Sleep Problems in Dementia: What Helps and When to Ask for Advice

Sleep problems are common in dementia, although they vary from person to person. Some people wake often during the night. Others sleep more during the day, feel unsettled in the evening or become confused about whether it is day or night.

For families, this can be one of the most tiring parts of dementia. Poor sleep affects everyone. The person living with dementia may feel more anxious, confused or low in energy the next day, while family carers may be trying to manage daily life on broken sleep.

The good news is that sleep problems are not always something families simply have to put up with. Sometimes small changes to routine, light, comfort, activity and evening habits can help. Sometimes there may also be a medical reason that needs checking.

At The Ness Care Group, we work every day with people living with memory changes, mild cognitive impairment and dementia. As Devon’s specialist provider of clinically led dementia and Cognitive Stimulation Therapy support, we often speak with families who are trying to understand changes in sleep, routine, confidence and day-to-day wellbeing.

Why can dementia affect sleep?

Sleep is shaped by many things, including the brain, body clock, light, activity, comfort, medication and general health.

Dementia can affect the body clock, which is why some people may feel sleepy during the day and more awake at night. A person may wake up unsure where they are, what time it is or whether they should be getting ready for the day.

Sleep may also be affected by:

• pain or discomfort
• needing the toilet during the night
• constipation
• medication side effects
• anxiety or low mood
• too much daytime sleep
• not enough daylight
• lack of activity
• sleep apnoea or other sleep conditions
• an unfamiliar or confusing bedroom environment

This is why it helps to look at the whole day, not just bedtime.

What is sundowning?

Some people with dementia become more unsettled later in the day. This is often called sundowning.

It can include increased confusion, anxiety, restlessness, pacing or distress in the late afternoon, evening or night.

Sundowning can feel worrying for families, but it is not a sign that nothing can be done. Often, the most helpful first step is to look for patterns.

Does it happen at the same time each day? Could the person be tired, hungry, uncomfortable, overstimulated or unsure what is happening next?

A calm, familiar evening routine can often help the person feel safer and more settled.

Practical ways to support better sleep

There is no single answer that works for everyone, but small changes can make a real difference.

Keep the daytime routine active

A structured day can help the body understand the difference between day and night.

This does not mean filling every minute. A short walk, gentle movement, helping with a simple task, spending time with others or going to a familiar group can all help create a clearer rhythm to the day.

Get natural daylight

Daylight helps support the body clock. Time outside can be helpful, even if it is just sitting in the garden, walking to the end of the road or spending time near a bright window. Dementia UK also gives helpful guidance on dementia and sleep, including practical ways to support a better daily rhythm.

Watch daytime naps

Some people with dementia need rest during the day, especially after a poor night. But long or late naps can sometimes make night-time sleep harder.

If sleep is difficult at night, it may help to keep naps earlier in the day and not too long.

Make evenings calmer

Evenings can feel more confusing when someone is living with dementia. Keeping the routine familiar can help.

Try reducing background noise, drawing curtains before it gets dark, putting lights on early and avoiding television that may feel distressing or overstimulating.

A warm drink, calming music, familiar photos or gentle conversation may help some people settle.

Make the bedroom easier to understand

If someone wakes in the night, a few changes to the bedroom can help them feel less disorientated.

Helpful changes may include:

• a clear clock that shows day and night
• a nightlight
• easy access to the toilet
• comfortable bedding
• a safe, clear route through the room
• reducing shadows where possible

Small practical changes can make the room feel safer and easier to understand.

When should families ask for medical advice?

It is worth speaking to a GP or community nurse if sleep problems are ongoing, getting worse, causing safety concerns or leaving the person or family exhausted.

It is especially important to ask for advice if there is a sudden change. Sudden confusion, new distress, signs of pain, fever, dehydration, falls or possible infection should not be assumed to be “just dementia”.

Sleep problems may sometimes be linked to pain, medication, low mood, infection, sleep apnoea or another health issue. Getting this checked can make a real difference.

Sleeping tablets are not usually the first answer for dementia-related sleep problems. They can sometimes increase risks such as falls, confusion and daytime drowsiness, so medication should always be discussed with a clinician.

How The Ness Care Group can help

Sleep problems in dementia rarely sit in isolation. They are often connected to the whole day: routine, confidence, activity, anxiety, social connection, physical comfort and how supported the family feels.

This is where specialist dementia support can make a real difference.

The Ness Care Group provides clinically led dementia and cognitive health support across Devon. Our work is built around structured therapy, including Cognitive Stimulation Therapy, meaningful activity, small groups and practical guidance for families.

At our Memory Hubs, we support people living with memory changes, mild cognitive impairment and early to mid-stage dementia through sessions that are carefully planned, purposeful and led by people who understand dementia properly.

A better daytime rhythm can often help evenings and nights feel more settled. Regular structure, social connection, movement, conversation and purposeful activity can all support wellbeing and reduce the sense of uncertainty that dementia can bring.

For families, this matters too. When sleep is broken, everyone feels it. Having specialist support in place during the day can give families reassurance, practical guidance and time to breathe, while helping the person living with dementia stay active, connected and involved.

If sleep problems are sudden, severe or linked to pain, infection, medication or another health concern, it is important to speak to a GP. But for families trying to understand how dementia is affecting daily life, routine and confidence, The Ness can help you look at the bigger picture and find the right support earlier.

What to do next

Sleep changes can feel unsettling, but they are often a useful signal that something in the day, routine, environment or health picture may need adjusting.

Start by noticing patterns. When does the person become more unsettled? Are they tired, hungry, uncomfortable, anxious or confused by the change from day to evening? Small changes to daylight, activity, naps, bedroom layout and evening routine can sometimes make a real difference.

If sleep problems are sudden, severe, getting worse or affecting safety, speak to a GP or community nurse. It is always worth checking whether pain, infection, medication or another health issue could be involved.

And if dementia is starting to affect the whole household, you do not have to work it all out alone. Specialist dementia support can help families understand what is happening, build a better daily rhythm and find practical ways to support the person living with dementia.