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.
There are several reasons why people with dementia sleep a lot. These include:
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.
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 People living with dementia often become less physically active and more withdrawn.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, 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.
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.
In New Zealand, there are a number of support services for the elderly which can be very helpful for people living with dementia.
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:
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.
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.
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:
Pain and skin care: Repositioning regularly, using pressure-relieving cushions, and applying soothing lotions help prevent discomfort and maintain skin integrity.
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.
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.
Signs of progression to watch out for include:
Monitoring these changes helps families prepare and seek appropriate care.
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.