When June’s father, who was living with Alzheimer’s, began sleeping most of the day, the family worried it meant his condition was worsening. They wanted to understand why people with dementia sleep a lot, and whether it was something to be concerned about.

Why do people with dementia sleep a lot?

There are several reasons why people with dementia sleep a lot. These include:

• Brain changes that disrupt circadian rhythm: Dementia affects the brain’s ability to regulate sleep-wake cycles, leading to increased daytime fatigue and nighttime confusion.
• Medications and their side effects: Some medications used to manage dementia symptoms or related conditions can cause drowsiness.
• Depression or social withdrawal: Low mood and reduced motivation are common in dementia and can lead to a person wanting to sleep more.
• Lack of stimulation: Without regular physical or cognitive activity, people with dementia may become less engaged and sleep more. Simple games that are suitable for people living with dementia can play an important role in supporting memory, lifting mood, and encouraging meaningful social connections.

Sleep changes are often expected, but the sudden onset of more or less sleep and day night reversal should be discussed with a healthcare professional.

What stage of dementia is sleeping a lot most common?

Sleeping a lot is most common as dementia progresses. People living with dementia often become less physically active and more withdrawn. Their bodies may begin to slow down, and sleep becomes a way to conserve energy.

The brain finds it more difficult to process stimuli and cope with noise, leading to increased fatigue and longer sleep periods. At this stage, people living with dementia often sleep more during the day due to these significant changes in brain function and reduced physical strength.

Vascular dementia and excessive sleeping: What’s different?

Vascular dementia, caused by reduced blood flow to the brain or stroke-related damage, can present differently from Alzheimer’s disease.

People with vascular dementia may experience intermittent fatigue, with sleepiness that comes and goes. This is often due to changes in areas of the brain responsible for alertness and awareness.

In contrast, Alzheimer’s disease tends to cause a gradual and progressive decline in cognitive function, often accompanied by increased daytime sleepiness as the disease advances. This sleepiness may become more persistent over time, especially in the later stages, as the brain’s ability to regulate sleep-wake cycles deteriorates.

Should you let a person living with dementia sleep all day?

While rest is important, sleeping for long periods during the day can disrupt nighttime sleep and contribute to day night reversal. It may also reduce opportunities for meaningful engagement. This can be stressful and physically draining for family members who are also coping with less sleep at night.

Gentle activity

• Encouraging gentle stimulation, such as short walks, music, or social interaction, can help maintain a healthy daily rhythm.
• It's often best to reduce larger events such as big family gatherings where the noise level and activity can become too much for the person.

Lighting can help

• Maximise exposure to natural light to help maintain day–night cues.
• At night time or in darker rooms, ensure the room is illuminated evenly to minimise shadows, which can cause distress.
• Avoid glare and reflections by using matte surfaces and diffused light sources.
• If appropriate, consider adding adjustable lighting with easy-to-use controls for the person living with dementia.

In New Zealand, there are a number of support services for the elderly which can be very helpful for people living with dementia.

Dementia, sleeping a lot and not eating: What it could mean

If someone with dementia is both sleeping a lot and not eating as much, it may indicate that they are entering the end stages of their dementia, but could also be due to:

• Medications and their side effects
• Delirium
• Dehydration
• Low mood or depression
• An undiagnosed medical issue

If these changes appear suddenly or worsen quickly, it’s important to consult a healthcare professional to rule out treatable causes and ensure the person receives appropriate care.

At what stage do people with Alzheimer’s sleep a lot?

Sleep patterns shift significantly across the progression of Alzheimer’s disease, reflecting changes in the brain’s ability to regulate rest and wakefulness.  Any change to a person’s physical health can cause a further change in their daily patterns. While sleep difficulties can begin in the early stages, excessive daytime sleeping is most common as the disease progresses. 

• Early stage: Difficulty falling or staying asleep. Sleep may be lighter and more fragmented, with frequent nighttime awakenings. Some people may also begin to nap more during the day, although this is not yet a dominant symptom.
• Middle stage: Increased fatigue and daytime napping. Sleep-wake cycles may become irregular, and the person may feel drowsy during the day but struggle to sleep at night. This stage often includes symptoms like sundowning, where confusion and agitation increase in the late afternoon and evening.
• Late stage: Extensive daytime sleep and reduced responsiveness. People living with dementia may sleep for up to 14-16 hours a day, due to widespread brain degeneration affecting the body’s internal clock and reducing energy levels.

End-stage dementia: sleeping all the time

 As the disease progresses, people will often sleep for most of the day and become increasingly unresponsive. This deep fatigue is part of the body’s natural process of slowing down. As brain function declines, even basic tasks like eating, communicating, or staying awake can become exhausting. Sleep may stretch across both day and night, with only short periods of wakefulness.

At this stage, the focus of care shifts from treatment to comfort, peace, and dignity. This can look like:

• Hydration: Offering small sips of water or ice chips to prevent dryness and discomfort, without forcing fluids.
• Soft, easy-to-swallow foods: Providing pureed or soft foods that are safe and soothing, especially as swallowing becomes more difficult.
• Gentle presence and reassurance: Sitting quietly with the person, holding their hand, playing familiar music, or reading aloud can offer emotional comfort even when verbal communication is no longer possible.

• Pain and skin care: Repositioning regularly, using pressure-relieving cushions, and applying soothing lotions help prevent discomfort and maintain skin integrity.

Understanding why people with dementia sleep a lot helps families provide better care

Understanding that sleep changes are a natural part of dementia’s progression can help families and caregivers respond with greater patience, empathy, and confidence. These shifts in sleep are signals of the brain’s changing needs and are to be expected.

Getting the right support can make a meaningful difference. Ryman offers dementia-specific living options that are designed to meet evolving needs. From tailored care plans to environments that promote calm and familiarity, Ryman’s approach centres on dignity, compassion, and quality of life at every stage of dementia.

Get some support

If you’d like to speak with our team to get some advice and support, please contact us by calling 0800 588 222 or send us a message and we’ll get in touch.

Frequently asked questions about dementia

What are the four common behaviours that people with dementia often exhibit?

As dementia progresses, changes in brain function can lead to changes in behaviour. These behaviours are often expressions of unmet needs, confusion, or emotional distress. They also reflect the brain’s declining ability to process information and regulate emotions.

Agitation

Agitation may appear as restlessness, irritability, pacing, or verbal outbursts. It can be triggered by pain, discomfort, overstimulation, or changes in routine. The person may be trying to communicate a need they can no longer express clearly. Calm reassurance, a quiet environment, and familiar routines can help reduce agitation.

Need to walk

The desire to walk is common but the person may become disorientated as to where they are going. There are several options available to help keep a person safe. A person may not recognise their own home any longer and want to walk to another house, such as their childhood home. It's important to have knowledge of a person's personal history and knowing where they may feel safe.

There are ways to support a person with dementia to walk safely, such as ensuring the environment is secure, using tracking discs in clothing, walking with the person regularly, or even joining a walking group for people living with dementia.

Confusion

Confusion affects orientation to time, place, and identity. Individuals may forget where they are, misidentify people, or become disoriented in familiar settings. This can lead to anxiety or fear. Gentle reminders, visual cues, regular routines, and frequent interactions can help maintain a sense of wellbeing.

Repetitive Questions

Repetition – asking the same question or performing the same action repeatedly – is often due to short-term memory loss or an underlying emotion such as anxiety. Instead of correcting them, offer reassurance and use tools like calendars, clocks, or written notes to remind the person. Creating a regular daily routine can also help to reduce anxiety.

Caregivers and family/whānau also need to remember to care for themselves and take breaks, as managing repetition can be emotionally taxing.

What are signs that dementia is getting worse?

Signs of progression to watch out for include:

• Increased memory loss
• Loss of independence
• Reduced appetite
• Sleeping more
• Difficulty communicating

Monitoring these changes helps families prepare and seek appropriate care.

What are the 7 stages of dementia?

The seven stages of dementia, as defined by the Global Deterioration Scale (GDS) developed by Dr. Barry Reisberg, outline the progression of cognitive decline from normal functioning to very severe impairment.

Stage 1 – No cognitive decline: The person shows no signs of memory loss or cognitive impairment. Daily functioning is normal, and there are no noticeable symptoms.

Stage 2 – Very mild cognitive decline: Minor memory lapses may occur, such as forgetting names or misplacing items. These changes are often dismissed as normal ageing and are not detectable in clinical evaluations.

Stage 3 – Mild cognitive decline: Friends and family many notice the person start to have trouble with word recall, organisation, or remembering appointments. This stage may mark the beginning of noticeable cognitive issues.

Stage 4 – Moderate cognitive decline: Clear signs of cognitive impairment emerge. The person may forget recent events, struggle with tasks like managing finances, and start to withdraw socially. A formal dementia diagnosis is often made at this stage.

Stage 5 – Moderately severe cognitive decline: The person begins to require help with daily activities. They may forget personal details like their address or phone number and become confused about time or place.

Stage 6 – Severe cognitive decline: Memory loss worsens significantly. The person may forget the names of close family members, need help dressing and bathing, and experience changes in sleep patterns and personality. Symptoms like agitation or wandering may appear.

Stage 7 – Very severe cognitive decline: In the final stage, the person loses the ability to communicate, walk, or control bodily functions. They may need full-time care and assistance with all aspects of daily living. Reflexes become abnormal, and swallowing may be impaired.

If you’d like to know how Ryman can help you or a loved one living with dementia, please contact us by calling 0800 588 222 or send us a message and we’ll get in touch.