Journal of Sleep Disorders & Therapy
Open Access

The Effects of Alzheimer's Disease on Sleep: Disrupted Rest in Dementia

Jean Chaput^{* *}Correspondence: Jean Chaput, Department of Neurology, University of Ottawa, Ottawa, Ontario, Canada, Email:

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Description

Alzheimer’s disease is a progressive neurodegenerative disorder that impacts memory, cognition and daily functioning. However, one of the lesser-discussed aspects of the disease is its profound effect on sleep. Sleep disturbances are common in individuals with Alzheimer’s, with issues ranging from difficulty falling asleep to frequent awakenings and daytime sleepiness. These disruptions worsen as the disease advances, significantly impacting both the patient and their caregivers.

Changes in sleep patterns

A hallmark of Alzheimer’s disease is the alteration in sleep-wake cycles. Individuals with Alzheimer’s may experience changes in their circadian rhythm, the internal biological clock that regulates sleep. This disruption often leads to fragmented sleep, meaning that individuals may wake up frequently throughout the night and struggle to fall back asleep. As a result, the quality of rest deteriorates, leaving them feeling tired during the day. As Alzheimer’s progresses, individuals may also experience sun downing, a phenomenon in which agitation, confusion and restlessness increase in the late afternoon and evening. Sun downing can further disrupt sleep by increasing anxiety and disorientation, making it difficult for patients to settle down at night.

Sleep apnea and insomnia

Sleep apnea, a condition where breathing repeatedly stops and starts during sleep, is more common in Alzheimer’s patients. This breathing disruption can lead to poor sleep quality and excessive daytime sleepiness. In some cases, sleep apnea exacerbates cognitive decline by further depriving the brain of adequate rest and oxygen. Insomnia is another frequent sleep complaint among individuals with Alzheimer’s disease. People with insomnia may have trouble falling asleep or staying asleep, which further contributes to sleep deprivation. Insomnia in Alzheimer’s patients is often linked to changes in brain regions that regulate sleep, such as the hypothalamus and brainstem, both of which are affected by the disease’s neurodegenerative processes.

Daytime sleepiness and nighttime restlessness

As nighttime sleep becomes more disrupted, individuals with Alzheimer’s tend to experience increased daytime sleepiness. Paradoxically, they may spend more time napping during the day but still struggle with poor nighttime sleep. This irregular sleepwake cycle makes it harder for individuals to establish a consistent sleep schedule, contributing to further sleep problems. Moreover, nighttime restlessness is common in later stages of Alzheimer’s. Individuals may wander during the night, exhibit disruptive behaviors, or experience vivid dreams, all of which can make sleep even more difficult. This can create significant challenges for caregivers, who must manage the patient’s needs and safety around the clock.

Impact on caregivers

The sleep disturbances associated with Alzheimer’s disease do not only affect the patients but also their caregivers. Sleep deprivation from nighttime caregiving can take a heavy toll on caregivers' physical and emotional well-being, often leading to caregiver burnout. Many caregivers report feeling exhausted, stressed and overwhelmed, making it crucial to find strategies that can improve sleep for both parties.

Managing sleep issues in Alzheimer’s disease

There are several strategies to help manage sleep problems in Alzheimer’s patients. Promoting sleep hygiene-such as maintaining a regular bedtime, limiting caffeine and ensuring exposure to natural light during the day-can help regulate sleepwake cycles. Exercise and daytime activities can also promote better sleep by reducing restlessness and promoting fatigue. In some cases, doctors may recommend medications to manage sleep disturbances, though this is typically a last resort due to potential side effects, especially in elderly patients. Cognitive- Behavioral Therapy-Insomnia (CBT-I) and light therapy have also shown promise in improving sleep patterns among individuals with Alzheimer’s.

Conclusion

Sleep disturbances are a common and troubling aspect of Alzheimer’s disease, affecting both patients and caregivers. From circadian rhythm disruptions to insomnia and nighttime restlessness, the impact on sleep can exacerbate cognitive decline and reduce the quality of life. Early intervention, lifestyle adjustments and targeted therapies can help manage these sleep challenges and provide relief for both patients and those caring for them.