Alzheimer's disease is a major cause of circadian rhythm disturbances, and these disturbances may begin years before memory loss is observed. In the early stages of Alzheimer's disease, patients often sleep more than they normally would, and they might be disoriented upon waking. As the disease advances, the patient may start to sleep during the daytime, remaining awake at night. In moderate to severe Alzheimer's disease, patients tend to doze irregularly during the day and night instead of sleeping for long blocks of time at once. These disruptions to the patient's circadian rhythm often increase the risk of both nighttime wandering and agitation during the evening hours (sometimes known as sundowning). Studies have suggested Alzheimer's patients might gradually lose their ability to stay asleep as the disease worsens. They may need sleep medications, antidepressants, and other medications to promote a healthier sleep-wake cycle.
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