As Canadians prepare to set their clocks back, the impact of daylight saving time goes beyond the inconvenience of resetting watches and clocks. For people living with Alzheimer’s and dementia, the subtle but significant time shift can create disruptions in their daily routines, causing confusion and potentially worsening symptoms.
Sleep disturbances are common among people with Alzheimer’s or other types of dementia, including changes in sleep schedule, insomnia and wandering throughout the night, according to experts.
“Sleep disturbances can cause problems with cognitive function and memory consolidation,” explained Melanie Martin, a professor of physics at the University of Winnipeg. “With people who have Alzheimer’s and dementia… even that hour can cause sleep disturbances, which will keep them up at night and make them not follow their routine.”
This, in turn, could exacerbate symptoms of Alzheimer’s, such as memory or cognitive decline, she said.
Daylight saving time ends for most Canadians on Sunday, Nov. 5. This is when clocks fall back one hour. However, the Yukon, most of Saskatchewan and some parts of British Columbia and Quebec stay on standard time.
The idea behind the clock shift is to maximize sunlight in the Northern Hemisphere, as days start to lengthen in the spring and then wane in the fall.
But the benefits of this change are controversial, and the shift can have measurable impacts on health. Some studies have even found that the risk of strokes and heart attacks may increase by seven per cent following the time change.
'Disruptive to a person with dementia'
Even without the impact of daylight saving, Alzheimer’s patients already experience disturbances in their circadian rhythms, meaning they have problems synchronizing with the light, said Andrée-Ann Bari, an assistant research professor in the department of medicine at the Université de Montréal.
“They tend to sleep a bit differently during the day. They tend to have really fragmented sleep, lighter sleep, and have problems with their satisfaction of sleep, depending on the advancement of the disease,” she told Global News.
Sleep disturbance may affect up to 25 per cent of people with mild to moderate dementia and 50 per cent of people with severe dementia, according to the Mayo Clinic.
“So any kind of further challenge to that is going to be problematic,” Bari said. “It’s highly possible that people with Alzheimer’s disease are going to struggle more than most of us when there’s daylight savings time.”
The time change that happens twice a year is “most likely” not great for their routine and their symptoms, she added.
One of the symptoms that can become more pronounced is a condition commonly referred to as “sundowning,” according to the Alzheimer’s Association. The organization said this is when a patient’s cognitive and behavioural symptoms worsen in the late afternoon or early evening. It may include difficulty sleeping, anxiety, agitation, hallucinations, pacing and disorientation.
“Sundowning is where they can have aggressive behaviour at night, and be more tired and sleepy,” Bari said.
“So all of these symptoms seem to be worsened by variation from day-to-day sleep patterns” she continued. “This is hard for caregivers, to be confronted with those symptoms. And these could be worsened by unstable sleep patterns.”
Although one hour of change may not seem like a lot, “it is really disruptive to a person with dementia,” said Dr. Samir Sinha, director of geriatrics at Sinai Health and the University Health Network in Toronto.
Many people living with the disease rely on signals from the sunlight to tell them it’s daytime and to be alert and oriented, he said.
“But when we change the clocks and it gets darker a little bit earlier in the day, that can actually trigger… sundowning,” he said, adding many people with dementia may get confused when it gets darker outside.
How to prepare someone with dementia for daylight saving
For caregivers assisting those living with Alzheimer’s through the challenges of daylight saving time, one key suggestion is to ensure early exposure to natural light, Bari said.
This might involve taking an early morning walk or opening all the blinds in the house, she continued, adding that it is also a good idea to minimize exposure to light during the evening hours.
“This could help almost everyone to synchronize themself a bit more with the new time.”
And if going for a walk isn’t possible, there is also the option of light therapy.
A 2022 study published in Clinical Intervention in Aging found that light therapy (exposure to artificial daylight) can improve nighttime sleep efficiency, reduce nocturnal wandering and alleviate evening agitation associated with Alzheimer’s disease.
Another effective way to prepare for daylight saving time is to gradually adjust the bedtime routine a few minutes at a time before the clock change occurs, Bari said.
“We have about a week now before this is happening, so change it a bit earlier this week so it’s less abrupt.”
Sinha advised caregivers to maintain a consistent routines during this period to facilitate a smoother transition.
“Otherwise, that internal clock gets really disregulated,” he said. “It can be really disruptive to their behaviours and the way they interact with the world.”
— With files from Global News’ Michelle Butterfield