“My husband snoozes all day on the couch and only sleeps an hour or two at a time all night. It’s exhausting!” one myALZteam member said. Another member shared, “I was up three different times last night. Mom kept getting up asking where her husband was. ‘Why are all his clothes gone? Did he leave me?’” one shared.

As a caregiver for a family member with Alzheimer’s disease or another type of dementia, you may feel like a good night’s rest is out of reach. Alzheimer’s disease and other types of dementia can lead to several sleep issues. Before you give up hope of ever getting a good night’s sleep again, here are some things you can try that may help you and your loved one sleep more soundly.

Alzheimer’s and Sleep

Sleep problems are common in older adults — estimated to occur in 30 percent to 70 percent of older people globally. This is partly due to physical changes as we age. Adults over 60 tend to see a decrease in deep sleep and total sleep time and an increase in nighttime sleep interruptions. This leads to poor sleep quality. In many older adults, sleep issues coexist with other health conditions, such as dementia.

It’s estimated that 25 percent of people with mild to moderate Alzheimer’s have sleep trouble. These sleep disturbances tend to get worse as dementia progresses. Among people with moderate or severe Alzheimer’s, around half have sleep issues.

Dementia can contribute to several types of sleep disorders and problems. The disorders below can also occur unrelated to dementia.

Insomnia

“My mom stays awake for two or three days straight. Two weeks ago, she was awake for 68 hours straight,” one member wrote.

“Insomnia” is the term used to describe when someone has a hard time falling asleep or staying asleep. People with insomnia might wake frequently at night or very early in the morning and not be able to get back to sleep. Insomnia is common among people with dementia. It may be caused by:

• Pain or discomfort
• Anxiety or depression
• Other health conditions, such as acid reflux, constipation, or incontinence
• Medications

Sundowning — agitated or distressed behavior that comes on in the late afternoon or evening — can also lead to insomnia. If these behaviors continue into the night, people who sundown can have a hard time falling asleep.

Daytime Sleepiness

“Mom naps all day and is up all night,” shared one member. Dementia may also impact your loved one’s circadian rhythm — the internal clock that tells them when to sleep and wake. This disrupted sleep-wake cycle can cause people with dementia to be tired during the daytime and nap. Napping too much can then lead to trouble sleeping at night. People in advanced stages of Alzheimer’s are more likely to have this sleep issue, as are those with Parkinson’s disease dementia and dementia with Lewy bodies (DLB).

Breathing Disorders

Obstructive sleep apnea (OSA) and other sleep-disordered breathing can also affect sleep quality and lead to daytime tiredness. OSA causes the airways to narrow or collapse during sleep, making it difficult for someone to breathe normally. They may even stop breathing for short periods. Someone who stops breathing may wake up gasping for air.

OSA commonly affects people with Alzheimer’s disease and vascular dementia. In addition to causing sleepiness and low oxygen levels, OSA can worsen dementia symptoms over time.

Movement Disorders

Sleep disturbances can also be due to movement disorders like restless legs syndrome. This disorder, which causes an urge to move the limbs, is more common at night. Another condition, periodic limb movement disorder, can make a person move their limbs while asleep. These disorders are more commonly found in people with DLB and Parkinson’s disease dementia.

While restless legs syndrome can make it hard to fall asleep, periodic limb movement disorder can cause someone to wake up frequently throughout the night. During the night, people with restless legs syndrome may leave their bed to walk around. One member wrote, “My husband was constantly walking out in the middle of the night. He didn’t wander away, but it was scary.”

Rapid Eye Movement Behavioral Sleep Disorder

Rapid eye movement (REM) behavioral sleep disorder is a condition that affects one part of the sleep cycle, REM sleep. During this stage, people physically act out their dreams, which can result in flailing, falling from bed, and suddenly waking up. In addition to disrupted sleep, violent or unpleasant dreams may lead to exhaustion the next day. The condition commonly affects people with DLB and Parkinson’s.

One member shared, “Momma almost jumps out of her chair at any noise. Her dreams are very vivid, with limb movements and articulation.”

How To Help Your Loved One Get a Good Night’s Sleep

If your loved one is having ongoing sleep issues, it’s important to speak with a healthcare professional. However, there are certain lifestyle and sleep habit changes that might help them sleep better.

1. Stick to a Routine

Dementia can alter the body’s internal clock. Doing things around the same time each day, like eating meals, engaging in activities, and going to bed, can help give your loved one a better sense of day and night. Try to limit napping, especially in the afternoon.

2. Be Active During the Day

Doing enjoyable activities during the day may help your loved one to feel more tired at bedtime, as well as improve anxiety and restlessness. Physical activity can also help improve sleep quality. Aim for 20 to 30 minutes of exercise a few times each week. Make sure to help them get exercise more than four hours before bedtime.

One member shared, “I try to get Dad to be more active during the day with light gardening and doing projects in the yard. I find he is much happier being active during the day — less cat naps and, as a result, he sleeps better and longer at night.”

3. Get Some Sun

Going out in the sunlight, especially in the morning, is another way to help reset your loved one’s internal clock and make them sleepier at night. Bright indoor light, such as from a lamp or lightbox, can be used for people who aren’t able to go outside. Dim lighting in the evenings can help encourage sleep at the right time.

4. Avoid Stimulants

Substances like caffeine, nicotine, and alcohol can make falling asleep more difficult. Avoid, or limit, stimulants later in the day and the evening. Caffeine and alcohol can also result in an increased need to use the toilet during the night.

5. Treat Underlying Conditions

Manage other conditions that may be contributing to their sleep problems, such as movement disorders or mental health conditions. If other health issues aren’t directly causing poor sleep, pain and discomfort can still make it hard to sleep. Over-the-counter painkillers, heat, or massage may be helpful for easing discomfort.

6. Follow a Relaxing Bedtime Routine

Wind down in the evening with calming activities to help your loved one prepare for sleep. For example, a warm bath, calm music, or a cup of herbal tea can encourage relaxation. Find the right sleep routine and stick to the same sleep schedule. One member shared, “I give my mom a tea called Tension Tamer. It helps calm her sometimes.”

7. Make Their Bedroom Cozy

You can improve sleep hygiene (sleep habits) by making sure your loved one’s bedroom is comfortable for sleeping. Ensure the room is:

• Dark (add a nightlight if the dark worries them)
• At a comfortable sleeping temperature
• Uncluttered
• Used only for sleeping and sexual intimacy
• Free of screens like TVs
• Equipped with a dementia-friendly clock to help ease confusion if they wake up in the middle of the night

8. Try Melatonin

Your body makes the hormone melatonin when it gets dark to help you fall asleep. Boosting natural levels with melatonin supplements may result in better sleep. Melatonin may also be useful for helping prevent sundowning. Be sure to talk to your loved one’s doctor or pharmacist before trying supplements for sleep.

9. Manage Medications

Certain drugs may cause insomnia as a side effect. Ask your loved one’s doctor if any medications could be impacting your loved one’s sleep. If switching medications isn’t possible, their provider may be able to offer advice on how to lessen side effects.

10. Ask Their Doctor About Sleep Medication

If adopting new lifestyle habits doesn’t bring on positive sleep changes, ask your loved one’s doctor if sleep medication is an option. Sleeping pills aren’t typically recommended for people with Alzheimer’s due to how they increase the risk of confusion and falls. However, if all other options have failed, their provider may prescribe sleep medication to help them get back to a normal sleep schedule. Keep in mind that they will likely have to stop taking the medicine after that happens.

Talk With Others Who Understand

On myALZteam, a social network for people with Alzheimer’s and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.

Do you have trouble getting healthy sleep while caring for someone with Alzheimer’s? Does your loved one with Alzheimer’s have difficulty sleeping? Do you have other tips that could help caregivers and their loved one get a good night’s rest? Share your experience in the comments below, or start a conversation by posting on your Activities page.