What is sleep disturbance?

Alzheimer's disease often changes sleep. The National Institute on Aging lists sleeping a lot or not enough, waking many times in the night, napping a lot during the day, and sundowning, which is restlessness, agitation and confusion as daylight fades. A person's sleep problems often disrupt the caregiver's sleep too, and both need rest to cope.

Sometimes. The National Institute on Aging says early symptoms of Lewy body dementia can include changes in sleep, and that REM sleep behavior disorder, in which a person seems to act out dreams by talking, thrashing or falling out of bed, can appear years before other symptoms. Sleep problems have many other causes, so talk with a doctor about lasting changes.

The Alzheimer's Association lists exhaustion after a busy day, a mixed-up body clock, confusing surroundings, shadows from low light, and needing less sleep with age. Physical problems such as urinary tract infections, incontinence, restless legs syndrome or sleep apnea can cause or worsen sleep problems, so a doctor should look for them. The disease itself can also disrupt sleep.

Build a steady routine. The National Institute on Aging suggests daily exercise, limiting naps and late dozing, planning active tasks such as bathing for the morning, and serving the largest meal at midday. In the evening, keep lights low and the house quiet, follow a relaxing bedtime routine without screens, avoid alcohol and caffeine, and use nightlights in the bedroom, hall and bathroom.

Usually with non-drug steps first. The Alzheimer's Association says most experts encourage non-drug measures rather than medication for sleep problems caused mainly by Alzheimer's. A doctor can look for treatable causes, such as an infection or sleep apnea, and review medicines and their timing. If non-drug approaches fail, medication may be considered after weighing its risks and benefits.