Sleep Disturbances and the Day After

Living with someone who has Alzheimer’s means, I sometimes don’t get a full night of sleep. My father-in-law, or Otosan as I call him, is usually a good sleeper. Most of our problems at night center around who is in the bathroom and who is waiting to get in.

Unfortunately, a few nights ago, Otosan had another nightmare. Or maybe it was a hallucination. Or, maybe it was a nightmare that transitioned into a hallucination as he awoke. It doesn’t matter. He was scared. Hearing him holler, I’m sure the neighbors on the floors above and below us were scared, too!

Otosan had gone to bed as usual around 9 PM, and I followed shortly after. Akira was still up watching TV in the living room. Around midnight, I awoke from a deep sleep, and at first, I wasn’t sure why I was awake. I normally get up at least once around 2 AM to pee. I didn’t have the urge to go, so why was I suddenly awake?

Then I heard a hooting sound. Ah, that’s why I was awake.

Otosan was yelling, “Oh! Oh! Oh!” in a high-pitched voice in the same rhythmic way he grunts throughout the day. His rhythmic grunting during the day is non-stop and in a lower-pitched voice, more like his speaking voice. This hooting was different.

I headed down the hall and asked Akira to join me before checking on his father. I usually handle most of Otosan’s needs alone. It’s easier. He trusts me, and there is no need for the posturing that happens between father and son. But, in the middle of the night, with a hooting man on the other side of the door, I wasn’t sure what we’d find. I wanted Akira to be there just in case. Otosan has never displayed violence. I am taller than him and outweigh him by about 10 pounds, but all the years of working the fields and forest have not taken away the 90-year-old’s fierce strength.

Otosan didn’t stop hooting when we opened the door. He was lying on his bed and waving his hands at the ceiling. We called his name and quickly turned on the light. He recognized us but was still caught in the dream or hallucination.

He said a rat was running across the ceiling. I tried to ask where the rat went. At first, he misunderstood and thought I was trying to deny there was a rat. He insisted several times that the rat was real and that he wasn’t lying. I assured him and asked again where the rat went, and if he could still see it? I was trying to determine whether or not Otosan still saw the rat. After a few moments, he was awake enough to realize that the rat was gone. He got up to go to the bathroom, and Akira and I headed down the hall to our bedroom.

I knew there never was a rat. I’ve never seen any signs of one in our building nor heard the other residents complain. It never occurred to me to worry about it mainly because Otosan has Alzheimer’s, and this was not his first nightmare or hallucination.

After the last nightmare, Otosan said he saw a childhood friend dying right in front of him, and he couldn’t stop it or do anything to help. That time, it took a while to remind him that his friend passed away only a few years ago as an older man. Another time, he saw some monster outside the window.

Fortunately, this time, Otosan settled down right away and went back to sleep. I know this because it was quiet in his room. If he were awake, we would have heard him grunting.

Akira went back to the living room to finish watching his show. I tried to go back to sleep, but my heart was still beating too fast. I tossed and turned. Eventually, Akira came to bed and had no trouble drifting off to sleep.

Finally, I gave up. I headed for the living room and stretched out on the couch. It was warm and quiet. I read my book, drank some mint tea, ate some hot rice, listened to a meditation, but never went back to sleep.

I used to worry about this. What if I’m tired in the morning? What if I can’t do my work? What if I’m grumpy? What if I get sick? Oh no, oh no, oh no! If I don’t get enough sleep, I won’t have yoyu!

Yoyu is a Japanese word used to express one’s capacity to deal with or handle a situation. When you have yoyu, it means you have enough of whatever you need to be in control and at peace with the situation. When you don’t have yoyu, it might be because you don’t have enough time, energy, money, bandwidth, experience, or even peace of mind.

Yes, it’s true. Just like most people, if I don’t get enough sleep, I don’t have yoyu. When I’m tired, I have less energy, less patience, less equilibrium.

And you know what, it’s ok. I don’t need to stress about it. I don’t need to feel resentful that my husband is asleep, and I’m not. Nor do I need to feel angry with myself for not being able to go back to sleep. I’ve tried all of those before, and they only make me feel worse.

What I’ve learned instead is to enjoy my middle-of-the-night quiet time. I always keep mint tea on hand because it tastes good, and sometimes it relaxes me enough to go back to sleep. I always keep a good fantasy or sci-fi book on hand because the story helps me escape, and sometimes that quiets my mind enough to help me fall back asleep. I keep my smartphone nearby (on airplane mode, of course!) with several meditations downloaded because they help me relax, shift the focus of my thoughts, and yes, I sometimes even fall back asleep. If I fall back asleep, great, but it’s not my goal because I’ve learned that fixating on whether or not I’ll fall back asleep never works.

And, I’ve learned that I can adjust my schedule a bit during the day after, too. If I don’t sleep well during the night, I might catch a mid-morning nap. Or, I’ll go to bed extra early. I might give myself a little extra time to do things because when I’m tired, my mind isn’t as sharp. If I can, I postpone calls or even cancel them. I do what I have to do but, the point is, I don’t push myself.

Finally, I’ve learned to ask for help. If I’ve had a rough night, I let my husband know. If I have to take a nap during the day and it makes me end up working late, he’s already aware and can help. For example, I’m usually the one to make dinner. When he knows I’m running short on time or energy, he jumps in and offers to cook and or picks up something on the way home to round out our meal. Letting him know when I’m not ok is so much easier than pretending I am ok and scrambling to do it all myself. Trying to do it all myself, when I’m not at my best, opens the door for resentment to sneak in.

I know sleep disturbances are common for people with Alzheimer’s. I can’t stop Otosan from having nightmares, but I can be there to help him wake up. And, if he goes back to sleep and I don’t, it’s ok because I know I can:

• relax and enjoy my middle-of-the-night quiet time instead of stressing over it,
• adjust my day as needed instead of pushing through, and
• let my family know I’m running low energy-wise and invite their help instead of pretending I’m ok.

How about you? Have you found something that helps you go back to sleep? Or, how about those nights when sleep evades you? How do you maintain your yoyu when you haven’t had a full night of sleep? I would love to hear!