Alzheimer's: Managing Sleep Problems

Sleep problems and Alzheimer's disease often go hand in hand. Understand what contributes to sleep problems in Alzheimer's—and what you can do to help.

Common Alzheimer's sleep problems

Many older adults have problems sleeping, but people who have Alzheimer's often have an even harder time. Problems include waking up more often, staying awake longer in the night, and feeling drowsy during the day. People with Alzheimer's might also experience a state of confusion occurring in the late afternoon and spanning into the night (sundowning). Sleep disturbances often increase as Alzheimer's progresses and can promote behavioral problems.

Factors that might contribute to Alzheimer's sleep disturbances include:

  • Mental and physical exhaustion at the end of the day
  • Changes in the body clock, causing people with Alzheimer's to mix up day and night
  • A need for less sleep, which is common among older adults
  • Disorientation
  • Reactions to nonverbal cues of frustration from exhausted caregivers at the end of the day
  • Reduced lighting and increased shadows, which can cause people with Alzheimer's to become confused and afraid

Supporting a good night's sleep

Sleep disturbances can take a toll on both you and your loved one. To promote better sleep:

  • Treat underlying conditions. If you suspect that an underlying condition—such as sleep apnea or restless legs syndrome—is interfering with your loved one's sleep, talk to his or her doctor.
  • Establish a routine. Maintain regular times for eating, waking up, and going to bed.
  • Avoid stimulants. Limit your loved one's use of alcohol, caffeine, and nicotine, which can interfere with sleep. Also, discourage your loved one from watching TV immediately before bedtime or when he or she wakes up at night.
  • Encourage physical activity. Plan your loved one's days to include walks and other physical activities, which can help promote better sleep at night.
  • Limit daytime sleep. If your loved one needs a nap, keep it short and make sure it's not too late in the day.
  • Create a comfortable sleeping environment. Make sure your loved one's bedroom is a comfortable temperature. Provide night lights and security objects.
  • Manage medications. Make sure your loved one is taking his or her medications at the appropriate times so that they don't interfere with sleep.

When a loved one wakes during the night

If your loved one wakes during the night, stay calm—even though you might be exhausted yourself. Don't argue. Instead, ask what your loved one needs. Gently remind him or her that it's night and time for sleep. If your loved one needs to pace, don't try to restrain him or her. Instead, allow it under your supervision.

Using sleep medications

If nondrug approaches aren't working, your loved one's doctor might recommend sleep-inducing medications. However, using these kinds of medications can increase the risk of falls, fractures, and confusion. Once a regular sleep pattern is established, the doctor will likely recommend attempting to discontinue use of the medications.

Remember that you need sleep, too.

Your loved one's sleep is important, but so is yours. If you're not getting enough sleep, you might not have the patience and energy needed to take care of someone who has Alzheimer's. Your loved one might also sense your stress and become agitated.

If possible, have family members or friends alternate nights with you—or talk with your loved one's doctor, a social worker, or a representative from a local Alzheimer's association to find out what help is available in your area.

Updated: 2017-11-15

Publication Date: 2002-12-05

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