阿尔茨海默病（Alzheimer’s disease，AD）患者的睡眠障碍是临床上常见且较为突出的精神行为症状之一，与AD疾病进展存在相互加重的关系。目前，西医治疗主要针对症状使用镇静催眠药和褪黑素受体激动剂等，但疗效有限且存在不良反应和药物依赖等问题。中医学将AD睡眠障碍中医归入“不寐”范畴，治疗上强调辨证论治，可选用中药、针灸和艾灸等多种手段。近年来，中西医结合在AD睡眠障碍治疗中展现出独特优势，两者通过优势互补，在提高睡眠质量、延缓认知衰退以及降低西药不良反应等方面取得了实际进展。该综述系统回顾了AD睡眠障碍的中西医病理机制以及中西医结合治疗策略，同时讨论了当前面临的挑战，以期为临床实践和后续研究提供参考依据。

Sleep disorders are among the most common and prominent neuropsychiatric symptoms in patients with Alzheimer’s disease (AD), which mutually exacerbates the progression of AD. Currently, western medicine treatment relies primarily on symptomatic management using sedative-hypnotics agents and melatonin receptor agonists; however, their efficacy is limited, and they are associated with adverse effects and potential drug dependence. In traditional Chinese medicine (TCM), sleep disorders in AD fall into the category of “Bu Mei” (insomnia), with treatment emphasizing syndrome differentiation and individualized therapies including herbal medicine, acupuncture, and moxibustion. In recent years, the integrated traditional Chinese and western medicine has demonstrated unique advantages in managing sleep disorders in AD. Through complementary strengths, it has achieved practical progress in improving sleep quality, delaying cognitive decline, and reducing the adverse effects of western drugs. This review systematically outlines the pathophysiological mechanisms underlying sleep disorders in AD from both TCM and western medical perspectives, reviews integrated treatment strategies, and discusses current challenges,with the aim of providing evidence-based guidance for clinical practice and future research.