How to Improve Your Sleep When Living With Mild Cognitive Impairment (MCI)

Here are some of the most important things to know about sleeping well when you have mild cognitive impairment.

Sleep plays a critical role in the removal of potentially harmful substances from your brain, says Daniel Callow, PhD, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine in Baltimore.

“In Alzheimer’s disease and mild cognitive impairment, there’s likely a breakdown in the flushing of those toxins out of the brain,” says Dr. Callow, potentially leading to further cognitive impairment. This process, he says, can be accelerated by sleep disturbances like sleep apnea.

Getting treatment for sleep apnea is especially important for people with cognitive issues, says Winnie Pao, MD, a neurologist and sleep medicine physician at Cleveland Clinic in Ohio. “When you treat it, you’re preventing the segmentation of sleep and helping maintain more slow-wave sleep,” she says. In this phase of sleep, potentially harmful proteins are flushed out of the brain more efficiently.

Dr. Pao says that older people with sleep apnea may not always experience daytime sleepiness or be aware of their sleep disturbances, so it’s a good idea for anyone with mild cognitive impairment to get tested.

Other common sleep disturbances include restless legs syndrome (RLS), a movement disorder involving your legs, and insomnia, in which it’s difficult to fall or stay asleep.

In restless legs syndrome, people often experience disruptive leg movements as they’re trying to fall asleep. “Once people transition to the sleep state, they can continue twitching their legs,” says Andrew W. Varga, MD, PhD, a neurologist and sleep medicine physician at the Mount Sinai Integrative Sleep Center in New York City. “And if you have enough of these episodes, that can be associated with arousal from sleep.” It’s essential to see a doctor, he says, to diagnose and treat RLS.

Unlike many people with sleep apnea, people with insomnia are likely to know they have issues with their sleep, Dr. Varga says. “In insomnia, there’s usually clear awareness — it’s 3 in the morning and I’m wide awake and can’t sleep.”

While it’s important to seek treatment from a doctor for persistent sleep problems, you can take steps on your own to improve sleep when you have mild cognitive impairment.

Physical Activity

“There’s some strong evidence that exercise and physical activity could improve sleep in individuals with mild cognitive impairment,” says Callow. While you shouldn’t do vigorous exercise close to your bedtime, physical exertion earlier in the day can help make sure that you’re actually tired at the end of the day.

Many kinds of movement may help you sleep better, so pick an activity that works for you. “Exercise or physical activity that you stick with and enjoy the most, that you’ll actually do, is the best type of activity,” says Callow.

Light Therapy

Rocking Beds

While rocking a baby to sleep is a well-known practice, some adults with insomnia may benefit from this technique using a specialized rocking bed.

Cognitive Behavioral Therapy

While different insomnia treatments work for different people, Varga says that the best evidence supports cognitive behavioral therapy (CBT), a form of talk therapy that helps people identify challenges and change behaviors.

Depending on the cause of your sleep disturbances, medications may be helpful. Sometimes this can mean treating an underlying condition like RLS.

Part of the challenge in identifying sleep problems is that you may not know how severely they’re affecting your sleep quality or cognitive performance. So even if you think you’re sleeping fine most of the time, it's a good idea for people with mild cognitive impairment to have a discussion about sleep with their doctor.

But in some cases, you should make an appointment specifically to focus on sleep issues. “If you’re feeling sleepy during the day, and you’re getting enough sleep duration and it’s consistent, that suggests something is going on and maybe it’s time to see a doctor,” says Varga.

Your doctor will likely ask questions about your sleep habits, including your sleep duration and timing, your sleep environment, and any issues or disruptions you’ve been experiencing. You may undergo testing for certain sleep disorders, including sleep apnea.

For many people with mild cognitive impairment and sleep disorders, a combination of lifestyle measures and targeted treatments can improve both sleep and cognitive performance, says Pao. “There are a lot of things we can do about sleep nowadays, a lot of things we can improve,” she says. “See a sleep doctor and let’s see what we can do for you.”

• If you have mild cognitive impairment and experience daytime sleepiness, disrupted sleep, or snoring, it's important to talk to your doctor, as these issues could be impacting your cognitive health.
• Engaging in regular physical activity and getting light exposure during the day can significantly enhance sleep quality for individuals with MCI.
• If you have insomnia, consider exploring cognitive behavioral therapy for insomnia as a treatment option. It has been shown to be effective at improving both sleep and cognitive function.