bedroom the bedroom. Keep your bedroom for the three S’s: Sleep, sickness and sex.

• No phone scrolling 
• Remove the television 
• No work or reading 
• Train your brain 

About the SLEEP-MATE Study

Dr. Brewster’s study is recruiting pairs. The person who is receiving the care doesn’t have to be diagnosed with dementia, just have a complaint or an experience of cognitive changes. Caregivers or care partners—different people want to be called different things based on where in the dementia journey they are—both people participating, both having some type of sleep disturbance or sleep problems.

That could be difficulty falling asleep, difficulty staying asleep (meaning that you fall asleep and then you wake up, and when you wake up, you have a hard time falling back asleep), or significant daytime sleepiness or some other type of impairment during the day. It’s for people who are living within the contiguous US. Each of you gets an honorarium for participating as a thank you for your time and investment in participating in the study.

If you have any questions or want to find out more about the study, please reach out at 404-712-9164 or you can check out their lab’s website at www.mindatrest.org.

Read More in This Blog here

Full Episode Transcript

Sue 

Do you wish you could get, do you wish you could get a good night’s sleep? Yes I do. In this episode, Nancy and I are talking with the amazing Dr. Glenna Brewster, who is with Emory University’s School of Nursing. We’re talking with her today about her sleep study and creating good sleep habits, which we can all use. And we’re sharing five tips.

Nancy

So welcome. 

Glenna

Thank you for having me. 

Nancy

We appreciate it. Let me introduce Glenna to you because you’re going to be very impressed. And then I can’t wait for you to hear all about these good sleep habits. Sue and I’ve already learned a lot just having a discussion with Dr. Brewster. So we’re really looking forward to sharing these with you. 

Dr. Glenda Brewster is a nurse scientist, family nurse practitioner, and assistant professor at Emory University School of Nursing. That’s a lot. I feel very under-educated. She leads the Mind at Rest research team, which develops and tests practical, evidence-based programs to reduce sleep problems and improve health outcomes for people living with memory loss or dementia and their caregivers. So listen up people, this isn’t just about your care receiver, this is about you too. Dr. Brewster’s work is recognized nationally and internationally for advancing dementia care and supporting family caregivers through community partnerships and research. So thank you very much for joining us today. 

Glenna

Thank you very much for having me. 

Nancy

Please tell us more about your study. 

Glenna

Thank you. Sleep problems, especially if you’re a caregiver or person living with cognitive impairment, you would recognize that they’re significant and you would have a hard time falling asleep. You might wake up multiple times during the night or you might notice that as the disease progresses that there is daytime sleepiness. So sleep disturbances are prevalent both in care partners or caregivers and people living with cognitive impairment.

And that is what I wanted to understand and address. As a result, I have developed the SLEEP-MATE study. That is a study for both caregivers and people living with cognitive impairment across a trajectory to dementia where we are wanting to see whether or not this intervention, it’s a six week virtual intervention and you participate together. And I want to see if it is feasible? Is it acceptable? And does it improve your sleep outcomes?

And when you participate, we are asking you to wear a watch because we want to see how it is, you know, objectively that you’re sleeping. We also want you to record it because we know sometimes how we feel and what we see might not be the same thing. So we want to look at it objectively and subjectively. We’re also asking you over a few months to fill out some questionnaires to determine, you know, does the intervention help with.

How do you feel psychologically? Does it help with your quality of life, both for you and the person living with cognitive impairment or dementia? So what I want to tell you is there’s more to find out, so stick around. And as we get to the end of the program, you can find out how you qualify for this step. That’s wonderful. Well, that’s really, really helpful. And I know that from my experience and Nancy, both talked about it.

Sue 

Glenna, this topic is so valuable and Nancy and I have both learned the need for quality sleep and what not having it is like. And while we’ve also learned that we’re so focused on quality sleep for our care receiver, that we don’t necessarily prioritize our own sleep and as caregivers.  Our quality of sleep is every bit as important and actually, you sometimes even more important than theirs. So what you’re doing is really, really helpful. And that leads us to the first tip, which is really pretty straightforward: how do you practice good sleep hygiene? 

Glenna

What does that mean? Sleep hygiene means developing daily habits that would facilitate and lead to getting good sleep and good sleep has to do with when you fall asleep, you’re able to not necessarily sleep all the way through the night, but at least get some consolidated and that means getting a few hours of sleep where you can sleep straight. Or if you wake up during the night, you’re able to go back to bed and fall back asleep.

I don’t necessarily say good sleep has to do with when you wake up in the morning and you feel refreshed because you can get good sleep but not necessarily feel refreshed when you wake up based on the stage of sleep that you’re in when you wake up. So we say when you’re practicing good sleep, one of the first things I say is do your best to go to sleep around the same time. So within about 15 minutes before or after. So for example, if you’re targeting 9 p.m. to go to sleep,

try to get to sleep by 9 but within the 8.45 to 9.15 window and then get up at the same time each day. Most of us may have a hard time getting up at the same time each day so set an alarm if you’re going to have a difficulty waking up at the same time. 

Nancy

And you the weekends too? 

Glenna

And I mean the weekends too, yes. It might be a little difficult. I know we want to sleep in but what we want to do is get our bodies into the pattern of waking up at the same time each day. And you’ll find eventually that you might not even necessarily need an alarm because your body gets used to doing that and then you just wake up at that same time each day without needing the alarm. And so what you’re saying is it’s, well we want to get to bed at about the same time, it’s more important that we wake up at the exact same time every day. Yes. Okay. So prioritize waking up at the same time each day.

The next thing is we many of us like to drink coffee, but caffeine can actually impact our sleep and you know how you respond to coffee and your loved one or the care recipient so based on what that response looks like then we recommend if Caffeine keeps you up then having your last cup of coffee or having your last caffeine drink before noon. Be aware though that coffee is in many things. So caffeine can be in medication, caffeine is in chocolates. So be aware of that whenever you’re eating anything and considering whether or not it contains caffeine. Also trying to limit alcohol and having large meals or if you do smoke, nicotine or anything like that, that might impact your sleep, to within two hours of bedtime. So if you’re planning to go to bed by nine, would say the last time you should have your drink or the last time you should have a large meal would be like seven o’clock, maybe the latest. Exercise too is something we encourage you to exercise, but when we’re exercising too close to bedtime, actually makes it a bit harder for us to fall asleep. So if you want to do something, we encourage you to do something like gentle stretches. And then finally, we all like to drink water, I’m sure. So whenever you’re drinking any types of fluids, also limiting the amount of fluid you have within tours of bedtime. We try to not have a lot of liquids within two hours of bedtime because we know for sure that when we do have those liquids, then it’s going to wake us up to go to use the restroom. And we want to minimize getting up during the night to use the restroom. we say limiting liquids. And if you do feel thirsty, then you can have a sip. Just don’t have eight ounces of water right before bed. 

Nancy

Sue and I talked about this for the care receivers in episode number 33 when we talk about overnight incontinence and really making sure that you limit fluids late in the day, but also don’t forget to make sure they’re getting enough fluids. So hydration is critical or else you’ll end up with UTIs and other things. You need to push through fluids earlier so that you can limit fluids later, but it helps everybody. So tip two is to limit daytime naps. I’m all about that. I limit daytime naps because I found if I take the slightest bit of nap, then I can’t go to sleep at night. 

Glenna

That happens. So we think about naps like snacks. Imagine if you’re having a snack and it’s close to dinner time. When dinner time gets around, you’re not hungry, so you don’t want to eat your dinner. So if you see napping like snacks, then when we’re ready to go to bed, then we’re not sleepy.

I do recognize though that many people like their naps during the day. So one of the things we say is if you must nap, try to keep it to less than 30 minutes before 3 p.m. 

Sue

Okay. Good. I have a quick question. One of the things I used to do is I would just go sit quietly with my eyes shut and I would literally have my phone timer on for either five minutes or 10 minutes. I wasn’t intending to go to sleep, but it was just to kind of decompress. Is that okay?

Glenna

Yes, that is okay. I see that like relaxation. So one of the things we also do in the intervention is we give you a short relaxation to do within about 10 minutes or so. So I see things like that where you take 10 minutes during the day and you just have that time to get back into yourself and that’s just a pleasant activity, a time to just relax and decompress for a few moments during the day. 

Another thing to think about is if the person who is living with cognitive changes or memory loss, as the disease progresses, we see them sometimes wanting to sleep more during the day, or sometimes even after the person gets the diagnosis, then all of a sudden they’re not doing anything anymore. And guess what? When we are not occupied doing things, what do we do? We tend to sit around and sleep. Meaning throughout the day, the person who’s living with cognitive changes or memory loss or dementia would be sleeping and napping a lot. And I say to many of the caregivers I interact with to work with them to find things that they enjoy doing. The diagnosis doesn’t mean that all of a sudden they’re no longer able to do anything. So is there something that they enjoy? Is there something that they did before that they could continue to do? And let them do it. 

So for example, my grandmother lived with vascular dementia for a few years and when she was living with us, she always loved taking care of us when I was growing up. an only child, I’m her only grandchild so you can imagine. But she liked taking care of us and taking care of the house. So when she lived with us, she would always take the broom and go and sweep and I would say that’s fine. It’s something that’s keeping her occupied and she was in a safe environment. So as long as there is something that you can identify that the person enjoyed doing before, that they can continue to do in a safe environment, they can help prepare meals, they can help do the dishes, they can sort the laundry, they can fold. It might not be how you would want it. It doesn’t have to be perfect, but it keeps them engaged. Keeps them engaged. 

Sue

Now there does come a time though when it is time to go to bed and you’ve got some really good guidelines about, okay, we’re serious about this now. Let’s be intentional when it is time to actually go to bed and sleep for the night. So tip three is make your bedroom like a cave. 

Glenna,

And yes, imagine with me what a cave feels like. So it is cool, dark, and quiet.

Cool is different for each person, so it’s relative. it is. My cool might be 65 degrees, but yours might be 70 or 75. So therefore, working with the care receiver to figure out which temperature is ideal, making sure that it’s cool, and then setting it there because our body likes cool when we’re falling asleep. Darkness and dark means you’re turning off the lights. I do recognize and one of the caveats I always say is especially for the person or yourself as the caregiver when you’re getting up to use the restroom at night you need light so perhaps having a small plug-in in one of the lower outlets would help. So when you get up, the light can come on and show you the way to the bathroom. But apart from that, if you can have the room darkening curtains, those will help to keep it dark. But sometimes we are at places where we don’t have blackout curtains, so take an eye mask with you that you can put over your eyes that would help with keeping the room dark. And the other thing is quiet. Quiet can be, you know, there is no sound, but then some people do like sound. So if you do like sound, I would recommend using white noise or brown noise or pink noise, having the fan, something with consistent noise, not something that’s going to change in frequency. So you don’t want something that’s going to change in frequency and variation with the noise. We’ll talk more about that later. 

Nancy

My favorite thing about quiet, if I think about it all the way through, is that quiet isn’t just the noise around you, but quiet is quieting your mind.

And tip four is something I never ever thought of before and I love it, which is to schedule worry time earlier in the day.

Glenna

Whether or not you’re a caregiver, you worry because life is happening and when life happens, we all have experiences that we’re going to think about and process. So it might be something that happened today that I need to process or that I have things that are happening tomorrow that I need to plan out. And the best time that we do that or we think about that when the day is done and we go and we lay down in our bed, it’s the ideal moment for all these things to come back and flood our minds. 

Sue

You’re like, hey, we’ve got a place to come. Come on, here we go. We’re good. They’re quiet. We can come in. We can come in now. You have time for me. Like, Here I come. 

Glenna

So we don’t want that to happen. So we are suggesting that you schedule time to process and think about all you have to do tomorrow before you get into bed. So about 15 to 30 minutes, you don’t need a lot of time to just think about that before you go to bed. And after you’ve done that, guess what? When you go to bed, you don’t have those coming again because you’ve already dealt with it. Now, if you do wake up during the night and there’s something on your mind, and you’re thinking about it and processing solutions, then wake up and get out of the bed and go somewhere else and do it.

Because we don’t want your mind to associate being in bed with doing all these other things. If it’s a small minor thing that you just need to write down and then turn over and go back to bed, then it might be okay to have a small notebook close to your bedside that you can jot it down and go back to bed. But if you’re going to be awake and thinking about it, be awake outside of the bed. 

Sue

That’s a huge distinction because I know that I would wake up and stay in bed and be thinking through things sometimes for hours, working through things or working on the computer. So that’s really a valuable tip. Which is the whole point, right? Of tip five, which is actually only do the things in the bedroom that need to be done in the bedroom, right? Make the bedroom the bedroom.

Glenna

Make the bedroom the bedroom. So keep your bedroom for the three S’s. Sleep, sickness and sex. Avoid scrolling on the phone, especially these days. We do that a lot. We get in bed and we say, we’re not ready to sleep yet. So let me get my phone and see what’s going on on Instagram, Facebook, Tik Tok. There’s so many things to keep us awake these days. The television, many of us have a TV in our bedrooms and we might have a hard time giving it up. But I tell people who participate in my studies, just try it for a week and see how it goes. And then after that, you can reevaluate. Avoid working, reading. So anything that’s not those three S’s, avoid doing them in the bed. And the goal is to connect your brain with going to bed, going to sleep. You want, when you get into bed, to be the cue for me to go to sleep and not a cue for me to do all these other things which are not sleep. 

Sue

That was huge for me because I was not aware of that being a thing. I mean when you’re talking about the time that you get up and have your body associate, what you’ve learned is that your body actually does associate. I’m going to bed, I’m going to sleep, and you teach that to it. You mentioned that there was someone in your study who at first was like, yeah, right, I’m not doing that. And then you encouraged them to do it for a week, which they did. And what was the outcome? 

Glenna

I think if it’s the only thing that they remember, it is that. And I have asked them to talk to other participants. And that’s one of the first things they mentioned. The fact that they initially didn’t want to give up the television and they did. And how much that actually improved their sleep in the end. 

Nancy

That’s awesome. Well, you mentioned this to us and I thought this was interesting, I hadn’t really thought about that, you go through sleep cycles, right? And some are lighter sleep. And when you’re in a lighter sleep cycle, the television is actually interrupting your sleep. 

Sue

Glenna, thank you so much. I’ve learned a lot from this. Nancy, I think you have as well. Things we just weren’t aware of that can be very, very helpful and you’re actually doing a study about this. So you kind of did the teaser about that very beginning. Please share with us more information about the study.

Glenna

I will be happy to. So hopefully you have learned a few tips that you can use to incorporate in both your and the care receivers sleep routine as you move forward. And this study, as a reminder, we’re recruiting pairs. The person who is receiving the care, the care receiver doesn’t have to be diagnosed with dementia, just have a complaint or an experience of cognitive changes. And caregivers or care partners, different people want to be called different things based on where in the dementia journey they are on. So both people participating, both having some type of sleep disturbance or sleep problems. That could be difficulty falling asleep, difficulty staying asleep, meaning that you fall asleep and then you wake up. And when you wake up, you have a hard time falling back asleep or significant daytime sleepiness or some other type of impairment during the day. It’s for people who are living within the contiguous US. Each of you gets an honorarium for participating as a thank you for your time and investment in participating in the study. And if you have any questions or want to find out more about the study, then please reach out to us or telephone number is 404-712-9164 or you can check out our labs website it’s www.mindatrest.org. 

Sue

And we’ll put all these links in the show notes as well so that if you didn’t get a chance to write those down. So it’ll be easy to find. Well, we really do appreciate it. I want to thank you very much as well and tell you how much we enjoyed and hopefully I’ll execute on some of these things myself. 

Nancy

Thank you very much. 

So let’s summarize. Today we talked with Dr. Glenna Brewster about her sleep study, as well as got some great tips on how to get better sleep, both for us, as well as for our care receivers.

We talked about five tips. First, practice good sleep hygiene. Second, limit daytime naps. Third, I love this one, make your bedroom like a cave. Fourth, and I love this one too, actually. I don’t know which one I love the most. Schedule worry time earlier in the day. I wish I’d known that years ago. so do I. And the fifth one is to keep the bedroom for the three S’s. 

If you have tips that will help people sleep, either as caregivers or for their care receivers, please put those tips on our Facebook page, our Instagram page. The links are in the show notes.

As with all our podcasts, pay attention to the podcast number and go to thecaregiversjourney.org and you can find the blog with the same number and effectively we’ve taken notes for you. That’s what the blog is. If you like this podcast, please share it with other people that you think it might help. Please follow us or subscribe to it. We really, really appreciate it. 

And as we always say:

We’re all on this journey together.