Alzheimer's and Sleep ~ Pt 1

To be clear, Alzheimer’s is a form of dementia. As in all forms of dementia, Alzheimer’s has “negative effects on the sleep/wake cycle” of the patient. According to the National Sleep Foundation, it is common for patients with severe forms of Alzheimer’s to sleep during the day and have fragmented and disruptive sleep at night.


  • Changing sleep architecture

  • Menopause

  • Chronic health issues like diabetes, heart disease, arthritis

  • Prescription medication

  • Increased sedentary lifestyle

  • Grief and loneliness

  • Depression and anxiety

  • Financial stress

Why do dementia patients get worse at night? Known as ‘sundowning’, this syndrome, which makes it difficult for some patients to transition from day to night, is real and is marked by a “regular change of behavior characterized by confusion, agitation and anxiety.”

So you see, it’s not uncommon for these patients to begin “pacing, yelling out, or getting violent” in the evenings. Even worse, some patients begin to wander around at night which is one of the two main causes for institutionalizing a dementia patient. The other is incontinence.

Though there are medications to help with the agitation, they have not always proven to be helpful. A physician will be able to explain the advantages and disadvantages of each type of medication.


Alzheimer’s patients cope with their disease better if they have routine in their daily lives.

The bottom line for any caregiver of an Alzheimer’s patient is to

be certain to keep the patient on a regular schedule which includes sleep and meals

elderly at beach

The National Sleep foundation also reports the majority of nursing homes only give their patients about 10 minutes of bright light per day. [Even] in a community, most patients only get about 30 minutes per day, but it is better that the patient has several hours [or more] of sunlight per day. Morning light is the best.

It’s an interesting fact that a dementia patient’s circadian rhythm is out of sync with the rhythm of the environment. Therefore, bright light improves this function. (National Sleep Foundation)

“So what the hey-who is circadian rhythm?”

Well, there are two systems in your body that regulate your sleep.

Sleep/wake homeostasis:

Sleep/wake homeostasis tells our body when it’s time to get some sleep as well as helps us to maintain sleeping enough through the night. It is more clearly understood by simply saying it:

Creates a drive that balances sleep and wakefulness.

Circadian biological clock

The circadian biological clock regulates the timing of periods of sleepiness and wakefulness throughout the day. It also helps us feel more alert at certain points of the day. “The circadian biological clock is controlled by a part of the brain . . . [located] in the hypothalamus [which] respond[s] to light and dark signals.” 

One example of circadian disruptions is jet lag.

When you experience jet lag, you are simply out of sync with your environment.

This is what an Alzheimer’s patient experiences. They are out of sync with their environment. Therefore if the caregiver can create an environment that has routine in it, it will go a long way in helping keep the patient’s biological clock intact.

This has been the first in a three part series. Watch for:

Alzheimer’s and Sleep Part Two: Fatigue

Alzheimer’s and Sleep Part Three: Memory Care

For more information on How Sleep Works please visit the comprehensive site

★ Call Missy Donaghy for a FREE consultation 321-279-3301.


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