How to Get Better Sleep When You’re Living With Early-Stage Alzheimer’s Disease

“Sleep problems are common among people living with dementia and their care partners, but common does not mean inevitable or untreatable,” says Glenna S. Brewster, PhD, a principal investigator at Mind At Rest Research Lab and associate professor at Emory University’s Nell Hodgson Woodruff School of Nursing in Atlanta.

Find out how your brain and sleep are linked and how you can get better sleep with early-stage Alzheimer’s.

The Brain-Sleep Connection

“Alzheimer’s disease can disrupt the brain systems that regulate when we sleep and when we are awake,” says Dr. Brewster. “One important area is the suprachiasmatic nucleus, or SCN, which helps regulate our circadian rhythm — our internal 24-hour clock.”

These internal clock changes lower levels of melatonin, a hormone that helps you get sleepy at night. “Deep sleep also drops off, which matters, because that’s when the brain seems to clear out proteins like amyloid,” says Morgan Soffler, MD, a sleep medicine specialist and assistant professor of medicine at New York Medical College in Valhalla, New York.

• Daytime sleepiness
• Wakefulness during the night
• Trouble falling asleep
• Restlessness or confusion in the evening
• Dozing a lot during the day
• Day-night reversal

Keep in mind that sleep problems in someone living with Alzheimer’s are not always caused directly by changes in the brain, says Brewster. “Changes in cognition and behavior, reduced daytime physical and social activity, less exposure to natural light, medications, pain, depression, other sleep disorders, and other health conditions can also contribute to disrupted sleep.”

Daily Habits to Anchor Your Circadian Rhythm

“Maintaining regular times for other daily activities, such as meals, physical activity, and social activities, can also help reinforce the body’s internal clock,” says Brewster.

• Use light as a signal. Light is your biggest tool, so try to get outside for 20 to 30 minutes in the morning, says Soffler.
• Stay active daily. Regular physical and social activity during the day can help you sleep better at night, says Brewster.
• Keep naps short. Limit how long you nap, and try to take them before midafternoon, says Soffler.

“I recommend going to bed when sleepy rather than simply because the clock says it is bedtime,” says Brewster. “Melatonin may be helpful for some individuals, but it should not replace these behavioral and environmental strategies and should be discussed with a healthcare provider before use.”

Create a Calming Bedtime Routine

“As bedtime approaches, establish a consistent and predictable wind-down routine,” says Brewster, which may include using the bathroom, dimming the lights, and reducing stimulating activities like watching TV.

• Read a few chapters of a book.
• Listen to audiobooks or music.
• Take a warm bath or shower.
• Meditate or do other relaxation exercises.
• Do breathing exercises.

“If using a tablet for reading, make sure it’s in ‘night mode,’ which limits blue light emission from the device,” says Miner.

Keep your bedroom dark, quiet, and comfortable, while still considering safety, says Brewster. “For example, motion-activated or sensor lights can provide enough light to safely navigate to the bathroom, without keeping the room brightly lit throughout the night.”

Getting Help From Your Healthcare Team

Sometimes, you may need more than the tips above to help you sleep.

Brewster recommends telling your provider about the following symptoms, especially if they persist, happen suddenly, or begin to affect daytime functioning, safety, or health:

• New or worsening difficulty falling or staying asleep
• Excessive daytime sleepiness
• Frequent nighttime awakenings
• Loud snoring
• Breathing pauses or gasping during sleep
• Acting out dreams or unusual movements during sleep
• Noticeable changes in daytime mood, alertness, or irritability

“If you’re routinely having trouble falling asleep or staying asleep, or if you’re regularly napping for an hour or more during the day, you should discuss your sleep with your primary care provider,” says Miner.

“Sleep problems can have many causes, so changes from a person’s usual sleep pattern or behavior should not automatically be assumed to be a normal part of Alzheimer’s disease,” says Brewster.

“Don’t forget about the caregiver’s sleep, because when one person is up at night, someone else usually is too,” says Soffler. “Caregiver exhaustion is real, and it’s okay to ask for help.”