Sleep and dementia

We all feel better when we get enough sleep. That’s also true for people living with dementia. But it’s common for people with dementia to have problems with their sleep, particularly in the earlier stages of dementia. This can have an impact on their day-to-day life and lead to changes in their behaviour.

If you’re caring for someone with dementia, you might notice they:

• sleep during the day
• have trouble falling asleep at night
• wake up a lot during the night
• sometimes struggle to tell if it’s day or night
• become inactive or need less sleep.

You might also find your own sleep disturbed, by stress, overtiredness and the duties of caring.

Causes of sleep problems in dementia

Dementia can cause changes in the brain that affect our internal “clock”, which helps our body to know what time it is and tells us to sleep at night-time. Ageing can also change sleep patterns, meaning that someone might need more or less sleep than they did before.

But there are also many other reasons why someone with dementia might have problems sleeping. These can include:

• pain
• physical or mental health conditions, including angina, diabetes, urinary tract infections, depression, leg cramps or “restless legs”
• side effects from medication
• snoring or sleep apnoea
• being overtired or not tired enough at bedtime
• feeling overstimulated, agitated or unable to relax
• being too hot or too cold
• feeling hungry
• not knowing where they are or where the bathroom is
• having bad dreams or nightmares.

What you can do

If someone close to you with dementia has sleep problems, there are things you can do to help.

Medical options

• Book an appointment with the person’s doctor to check whether physical illness, mental health conditions or medication side effects might be affecting their sleep.
• Keep a sleep log or diary to help identify sleep patterns.
• Ask the doctor about sleep medications, including any negative effects for people with dementia.
• Consider using pain relief at bedtime to reduce any pain.

Adjusting the bedroom

• Try to keep the bedroom at a constant temperature. If the person wakes up during the night, check whether they’re too cold or too warm.
• If they’ve moved house, put familiar objects in the bedroom.
• Use nightlights to softly light the room. This can also help if they struggle to find the bathroom, or you could try a commode or pot by the bed.
• Move or cover bedroom mirrors if the person can’t recognise themselves in the reflection.
• Put daytime clothes away at night. Seeing daytime clothes may make the person think it’s time to get up.

Planning the day

• If there are tasks or activities that are upsetting for the person, try to schedule them for the morning or early afternoon.
• Encourage them to exercise, as this can help with sleep. Try for one or two walks a day.
• Avoid too much sleep during the day.
• Limit caffeine, alcohol and screentime, particularly before bedtime.

Bedtime

• Try a calming back rub, if it’s appropriate.
• If a bath or shower is soothing, consider timing this for bedtime.
• Offer them a herbal tea or warm milk. You could also make them a snack if they’re waking up hungry.
• Play a radio or relaxing music by the bed.
• Gently remind them that it’s night-time and time to sleep.
• If they refuse to go to bed, offer an alternative such as sleeping on the couch.

If you’re caring for someone living with dementia, you might also find your own sleep is affected. Try to make sure you get enough rest and can take regular breaks.

It’s okay to take care of your own health and happiness. If you're struggling as someone who cares for a person with dementia, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night, for information, advice and support.