How to Manage the Sleep Disturbances Associated with Alzheimer's Disease
Our sleep patterns naturally change as we age. Unfortunately, many of these changes can be for the worse, with older individuals more likely to suffer from fragmented sleep and nighttime awakenings, according to a study published in Sleep.
- Taking longer to fall asleep
- Finding it difficult to stay asleep
- Frequent nighttime and early morning awakenings
Alzheimer's disease also has a negative effect on sleep. In fact, one study found that up to 40 percent of those with Alzheimer's disease experienced some form of sleep disruption.
Sleep disturbances associated with Alzheimer's disease
A clinical review published in 2015 revealed that those with Alzheimer's disease experienced far more severe sleep disturbances compared to healthy elderly adults.
Those with Alzheimer's took longer to fall asleep, spent less time asleep, and woke more often during the night.
Changes to the sleep-wake cycle also were identified and linked to sundowning syndrome — a symptom of Alzheimer's characterized by confusion and agitation in the evenings and late afternoons.
The review also pointed out that restless legs syndrome was found to affect up to 24 percent of patients suffering from dementia.
Finally, the review revealed that those with Alzheimer's Disease were at higher risk for obstructive sleep apnea compared to healthy older adults.
All of these symptoms should be of particular concern because sleep-related breathing disorders have been found to be a risk factor for cognitive decline. Sleep issues in general also have been found to have a negative effect on Alzheimer's disease as they can further damage memory consolidation.
Primary risk factors for sleep disturbancehe authors of the review identified the following risk factors for sleep disturbances in Alzheimer's patients:
- Lifestyle habits
- Medical and psychiatric illnesses
How to manage sleep disturbances in those with Alzheimer's disease
The review identified the following pharmaceutical and non-pharmaceutical approaches for addressing sleep disturbances in those with Alzheimer's:
Because melatonin production declines as we age, melatonin supplements may help regulate the sleep-wake cycle in Alzheimer's patients.
These types of drugs may be prescribed to help control the behavioral issues that are associated with Alzheimer's disease. They also may be used to treat insomnia. However, the authors of the review pointed out that they are associated with an increased risk of falls and may have other serious side effects, too.
Benzodiazepines and non-benzodiazepines are sedatives that can make it easier to fall asleep. However, the review pointed out that they also affect our overall sleep architecture and that there is limited data supporting their effectiveness in managing sleep disturbances in those with Alzheimer's disease.
These drugs may reduce the amount of time it takes to fall asleep, but they come with side-effects that can be particularly undesirable in those with Alzheimer's, such as drowsiness and dizziness.
Although antihistamines are often used as sleep aids, they were not intended to be used in this way. Their side effects can be a particular problem; as this review pointed out, some users may experience cognitive impairment.
Behavioral and educational strategiehe review recommended the following non-pharmaceutical strategies to improve sleep and reduce the effects and incidence of sleep disturbances:
- Taking frequent walks outdoors
- Using the bedroom only for sleep
- Keeping a regular bedtime and wake time
- Reducing the amount of time spent in bed during day
- Regularly getting at least 30 minutes of daytime exercise
- Avoiding daytime naps longer than 30 minutes or taken after 1 p.m.
- Avoiding cholinesterase inhibitors and stimulating drugs at night
Of course, you should not make any changes to a drug regimen or make significant changes to your exercise routine without speaking to your doctor first.
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Martin is the creator of Insomnia Land’s free sleep training for insomnia. His online course uses CBT techniques to teach participants how to sleep without relying on sleeping pills. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.