Why Do Dementia Patients Sleep a Lot? What Oversleeping Can Mean and How to Help

Sleeping more is very common in people within the later and end-stages of dementia.^[01] A healthy sleep schedule is critical to the health, happiness, and ultimate well-being of seniors, so it’s important to address this and work to support proper sleep hygiene in your loved one.

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As dementia progresses, the damage to the brain becomes excessive, which makes a person with dementia feel weaker and more frail over time. It’s important to note that executive function changes in the frontal lobe of the brain can result in a lack of motivation, and what appears to be apathy. This can make seemingly easy tasks, like talking or eating, feel exhausting.

People with dementia may also experience drastic changes in their circadian rhythm, or the sleep-wake cycle, which works against their quality of sleep. The brain’s internal clock tells us when we should be alert and when we should sleep. In people with dementia, brain cells related to the sleep cycles are often impaired as a result of dementia-related brain damage.^[02] Sadly, this makes it more and more difficult for your loved one to follow a 24-hour sleep-wake cycle. So instead, they may sleep excessively during the day and less at night.^[01]

While excessive sleeping during the day is a fairly common symptom of dementia, there are a number of other factors that may also be contributing to a dementia patient’s poor sleep habits:

• Medications, such as some of those used to treat dementia symptoms
• Leaving lights on at night
• Difficulty differentiating between dreams and reality
• Untreated pain
• Excessive napping during the day time

Another possible cause is that your loved one is suffering from an underlying condition or a sleep disorder that disturbs their sleep at night, causing them to sleep through the day.^[02]The type and severity of sleep disturbances may vary depending on the cause and stage of your loved one’s dementia. The following conditions are especially common among dementia patients and can affect their sleeping patterns.

Restless legs syndrome (RLS)

Restless legs syndrome (RLS) is an overwhelming urge to move your legs. It’s especially common at nighttime, particularly in those with Lewy body dementia, and can disrupt sleep. This sleep disruption at night can make your loved one feel tired during the day, thus, causing them to sleep more during the day and throwing off their entire sleep schedule.

Periodic limb movement disorder (PLMD)

Periodic limb movement disorder (PLMD) causes uncontrollable movements of the arms or legs at night. Similar to restless legs syndrome, PLMD can disrupt a person’s sleep at night and make them want to sleep more during the day. Many people with PLMD also have RLS.

Obstructive sleep apnea (OSA)

Obstructive sleep apnea (OSA) affects a person’s breathing while they sleep, and nearly 40% of dementia patients experience it at some point. OSA essentially causes the person’s airway to collapse at night, which causes lapses in breathing and poor quality sleep.

Rapid eye movement (REM) sleep behavior disorder

Accounting for about 25% of a total night’s sleep, REM sleep is a phase in the sleep cycle that plays an important role in dreaming, memory, emotional processing, and healthy brain function. For most people during this stage of sleep, their bodies experience temporary paralysis so the brain can dream and process quietly and safely through the night. Someone with REM sleep behavior disorder doesn’t experience that moment of paralysis. Instead, they’ll sleep talk or act out their dreams, which causes disturbed sleep and poor sleep quality.^[03]

It’s important to note that people with dementia with Lewy bodies may be more likely to have REM sleep behavior disorder.

Depression

Elderly depression is common in seniors with dementia. It can impair cognitive and physical abilities, reduce quality of life, and affect their overall health. Although it’s a mood disorder, it’s also associated with sleep disturbances that include sleepless nights and daytime sleepiness.

Sundowning

Many elderly adults experience a phenomenon called sundowning or sundowner’s syndrome. This term describes a range of behaviors such as agitation, confusion, and restlessness that occur during the late afternoon and into the evening.

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Supporting healthy sleep hygiene and a regular sleep schedule can help manage your loved one’s sleep problems and promote their ultimate well-being. Just a little help can go a long way. Try incorporating the following tips to help your loved one get a good night’s sleep:

• Limit daytime napping
• Find ways to encourage your loved one to stay busy and exert energy during the daytime
• Limit caffeine to the morning hours
• Avoid alcohol
• Eat larger meals earlier rather than later, and keep evening snacks light and easily digestible
• Keep the bedroom temperature comfortable
• Keep dim nightlights in the hallways and bathrooms to help prevent confusion or disorientation
• Limit screen time before bed, or at least turn the screen brightness down as much as possible
• Keep noise levels as low as possible^[04]

Develop a bedtime routine

It’s important to develop a regular schedule for nighttime. You should consider doing the following:

• Stick to a set bedtime
• Create a calming ambience a couple hours before bedtime
• Offer sleep-supporting items, such as chamomile tea or essential oil aromatherapy for sleep ^[05]
• Always keep the lights low to create a soothing environment, with comforting objects or activities tailored to your loved one

Utilize bright light therapy

Recent research into bright light therapy for dementia patients also shows promising results to help get dementia patient’s sleep schedules back on track.^[06] Even if you don’t opt to buy a light therapy lamp, you can still help your loved one practice bright light therapy by simply taking them outside on sunny days. This exposure to sunlight earlier in the day can naturally support their sleep-wake cycle.

When to seek extra help

If you’re concerned that your loved one’s sleeping habits are causing them to become ill, and you’re at a loss on how to help them after trying everything, have them evaluated by their doctor. A doctor may help pinpoint the specific cause of the sleep disturbance, especially if it’s caused by an underlying health condition that requires treatment.

Over time, your loved one with dementia may require advanced support that you may not be able to provide, especially if your own health has become affected as a caregiver.

If you feel like you can no longer manage caring for your loved one, in-home care services and memory care communities are great options for seniors with dementia and other cognitive impairments. It can feel overwhelming to consider senior care for your loved one, but you don’t have to go it alone.

A Place for Mom’s Senior Living Advisors can offer free advice on senior care and connect you with local caregivers suited to your loved one’s individualized needs.