Sleep Problems in Dementia, Practical Help for Carents

Medically Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed February 2026)

Do not automatically assume dementia is the cause of sleep problems. Always seek medical advice. Other conditions, such as delirium, pain, infection, or medication side effects, can also disrupt sleep and may be treatable.

Most commonly, the usual nighttime sleep pattern is reversed, leading to more daytime slumber and frequent nighttime awakenings.

A vicious cycle can soon arise with more daytime napping to compensate for lost sleep at night.

Falls can be a sign of a sleep problem, and sleep talking or frequent leg movements can also indicate problems.

Sleep problems in elderly parents with dementia usually develop due to a mix of factors:

• Changes in the brain caused by dementia

• Normal age-related changes in sleep

• Reduced daytime activity

• Less exposure to daylight

• Disrupted or new routines

Together, these can interfere with the body’s natural sleep-wake cycle..

As dementia progresses, sleep disruption often becomes more noticeable. Many people experience a reversal of their normal sleep pattern, sleeping more during the day and waking frequently at night.

This can create a difficult cycle. Daytime napping leads to poorer sleep at night, which then leads to more daytime exhaustion and sleep.

Signs that sleep problems may be developing include:

• Frequent night-time waking

• Increased daytime sleeping

• Night-time wandering

• Falls, especially overnight

• Sleep talking or repeated leg movements

• Increased confusion or agitation at night

If these symptoms appear suddenly, medical advice should be sought urgently.

Dementia sundowning is sometimes linked to night-time sleep problems. It refers to increased confusion, agitation, or restlessness in the late afternoon and early evening. For carents, this can be one of the most draining parts of the day.

Sundowning is thought to be linked to fatigue, low light levels, and difficulty processing the day’s events. Symptoms may include pacing, anxiety, repetitive questioning, or refusal to relax or go to bed.

Reducing afternoon stimulation, avoiding stimulants like caffeine or alcohol, keeping lighting bright as daylight fades, and maintaining a predictable late afternoon and evening routine can help. 

Calm activities, familiar music, or reassurance can ease anxiety. While sundowning may not disappear completely, these steps can reduce its impact and improve night-time sleep.

Many doctors recommend trying practical steps before medication.

Maintain a regular sleep schedule

Keeping regular times for meals, exercise, and bedtime helps reinforce the body clock. Clocks, calendars, and clear lighting can help someone distinguish between day and night. Dementia clocks that show the day and time can be especially helpful.

Increase daytime activity

Lack of meaningful activity can worsen sleep problems. Gentle exercise, household tasks, games, or anything familiar and enjoyable can help reduce daytime napping and improve night-time sleep.

Increase light exposure

Natural daylight helps regulate sleep hormones. Spending time outdoors or sitting near a window during the day can improve night-time sleep. Bright light in the morning is particularly helpful.

Review all medicines

Both prescribed and over-the-counter medicines can affect sleep. Some cause vivid dreams, nightmares, or daytime drowsiness. A GP or pharmacist can review medications and, in some cases, adjust timing to reduce night-time disruption.

Identify and manage other health problems

Pain, indigestion, breathing problems, or frequent urination can all disturb sleep. Managing these issues can significantly improve night-time rest.

Ensure sleeping areas are dark and quiet

A calm, dark, and quiet bedroom helps promote sleep. Some people find gentle white noise soothing.

Avoid stimulants

Limit caffeine, cigarettes, and alcohol, especially later in the day.

Consider a light evening snack

A small snack can prevent night-time hunger. Avoid heavy meals and limit fluids in the evening to reduce night-time bathroom trips.

Try a bedtime massage

Slow, gentle back massage before bed has been shown to improve sleep in people with dementia and can be calming for both person and carent.

Chronic sleep deprivation affects carers as much as the person with dementia. Interrupted nights can lead to burnout, depression, and physical health problems. Many carers feel guilty admitting they cannot cope, especially when night-time care becomes relentless.

If sleep problems are affecting your own health or safety, it is not a failure to ask for help. GP support, respite care, or community services can provide relief. For some families, ongoing night-time disruption is a key reason for considering residential care.

Recognising limits early can prevent crisis decisions later. Supporting the carent is part of supporting the person with dementia.

Night-time walking is a serious safety concern linked to dementia sleep problems. People may wake confused, attempt to leave the house, or fall while moving around in the dark.

Walking is common for people with dementia and often has meaning behind it. Our guide explains why it happens, the risks involved, and how to plan ahead if someone goes missing. It also includes information on The Herbert Protocol, a scheme the police use to help find people more quickly when they go missing.

Simple safety measures can reduce risk. Motion-sensor night lights, removing trip hazards, and using fall safety alarm pads or door alarms can alert carers if someone is moving around. Keeping essential items, such as the toilet or a glass of water, easy to find or access can reduce unnecessary wandering.

If walking becomes frequent, it is important to speak to a GP. Sudden changes may indicate infection, pain, or medication issues rather than dementia progression alone.

Medically reviewed by Dr Jackie Gray, February 2026