How to Manage Sleep Disturbances in Those with Alzheimer’s Disease

October 20, 2021

Not only do those with Alzheimer’s experience several disorienting symptoms that impact their daily functions—such as memory loss, difficulty with planning or solving problems, confusion with time or place, and problems with speaking or writing—but they also have a hard time sleeping well at night. In fact, according to the Alzheimer’s Association, “in late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping.”

When those with Alzheimer’s disease have a hard time getting the sleep they need, this can further disrupt their quality of life and may even worsen the symptoms associated with dementia. For example, many of those who are unable to sleep at night spend much of their days feeling drowsy, restless, and agitated—an experience referred to as “sundowning.” This experience is not only potentially unsafe if the individual begins night wandering, but it can also contribute to problems with sleep and lead to increased confusion, anxiety, agitation, and disorientation.

Do you want to know more about sleep disturbances associated with Alzheimer’s disease, such as obstructive sleep apnea (OSA) and insomnia, and how you might be able to help a loved one? Keep reading for information about why those with the disease struggle with sleep, the sleep disorders most commonly associated with it, and how to encourage better sleep.

Why Those with Alzheimer’s Struggle with Sleep

Up to 70 percent of people with cognitive impairment or dementia have a hard time sleeping at night. This is because changes in the brain associated with these chronic diseases can affect one’s circadian rhythm, which is in charge of regulating our sleep-wake cycle. There are many factors that may contribute to poor sleep in dementia, including the following:

  • Chronic pain
  • Side effects of medication
  • Physical or mental exhaustion at the end of the day
  • Less exposure to sunlight
  • A noisy or bright environment for sleeping
  • Underlying health concerns
  • A need for less sleep, which is common in older adults

Sleep disturbances tend to worsen over time as dementia becomes more severe, which means they can also take a toll on caretakers and other loved ones as they try to help. This is especially true in situations where dementia makes it more difficult for someone to communicate how they are feeling. Whether you, your loved one, or your patient struggles with getting enough sleep every night, don’t hesitate to reach out for help. Everyone deserves to be well-rested as they take on each day!

Common Sleep Disturbances Related to Dementia

There are a few sleep disturbances that those with Alzheimer’s experience more often than others. On top of sundown syndrome, many people with dementia also experience the following:

  • Difficulty staying or falling asleep: This may be caused by insomnia, medication, problems with their sleep-wake cycle, or other factors.
  • Restless leg syndrome: This syndrome is characterized by an urge to move the legs during rest periods. Those with Alzheimer’s may also experience other problems with movement, such as REM sleep behavior disorder.
  • Breathing disorders: Sleep apnea, including OSA and central, for example, affects 50 percent of people with Alzheimer’s disease.
  • Mood disorders: Mental health concerns like depression and anxiety are known contributors to sleep problems. Many of the symptoms of depression—like lack of social support, feeling upset, and an inactive lifestyle—can make sleeping more difficult.

Insomnia is amongst one of the most common sleep disorders in the population of those with Alzheimer’s disease. This sleep disorder is characterized by having difficulty falling and staying asleep, waking up too early, or getting poor quality sleep.

How to Encourage Better Sleep

While it may seem like the situation is hopeless, there are a few steps you can take that may help those with Alzheimer’s get better sleep. Getting that deeper and longer sleep may be the key to improving their physical health, overall happiness, and well-being. Here are a few steps to consider taking that improve sleep hygiene and may help you and your loved one achieve better rest:

  • Screen for other medical conditions: Because sleep apnea and restless leg syndrome are so common in older age groups, it’s worth identifying whether your loved one has either of these sleep disorders. Treating them can resolve the biggest reason why they are having a hard time sleeping. Consider discussing these concerns with your primary care provider (PCP) or a dentist specializing in sleep and airway.
  • Create comfortable sleeping conditions: If a room is too bright, loud, or hot, it can make it more difficult to fall asleep. Using blackout curtains, a comfortable bed, and motion sensor lights can help facilitate a better sleep environment.
  • Establish a routine: Waking up and going to bed at the same time every day can help establish sleeping patterns. Similarly, establishing a morning and nighttime routine can signal what time of day it is. Consider playing music, giving them a hot drink in the evenings, or bathing them at the same time every day.
  • Look into medications: Some medications that are prescribed for dementia may disrupt sleep. A chat with a doctor about the best time of day to take them may help counteract any disruption.
  • Promote activity throughout the day: Exposure to sunlight can help regulate the body’s clock, and exercise and getting outside both facilitate good physical health.
  • Pay attention to diet: Foods and drinks with caffeine can disrupt sleep. For example, tea and coffee should be avoided from late afternoon onwards, and even chocolate could have enough caffeine to keep someone awake. Similarly, alcohol should be avoided for at least three hours before bedtime for better quality sleep.

Should your loved one wake up in the middle of the night, the most important thing you can do is comfort them. Sit and talk with them for a while, promote relaxation with soft light and music, and repeat actions until they are ready to return to bed.

If you have implemented a solid nighttime routine with excellent sleep hygiene and still find that your loved one is having a hard time sleeping, reach out to a doctor. They can help identify any underlying conditions that may need to be addressed and provide more advice to promote better sleep.