In the popular imagination, dementia primarily affects memory. But as anyone who’s ever cared for a person with dementia knows, the disease is far more sinister. Dementia is a type of brain failure that ultimately affects every aspect of functioning, from movement to sleep. Moreover, there are dozens of different kinds of dementia–from primary progressive aphasia, which attacks speech first, to the better known Alzheimer’s, which primarily targets short-term memory. Melatonin won’t cure or treat dementia, but it can ease insomnia and sundowning, making life easier for people with dementia and those who love them.
Article at a Glance
Dementia is a chronic and progressive disease with no known cure. Melatonin will not cure dementia. It can only help with some symptoms.
Sundowning means that a person’s dementia symptoms tend to get worse in the evening. Melatonin may ease symptoms of sundowning.
Many people with dementia struggle with insomnia, nightmares, or nighttime restlessness. Melatonin may help.
Dementia and Sleep Problems: Causes
Dementia permanently and progressively changes how the brain works. With most types of dementia, tangles of protein accumulate in the brain, damaging brain function. Over time, these proteins accumulate throughout the brain, damaging many aspects of functioning. As a result, the symptoms of various dementias tend to look more similar over time.
As plaques accumulate in the brain, they can damage various brain functions, as well as the body’s ability to regulate the sleep-wake cycle. This causes symptoms such as insomnia, nighttime restlessness, and changes in mood and behavior when the sun sets.
What Does Melatonin Do for Dementia Patients?
Melatonin can help naturally regulate a person’s sleep cycles when their brain begins to fail.
A number of studies have found that melatonin can ease insomnia and reduce sundowning behaviors. However, a 2006 Cochrane review suggests that, in some people with dementia, melatonin supplements may increase mood issues. So people with depression or severe dementia-related behavior problems should not take melatonin.
Most studies have looked at melatonin at a dosage of 2.5 to 5mg. Many have also assessed the effectiveness of melatonin along with dementia medications, and have not found any serious drug interactions. But if you or a loved one are taking any other drugs, talk to a doctor before trying melatonin.
While there is promising emerging data, the research supporting melatonin’s use in people with advanced or end-stage dementia is mixed. Moreover, most research has looked at people with Alzheimer’s or mild cognitive impairment–not other types of dementia. So researchers don’t know as much about how well melatonin works in atypical dementias like Lewey body dementia or frontotemporal dementia.
Some studies suggest that melatonin might only work in early stages of dementia. For example, a 2021 study found that melatonin levels were only low in people with mild cognitive impairment (MCI). In Alzheimer’s disease they steadily increased. This suggests that melatonin supplements might not work as well as dementia progresses, and may be most effective in people with MCI and the early stages of dementia.
Dementia is an unpredictable disease, and what works well for one family can be catastrophic for another. Keep a log of symptoms and medications so you can track progress over time. And if a person with dementia doesn’t want to take medication, do not force it. Ultimately, there is no cure for dementia, so forcing medication only increases conflict and stress.
Melatonin Safety in People With Dementia
People with dementia may react more strongly to certain drugs than people without dementia. They may also be anxious about taking medication. So start with a low dosage of melatonin–1 to 2 mg, and gradually increase to 2.5 to 5 mg based on the person’s response to the drug.
If the person with dementia takes other drugs, be sure to clear melatonin with their provider first. The more medications a person takes, the more likely they are to experience negative drug interactions and side effects.
Dementia patients respond best to a comprehensive approach. So it’s best to try a supplement like melatonin along with lifestyle changes. Try these strategies:
Establish a daily routine, and ensure the person with dementia spends time in natural sunlight each day.
Avoid taking unnecessary medications, or medications that do not work. Too many medications can increase behavioral and insomnia symptoms.
Remain active during the day, and discourage a person from excessively napping.
Develop a bedtime routine to help a person with dementia calm down before bed.
- Avoid alcohol and caffeine. They can make many dementia symptoms worse, including insomnia.
- Help the person with dementia get more exercise during the day.
If home remedies do not work, talk to a doctor about other alternatives. People with dementia deserve a good night’s sleep, and their ability to sleep may improve the health of their caregivers and loved ones.