Dementia can cause a wide range of behavioral changes, including how and when a person sleeps. It’s common for people with dementia to start sleeping more than they used to, especially as the disease progresses toward its late stages.
It’s important for families and caregivers to understand how dementia impacts sleep so that they can build appropriate care plans, support healthy sleep patterns, and know what to expect at each stage of disease progression with their loved ones.
In this guide, we’ll explain why dementia changes sleep patterns, share tips on how caregivers can offer support, and discuss how each stage of dementia affects sleep differently.
- What's Normal: Understanding Sleep and Dementia
- What Stage of Dementia Causes Excessive Sleeping?
- Reasons for Increased Sleep in Dementia Patients
- Red Flags: When Excessive Sleeping May Signal a Problem
- How Caregivers Can Support Healthier Sleep Habits
- Knowing When to Seek Professional Support
- FAQs About Dementia Sleep Patterns
What’s Normal: Understanding Sleep and Dementia
Does a person with dementia sleep a lot? And how much sleep is normal? Due to changes in the brain, it’s common for people who have dementia to start sleeping more than they used to. However, the amount of sleep that’s considered “normal” varies from person to person.
The amount of sleep needed for a person with dementia depends on factors like what stage of dementia they have reached, along with their overall mental and physical health.
What Stage of Dementia Causes Excessive Sleeping?
Dementia progresses in three main stages: early-stage (mild) dementia, middle-stage (moderate) dementia, and late-stage (severe) dementia. Each stage of dementia causes different cognitive and physical effects, including effects on sleep and wakefulness.
Early-Stage Dementia
In the early stages of dementia, you might notice your loved one starting to sleep more than they used to. This may involve sleeping longer in the evening and/or taking more frequent naps during the day.
Mid-Stage Dementia
As dementia progresses toward the middle stages, the sleep-wake cycle becomes disrupted, resulting in increased insomnia and nighttime wakefulness.
Late-Stage Dementia
In the advanced stages of dementia, it’s common for loved ones to wake throughout the night and take longer, more frequent daytime naps. This is caused by disturbances to the sleep-wake cycle, which is regulated by circadian rhythms and the brain’s internal clock.
Reasons for Increased Sleep in Dementia Patients
Why do dementia patients sleep so much? There are many different factors that contribute to dementia patients sleeping more, including (but not limited to):
- Coexisting sleep disorders
- Medication side effects
- Mental or mood disorders
- Dementia-related disruptions to normal circadian rhythms
Sleep patterns are also affected differently depending on what type of dementia the person is diagnosed with. Let’s take a closer look at how these and other factors can lead to increased or irregular sleep patterns.
Type of Dementia
There are more than 100 different kinds of dementia, including Alzheimer’s disease, frontotemporal dementia, vascular dementia, and dementia with Lewy bodies. These distinctions are important for caregivers to be aware of because different types of dementia affect sleep patterns differently.
For example, Alzheimer’s disease tends to cause progressive (i.e., gradually increasing) sleep disturbances, while vascular dementia is characterized by daytime fatigue with fragmented sleep at night. Lewy body dementia, which involves irregular buildups of protein in the brain, frequently causes vivid dreams and excessive daytime sleepiness.
Brain Changes & Circadian Rhythm Disruption
During sleep, the brain’s glymphatic system clears away harmful proteins known as tau and amyloid proteins. When sleep is irregular, this process becomes less effective, creating a vicious cycle that both worsens dementia and increases sleepiness.
Dementia also damages a brain structure called the suprachiasmatic nucleus (SCN), which controls our internal clock and sense of time. These brain changes can reduce the amount of deep, restorative sleep the person is able to get. They can even reverse the sleep-wake cycle, which may lead to conditions like irregular sleep-wake rhythm disorder (ISWRD).
Coexisting Sleep Disorders
Certain medical conditions tend to occur together, such as heart disease and high blood pressure, or depression and anxiety. These co-occurring conditions are known as “comorbidities.”
Dementia has its own set of comorbidities, which commonly include sleep apnea, restless leg syndrome, and REM sleep behavior disorder (RBD), which causes people to shout, kick, thrash, or physically act out in their sleep. These disorders interfere with regular sleep patterns, which can result in daytime drowsiness and severe fatigue.
Medications & Side Effects
Doctors may prescribe a variety of medications to ease dementia-related symptoms, including sedatives, antidepressants, antipsychotics, antihistamines, and cholinesterase inhibitors, which strengthen communication between brain cells.
These medications can help your loved one enjoy a better quality of life, but they can also produce a wide range of side effects. Depending on the medication and individual, these side effects can include drowsiness, fatigue or insomnia.
Physical Illness or Frailty
Infections, chronic pain, physical frailty and dehydration-related health issues are common in people with dementia, particularly during the late stages of the disease.
These types of illnesses and injuries increase the person’s need for rest, while at the same time, makes it harder for them to fall and stay asleep. This can lead to some people with dementia sleeping as much as 14 to 15 hours per day, while also experiencing higher levels of daytime fatigue.
Mental Health and Emotional Withdrawal
Dementia patients often develop mental health disorders like anxiety and depression. In addition to causing social and emotional withdrawal, these types of disorders can seriously disrupt sleep patterns by causing insomnia, excessive sleep, and feelings of daytime fatigue.
Combined with the mental effort needed for everyday tasks, those with dementia may be left feeling exhausted and overwhelmed. This can lead to effects like frequent napping, sleeping at irregular times, or having trouble staying asleep at night.
Red Flags: When Excessive Sleeping May Signal a Problem
Is excessive sleeping a sign of dementia? Not necessarily, and not in every case. But there are some specific red flags to watch out for if your loved one is sleeping more than usual. Warning signs of excessive sleep due to dementia can include:
- Sudden or abrupt increases in sleep
- Sleeping more than 16 hours per day
- Skipping meals or hygiene routines due to fatigue
- Becoming less responsive or harder to wake from sleep than normal
If you notice any of these changes in your loved one, you should promptly seek medical attention from a healthcare provider.
How Caregivers Can Support Healthier Sleep Habits
There are many different ways that family caregivers and home health aides can help dementia patients establish healthier, more restful sleep habits. Some of the most effective tips include:
- Building a consistent daily routine
- Encouraging daytime activities
- Monitoring medications and mealtimes
- Controlling exposure to light
Here’s how you can use each of these strategies to help your loved one enjoy more restful evenings and experience less daytime sleepiness.
Creating a Consistent Daily Routine
Building a predictable daily routine can help loved ones with dementia establish more stable sleep patterns. By setting and sticking to scheduled times for daily activities like waking up, eating, and going to bed, caregivers can help loved ones with dementia sleep and rise at consistent hours.
Not only is routine important for sleep quality, but it also lowers the risk of mortality, with one study finding that “consistency across nights in sleep-wake timing may be more strongly related to mortality risk than sleep duration.”
Using Light and Environment Effectively
Light exposure has proven effects on the way people sleep and rise, which is why sleep experts recommend limiting screen time before bed.
For people with dementia, light can have an especially powerful impact. Dementia caregivers can support stable sleep rhythms by providing bright light exposure early in the morning, natural light exposure during the day, and gentle lighting during the evening. It’s also important to create quiet, tranquil sleeping environments that promote rest and relaxation.
Caregivers may also need to manage a common dementia symptom called sundowning, where the transition from day to night causes increased confusion and agitation, with some experiencing additional symptoms like difficulty sleeping, hallucinations and disorientation. Although doctors don’t know exactly what causes sundowning, they do know that certain activities can reduce it, such as limiting caffeine and sugar intake, reducing background noise and stimulation in the evening, and using a nightlight for when surroundings are dark or unfamiliar.
Encouraging Daytime Activity and Engagement
We usually think of fatigue as something negative or unwanted, like when a person feels tired because of an illness or disorder. However, there’s also healthy fatigue, like how you feel after completing a workout or challenging study session.
By encouraging your loved one to be mentally and physically active during the day, you can promote healthy fatigue and make it easier for them to rest at night. Some examples of daytime activities for people with dementia include doing puzzles, going for supervised walks, and listening or singing to music.
Monitoring Diet, Hydration, and Medications
Factors like dehydration, hunger or malnourishment, and medication timing can all impact the sleep patterns of a person with dementia. Sleep patterns can also be disrupted by the consumption of alcohol, caffeine, or even heavy meals prior to bedtime. This makes it vital for caregivers to monitor their loved ones’ food and drink intake, as well as medication schedules.
Knowing When to Seek Professional Support
It’s important to consult a healthcare professional if you notice any sudden or persistent changes to your loved one’s sleeping habits, such as excessive sleeping, new and persistent insomnia or frequent daytime drowsiness.
There are a variety of care services and medical professionals who may be able to offer support for dementia-related sleep changes, such as neurologists (doctors who specialize in the brain), sleep clinics, and memory care providers.
Frequently Asked Questions About Dementia Sleep Patterns
How can dementia-related sleep problems affect caregivers?
Dementia-related sleep problems don’t just impact the patient; they also affect family caregivers. Research shows that compared to the general population, dementia caregivers are significantly more likely to experience anxiety and depression, which are both major risk factors for insomnia and other sleep disorders.
Additionally, responding to a loved one’s care needs can significantly disrupt a family caregiver’s sleep schedule, reducing their ability to provide care effectively. In these types of situations, respite care can offer crucial support.
What role does diet and hydration play in dementia sleep patterns?
Hunger and dehydration can cause effects like headaches, low mood, dizziness, and stomach pain that interfere with falling and comfortably staying asleep. These are major challenges for people with dementia, who often have difficulty staying adequately nourished and hydrated. It’s crucial for caregivers to track loved ones’ food and water intake carefully, especially during the hours leading up to bedtime.
Is there a link between dementia sleep problems and life expectancy?
Research shows that inadequate sleep can decrease anyone’s life expectancy, regardless of whether they have dementia. However, the risks are greater for dementia patients, who tend to be physically frail and have comorbid or underlying conditions.
A study published in Aging in 2024 concluded that “both short and lengthy sleep durations, as well as other disturbances, are associated with higher risks of mortality from all causes” in dementia patients.
How should caregivers track and monitor sleep changes in dementia patients?
Smartwatches, which can be comfortably worn during sleep, can help caregivers monitor loved ones’ sleep patterns by collecting detailed data in real time. Depending on the specific brand and model, smartwatches can provide data about the wearer’s heart rate, sleep times, and even their physical motions, including fall detection.
Smartwatches can also be combined with other wearable tech, such as GPS trackers, along with apps designed to support dementia patients and caregivers, such as Iridis, Medisafe, and Alzheimer’s Daily Companion.
Are there non-medication therapies that help dementia patients sleep better?
Yes. One common example is bright light therapy (BLT), which involves brief periods of daily exposure to a specially designed therapy lamp called a light box. Sessions can last anywhere from 10 to 90 minutes and produce the best results when conducted in the morning, ideally between 6 and 9 a.m.
Bright light therapy works by helping regulate circadian rhythms, which influence sleep-wake cycles but are irregular in dementia patients.
BrightStar Care Can Support You and Your Loved One Through Changing Sleep Patterns
Sleep changes like increased sleeping are regular parts of dementia’s progression, but can still be confusing and challenging for families to navigate. If you’ve been feeling overwhelmed or need professional caregiving guidance, BrightStar Care® is here to offer your family support.
With over 400 locations throughout the U.S., our award-winning network of licensed nurses and in-home caregivers offers flexible memory care, dementia care, and companion care services. We also have respite care services for family caregivers who need a temporary break from caregiving responsibilities.
Find a BrightStar Care near you or contact us to schedule a free consultation or learn more about how we can help provide compassionate, nurse-led care for those with dementia or Alzheimer’s disease.