Expert Advice：What to Do When Dementia Patients Sleep Too Much

Written by Nguyenjessica

Published on February 11 , 2025

Excessive sleeping in dementia patients is a common yet complex issue. As the disease progresses, changes in sleep patterns can indicate deeper cognitive decline. In this article, we explore whether excessive sleep is a sign of dementia, the most common sleeping positions linked to cognitive health, and how sleep aids can help manage these challenges. We also examine how different stages of dementia influence sleep habits, from excessive napping to full-day sleep cycles. Understanding these changes can help caregivers provide better support for dementia patients, improving both their quality of life and sleep.

Key Points

1.It's common for individuals with dementia to sleep more, particularly in the later stages of the condition. As the disease progresses, brain damage becomes more significant, leaving individuals weaker and more fatigued.

2.Sleeping on your side may help the brain effectively clear waste products, including beta-amyloid, a protein linked to Alzheimer’s disease.

3.Managing Sleep Issues in Dementia Patients: Effective sleep aids and lifestyle adjustments, including structured routines and environmental changes, can improve sleep quality and support the well-being of dementia patients.

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Table of content

Is excessive sleeping a sign of dementia?

Is it normal for dementia patients to sleep a lot?

What is the best sleep aid for dementia patients?

What is the best sleeping position to avoid dementia?

What sleep position is linked to dementia?

What stage of dementia is associated with a lot of sleeping?

Is excessive sleeping a sign of dementia?

Excessive sleep, particularly daytime sleepiness, has drawn attention for its possible connection to dementia and Alzheimer's disease. Research suggests that changes in sleep patterns, especially prolonged sleep or frequent naps, might be early indicators or contributing factors for these conditions.

Studies have shown that people who transition from shorter to longer sleep durations—specifically sleeping more than nine hours a night—may face a higher risk of developing Alzheimer’s. Similarly, those who consistently sleep over nine hours a day appear to have a greater likelihood of developing dementia compared to those who sleep less.

Daytime sleepiness, often marked by an overwhelming urge to nap, has also been linked to Alzheimer's pathology. Elevated levels of beta-amyloid, a protein associated with Alzheimer's, have been observed in individuals experiencing excessive daytime drowsiness. Such sleep disruptions are not limited to Alzheimer's but can also be seen in vascular dementia, where changes in sleep patterns may signal the onset of the disease.

Excessive daytime sleepiness (EDS) is particularly pronounced in patients with mild dementia with Lewy bodies, even more so than in those with Alzheimer’s or frontotemporal dementia. In later stages of dementia, increased sleep becomes a common occurrence, often reflecting the progression of the disease.

Interestingly, a study revealed a two-way relationship between daytime napping and cognitive decline. While frequent naps might point to a heightened risk of Alzheimer’s, the diagnosis itself can accelerate the tendency to nap excessively as individuals age.

It’s essential to remember that while these findings highlight a connection between sleep and dementia, they don’t imply that extended sleep directly causes these conditions. Other elements, like sleep quality or underlying health issues, play a significant role. If you’re concerned about your sleep habits or notice changes, reaching out to a healthcare professional can provide clarity and guidance.

Healthy sleep patterns are vital not only for overall well-being but may also play a role in maintaining cognitive health.

Is it normal for dementia patients to sleep a lot?

It's common for individuals with dementia to sleep more, particularly in the later stages of the condition. As the disease progresses, brain damage becomes more significant, leaving individuals weaker and more fatigued. Even basic activities like eating or communicating can become exhausting, leading to longer periods of sleep during the day.

Dementia can also disrupt the body’s natural sleep-wake cycle, known as the circadian rhythm. For those with Alzheimer’s disease, damage to the suprachiasmatic nucleus (SCN)—the brain's internal clock—can make it difficult to maintain a regular 24-hour cycle. This often results in excessive daytime sleepiness and less restful sleep at night.

In vascular dementia, altered sleep patterns, including extended sleep, are also quite common. Additionally, some medications prescribed to manage dementia symptoms may cause drowsiness, contributing to more frequent or prolonged sleep.

To improve sleep quality for individuals with dementia, creating a calm and soothing environment is key. Establishing a consistent bedtime routine, limiting daytime naps, encouraging physical activity, and arranging social interactions can all support healthier sleep habits. These steps not only help with sleep but also improve overall well-being.

Maintaining a structured and supportive environment can make a world of difference for those living with dementia.

What is the best sleep aid for dementia patients?

Improving sleep quality in individuals with dementia can involve a combination of medications and lifestyle adjustments. It's essential to consult a healthcare provider before using any sleep aids to ensure they are safe and appropriate.

Pharmacological Options

Zolpidem: This medication can improve sleep and help with nighttime wandering by calming the brain via GABA receptors. However, its safety and long-term effects are still debated, with some studies suggesting it may increase dementia risk.
Suvorexant: An insomnia drug shown in trials to extend sleep duration and reduce nighttime wakefulness.
Melatonin: Helps regulate the sleep-wake cycle and can increase sleep duration.
Other medications: Drugs like antipsychotics (olanzapine, risperidone), benzodiazepines (lorazepam, clonazepam), and antidepressants (amitriptyline, doxepin) may assist with sleep but often come with side effects, so they must be used cautiously.

Non-Pharmacological Options

Light Therapy: Mimics natural light to regulate the body's internal clock, improving sleep patterns in a noninvasive way.
Exercise: Regular activity can enhance mood and promote better sleep quality.
Social and Physical Activity: Planned activities, including caregiver support, can modestly improve nighttime sleep.
Specialized Bedding: Beds, pillows, and mattresses designed for comfort can aid restful sleep.
Environmental Adjustments: Reducing noise and dimming lights at night creates a calming atmosphere.
Sensory Practices: Techniques like aromatherapy, massage, and multi-sensory stimulation can help relax the individual.
Structured Routines: Establishing consistent bedtime rituals, such as bathing or mouth care, encourages better sleep habits.

Non-pharmacological approaches are often tailored to the individual, focusing on the root causes of sleep disturbances. These methods provide a more person-centered way to address sleep issues without the risks associated with medications.

A thoughtful combination of medical advice and personalized care can significantly enhance sleep quality for those living with dementia, improving their overall well-being.

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What is the best sleeping position to avoid dementia?

Sleeping position may play a role in brain health and potentially reducing the risk of dementia, though more research is needed to fully understand this connection. Among the various sleeping positions, side sleeping, particularly on the left side, has shown some promise in benefiting brain health.

Why Side Sleeping Could Be Beneficial

Enhanced Waste Clearance: Sleeping on your side may help the brain effectively clear waste products, including beta-amyloid, a protein linked to Alzheimer’s disease. This position supports the glymphatic system, a mechanism responsible for removing toxins from the brain during sleep.
Improved Cerebrospinal Fluid Flow: Lateral sleeping (on your side) has been suggested to optimize the flow of cerebrospinal fluid, aiding the brain's natural detox process and potentially reducing the accumulation of harmful proteins associated with dementia.

What This Means

Adopting side sleeping, particularly the left side, may support the brain's health by enhancing its ability to eliminate waste and reduce the risk of dementia. However, sleep quality, duration, and consistent sleep patterns are also critical factors to overall health. If you’re considering changes to your sleeping position to support better brain health, consulting a healthcare professional can provide personalized advice.

What sleep position is linked to dementia?

Sleeping in the supine position (on your back) has been linked to a potential increase in the risk of dementia, including Alzheimer’s disease. Here's a breakdown of why this sleeping position might pose risks:

Reasons Back Sleeping May Be Problematic

Impaired Waste Clearance: Sleeping on your side, especially the left side, helps the brain clear harmful waste products like beta-amyloid, a protein associated with Alzheimer’s. In contrast, back sleeping may reduce the brain’s efficiency in clearing these substances, leading to their accumulation over time, which could harm cognitive health .
Glymphatic System Inefficiency: The glymphatic system, which flushes out toxins during sleep, is less effective in the supine position. This system plays a key role in maintaining brain health by clearing neurotoxins, but its activity is diminished when sleeping on your back .
Reduced Oxygenation: The supine position can lead to lower brain oxygen levels due to restricted blood flow and reduced lung efficiency, which may contribute to cognitive decline.

Key Findings from Studies

Harvard studies and other research have demonstrated a connection between back sleeping and increased levels of beta-amyloid in the brain, as well as greater cognitive impairment.
One study found that spending more than two hours per night sleeping on your back significantly increased the risk of developing dementia, particularly in older adults.

What This Means

While these findings are compelling, it’s important to note that the link between back sleeping and dementia is associative, not causal. Researchers are still investigating whether back sleeping directly contributes to neurodegeneration or if individuals with neurodegenerative conditions are more likely to sleep in this position due to other factors like reduced mobility .

What stage of dementia is associated with a lot of sleeping?

Increased sleep is often observed in the later stages of dementia, as the brain sustains more extensive damage and individuals grow weaker. Everyday tasks, such as eating or communicating, may become exhausting, leading to prolonged periods of daytime sleep .

Sleep Changes Throughout Dementia Stages

Later Stages: Sleep increases significantly. In advanced Alzheimer's, individuals may spend 40% of their nighttime awake and sleep for much of the day. In extreme cases, their sleep-wake cycle may reverse entirely, with more wakefulness at night and sleep during the day .
Early Stages: Sleep disturbances, such as difficulty falling or staying asleep, can occur even in the early stages of Alzheimer’s. These disruptions may be linked to changes in the brain's sleep-regulating systems .

Why Does Sleep Increase?

In the later stages, the brain's ability to regulate sleep-wake cycles diminishes. This, combined with physical and cognitive fatigue, contributes to excessive sleep during the day and disruptions at night .