Understanding Alzheimer's and Sleep

Alzheimer's disease is a progressive brain disorder that affects a person's memory, thinking, and behavior. Meanwhile, sleep disorders are conditions that make it difficult to fall asleep, stay asleep, or get quality sleep.

It is common for people with Alzheimer's disease to have sleep problems. In fact, research suggests that 40%-90% of people with Alzheimer's disease suffer from some form of sleep disturbance. Poor sleep can also worsen Alzheimer's symptoms. In addition, researchers are studying whether sleep may play a role in the development of Alzheimer's disease.

In this article, we discuss the connection between Alzheimer's and sleep, the different types of sleep problems that can occur in people with Alzheimer's, and some tips for improving sleep.

The Connection Between Alzheimer's Disease and Sleep

Alzheimer's disease is related to sleep in several ways. Poor sleep can worsen Alzheimer's symptoms, and research suggests that sleep may play a role in the development of Alzheimer's disease.

There are a few possible explanations for the link between Alzheimer's and sleep problems. First, the same changes in the brain that cause Alzheimer's disease may also disrupt a person's sleep. Second, certain medications used to treat Alzheimer's can cause insomnia. Finally, the stress and anxiety associated with Alzheimer's may make it difficult to sleep.

Poor sleep may worsen Alzheimer's symptoms. In fact, research has shown that people with Alzheimer's who sleep poorly may accumulate a protein in the brain called "tau" that interferes with normal brain functioning. This is because sleep is required to clear away the protein.

There is also some evidence to suggest that sleep may play a role in the development of Alzheimer's disease. One study found that people who had poorer sleep were more likely to develop Alzheimer's disease and cognitive impairment than people who did not have sleep problems.

Risk factors for sleep disturbance in Alzheimer's disease include the following:

• Age: Sleep problems become more common as a person gets older.
• Dementia severity: People with sleep problems and Alzheimer's have more severe cognitive impairment than those without sleep problems.
• Depression: Depression is a common symptom of Alzheimer's disease, and it can contribute to sleep problems.
• Anxiety: Anxiety is another common symptom of Alzheimer's disease, and it can also interfere with sleep.
• Medications: Certain medications used to treat Alzheimer's disease, such as cholinesterase inhibitors, can cause insomnia.

Latest Research

While the link between Alzheimer's and sleep is still being explored, recent research has provided some insight into the connection between these two conditions.

A 2011 review study found that behavioral modification, stimulus control, and bright light therapy were effective non-pharmacological treatments for sleep disturbance in Alzheimer's disease.

A 2022 study hypothesized that people with mild cognitive impairment who participated in a ketogenic diet program would experience improvements in their sleep, mood, and behavioral symptoms.

Complications of Alzheimer's Disease and Sleep

Sleep disturbance can lead to a number of complications in people with Alzheimer's disease, including the following:

• Cognitive decline: Poor sleep can worsen cognitive symptoms in people with Alzheimer's disease.
• Increased risk of falls: People with Alzheimer's disease who have sleep problems are at an increased risk of falling.
• Mood changes: Sleep disturbance can lead to mood changes, such as irritability, depression, and anxiety.
• Stress: The stress associated with sleep disturbance may worsen Alzheimer's symptoms.

When to See a Doctor

If you or a loved one is experiencing sleep problems, it's important to talk to a doctor.

Please see your doctor if you or a loved one are experiencing any of the following:

• Difficulty falling asleep or staying asleep
• Excessive daytime sleepiness
• Nighttime waking
• Irritability or mood changes
• A decline in cognitive function or daily functioning

Diagnosis of Alzheimer's Disease and Sleep Disorders

Both Alzheimer's disease and sleep disorders are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The main DSM criteria for the diagnosis of Alzheimer's disease include the following:

• A gradual decline in cognitive function that interferes with daily life
• Memory problems that are not due to another medical condition or substance abuse

At least one of the following:

• Problems with language
• Executive dysfunction (e.g., problems with planning and organization)
• Visuospatial dysfunction (e.g., problems with perception and spatial orientation)

The main DSM criteria for the diagnosis of sleep disorders include the following:

• Sleep disturbance that causes significant distress or impairment in social, occupational, or other important areas of functioning
• The sleep disturbance is not due to another medical condition or substance abuse
• The sleep disturbance is not better explained by another mental disorder (e.g., depression)

To diagnose Alzheimer's disease, a doctor will typically perform a physical exam, order laboratory tests, and assess cognitive function. A diagnosis of Alzheimer's disease may also be made based on the presence of certain brain changes on an MRI or PET scan.

To diagnose a sleep disorder, a doctor will perform a physical exam and order laboratory tests to rule out other conditions. A sleep study may also be ordered to assess sleep patterns.

Self-Test for Alzheimer's Disease

Online screening tools for Alzheimer's disease are available, but they should not be used to replace a formal evaluation by a doctor.

Dementia Care Central lists a number of self-assessment tools for Alzheimer's disease. The self-assessments are not diagnostic but can help you decide whether to see a doctor for further evaluation.

Online screening tools for sleep disorders are also available. Good Thinking UK's sleep self-assessment can help you identify whether you might have a sleep disorder. The self-assessment is not diagnostic but can help you decide whether to see a doctor for further evaluation.

Treatment of Alzheimer's Disease and Sleep Disorders

There is no cure for Alzheimer's disease, but treatments are available to manage symptoms. Treatment options include medications, therapies, and support services.

There are also several treatment options for sleep disorders. Treatment depends on the type of sleep disorder, but it may include medications, lifestyle changes, and therapies.

Medications for Alzheimer's Disease

The most common medication used to treat Alzheimer's disease is a cholinesterase inhibitor. These medications work by boosting levels of the neurotransmitter acetylcholine, which is involved in memory and learning. Cholinesterase inhibitors include donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), and tacrine (Cognex).

Other medications that may be prescribed for Alzheimer's disease include memantine (Namenda), antidepressants, antipsychotics, and sleep aids.

Medications for Sleep Disorders

There are several types of medications that can be used to treat sleep disorders, including hypnotics, sedatives, and wake-promoting agents.

Hypnotics are medications that induce sleep. The most common hypnotic medication is zolpidem (Ambien). Other hypnotic medications include eszopiclone (Lunesta), zaleplon (Sonata), and ramelteon (Rozerem).

Sedatives are medications that help to relieve anxiety and promote relaxation. The most common sedative medication is diazepam (Valium). Other sedative medications include alprazolam (Xanax) and lorazepam (Ativan).

Wake-promoting agents are medications that help to increase alertness and combat fatigue. The most common wake-promoting agent is modafinil (Provigil). Other wake-promoting agents include armodafinil (Nuvigil) and methylphenidate (Ritalin).

Psychotherapy for Alzheimer's Disease

There are several types of therapies that can be used to manage the symptoms of Alzheimer's disease, including cognitive training and behavioral management. Below is a bullet point list of different types of psychotherapy that may be used to treat patients with Alzheimer's disease:

• Cognitive behavioral therapy: CBT works by helping patients to identify and change negative thinking patterns and behaviors.
• Interpersonal therapy: IPT focuses on the relationships between people and how they communicate with each other.
• Problem-solving therapy: This type of therapy helps patients to learn how to solve problems in a more effective way.
• Reminiscence therapy: RT involves talking about past memories and experiences in order to promote positive emotions and reduce anxiety and depression.

Coping with Alzheimer's Disease and Sleep Disorders

Lifestyle Changes

There are several lifestyle changes that can help to manage the symptoms of Alzheimer's disease and sleep disorders. These lifestyle changes include the following:

• Staying physically active: Physical activity can help to improve mood, cognitive function, and quality of sleep.
• Eating a healthy diet: A healthy diet can help to improve mood, cognitive function, and overall health.
• Managing stress: Stress can worsen the symptoms of Alzheimer's disease and sleep disorders. Learning how to manage stress can help to improve overall well-being.

Support Groups

There are several types of support groups that can help people with Alzheimer's disease and sleep disorders. These support groups provide education, information, and emotional support.

• Alzheimer's Association: The Alzheimer's Association is a national organization that provides support and resources for people with Alzheimer's disease and their caregivers.
• National Sleep Foundation: The National Sleep Foundation is a national organization that provides information and resources on sleep disorders.

A Word From Verywell

Alzheimer's disease and sleep disorders are both serious medical conditions that can cause distress for patients and caregivers. There are several types of medications and therapies that can be used to manage the symptoms of these conditions. Additionally, lifestyle changes and support groups can also be helpful in coping with Alzheimer's disease and sleep disorders.

If you or a loved one are dealing with Alzheimer's disease and sleep disorders, it is important to seek out the help of a doctor or other medical professional. These conditions can be complex and difficult to manage on your own. There are many resources available to help you cope with these conditions. Don't hesitate to reach out for help if you need it.