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.