The importance of sleep for seniors with dementia: Boosting memory and mood

A full night’s sleep is an everyday pleasure that we so often take for granted. Sleep patterns change as we age, and unfortunately, quality sleep often becomes more elusive for seniors with dementia. 

The struggle for a stable sleep routine brings significant challenges for those living with dementia, and for the caregivers who support them day and night. The ripple effects of sleep disorders in dementia can be felt in the mood swings, exhaustion, deeper confusion, and emotional strain that poor sleep triggers. 

At Cogir Senior Living, our personalized memory care approach prioritizes practices that address sleep deprivation with expertise and compassion. We’ve assembled a quick guide on why sleep matters so much for seniors with dementia, with some practical strategies to help improve it for your loved one at every stage.

Note: Early recognition and support for dementia are crucial to prepare for all of the cascading effects that come with it (including sleep issues) so exploring what memory care involves and how it can help seniors with dementia is your first step if you might be encountering signs of dementia for the first time. 

Why sleep matters for seniors with dementia

Sleep plays an essential role in preserving memory, emotional balance, and cognitive health. It is the body’s chance to heal – especially for the brain. An important nightly function that occurs during sleep is the removal of toxins and waste by-products that accumulate while we’re awake. 

During deep sleep, the brain’s glymphatic system becomes highly active, flushing out substances like beta amyloid, a protein linked to Alzheimer’s and other dementias. Research shows that when sleep is disrupted or too brief, beta amyloid can build up more quickly, further interfering with brain cell function and memory formation. 

For people with dementia, the struggle to achieve quality sleep means this essential “cleaning” process is less effective, accelerating neurodegeneration and making it even harder to preserve cognitive function and mood stability. 

This and other changes in the brain that come with aging can disrupt circadian rhythms (the body’s internal clock). The result is typically confusion between daytime and nighttime patterns, and ultimately poor sleep. 

According to research on managing sleep problems in Alzheimer’s disease from the National Institute on Aging (NIA), adults with dementia may experience fragmented sleep, frequent awakenings or periods of excessive daytime drowsiness. These fluctuations not only affect the individual’s memory and energy but can also wear down caregivers who may struggle to maintain their own rest.

The Alzheimer’s Association’s guide on sleep issues and sundowning notes that evening hours can be especially difficult. Many people with dementia become more agitated, restless or confused at dusk, a phenomenon known as “sundowning.” Factors such as mental exhaustion or heightened stress may make these behaviors worse. 

Families who understand these sleep challenges and their links to dementia progression early are better equipped to recognize worrisome patterns and seek help, before anyone’s safety or health becomes compromised.

Quick facts / key takeaways

• Why sleep is vital: Deep sleep supports the brain’s nightly “housekeeping” process, flushing away beta amyloid and other toxins that can accumulate and harm brain cells. This process protects memory, mood, and overall cognitive health. When seniors with dementia experience poor sleep, these restorative processes are disrupted, leading to greater confusion, agitation and accelerated cognitive decline.
  
• Common disturbances: People living with dementia often experience disrupted circadian rhythms, making it hard to stay awake during the day and fall asleep at night. Common sleep disorders in dementia include insomnia, excessive daytime napping, frequent nighttime awakenings, and evening agitation known as “sundowning.”
  
• Signs to watch for: Look for increased restlessness after sunset, reversed sleep patterns (awake at night, drowsy during the day), or excessive sleeping. These can all indicate worsening sleep disturbances linked to dementia progression.
  
• When to seek help: If your loved one’s sleep issues become persistent, lead to exhaustion or safety concerns, or begin to overwhelm caregivers, it may be time to explore professional memory care support. Expert programs can provide structure and therapies to promote healthier sleep routines.
  

For more information specifically regarding sleep issues connected to sundowning, we suggest consulting the Alzheimer’s Association’s guide on sleep issues and sundowning.

Causes & triggers of sleep disturbances

Dementia can significantly affect how the brain regulates sleep, influencing everything from melatonin production to nighttime alertness. Seniors may struggle with a “mixed-up internal body clock,” a common challenge detailed by the NIA’s discussion on sleep and older adults, leading to difficulties distinguishing day from night. 

Certain stages of dementia bring distinct sleep problems. For example, sleep disruptions such as staying awake for long periods at night are more prevalent in mid- to late-stage dementia, while vascular dementia is often linked with excessive sleeping or daytime drowsiness.

Sleep disturbances in dementia can stem from multiple triggers, including:

• Medication side effects: Antidepressants, antihistamines, antipsychotics and certain Parkinson’s medications can cause drowsiness or disrupt normal sleep patterns​.
  
• Physical discomfort: Pain from arthritis, frequent urination (nocturia), restless leg syndrome and sleep apnea can disrupt sleep.
  
• Brain changes: Damage to areas of the brain that regulate sleep-wake cycles directly impacts circadian rhythms​.
  
• Mental health factors: Depression and anxiety, both common in dementia, can worsen sleep quality and increase fatigue​.
  
• Environmental stressors: Noise, inadequate lighting, unfamiliar surroundings or overstimulation late in the day can all trigger restlessness or confusion​.
  
• Reduced melatonin production: As dementia progresses, the brain produces less melatonin, the hormone crucial for regulating sleep cycles. This results in a compromised sleep routine.

Understanding your loved one’s unique sleep pattern and possible triggers is a crucial step toward finding meaningful solutions with a doctor.

Symptoms & sleep behaviors to watch for

We hear the question all the time: “Why do people with dementia sleep so much?”

Sleep patterns change because dementia disrupts the areas of the brain responsible for regulating sleep and wakefulness. As dementia progresses, neurodegeneration interferes with the body’s circadian rhythms. This is the core of what leads to seniors with dementia being sleepy during the day and agitated at night. 

This need for more sleep can be exacerbated by physical tiredness, diminished brain activity, reduced engagement or inflammation. Other contributing factors include physical inactivity, medication side effects, metabolic changes or co-existing medical problems. 

For some, these changes and accumulating factors escalate until a senior with advanced dementia sleeps nearly all day. This situation, as detailed by the Alzheimer’s Society’s advice on end-stage dementia, is a common aspect of the later phases of dementia. Excessive sleeping is most commonly seen in moderate to late-stage dementia, but can also occur in more specific types of dementia like Lewy body or vascular dementia. 

It’s important to note that not all excessive sleep is solely caused by dementia. Underlying infections, pain, depression or sleep apnea can further worsen sleep quality and quantity.

Common sleep behaviors and symptoms to monitor:

• Daytime naps becoming routine or excessive
  
• Long stretches of sleeping during both day and night
  
• Nighttime confusion or agitation (“sundowning”)
  
• Insomnia or difficulty falling asleep
  
• Frequent nighttime awakenings
  
• Pacing or wandering at night
  
• Apparent fatigue or lack of energy during daytime hours
  
• Reduced participation in daytime activities
  
• Sleeping in unconventional places (e.g., chairs, couches, dining tables)
  
• Changes in alertness: alternating between periods of over-alertness and lethargy
  
• Noticeable changes following medication adjustments
  
• Restlessness, agitation or irritability upon waking
  
• Worsening memory, mood and overall functioning with poor sleep

Persistent sleep deprivation can amplify other symptoms, resulting in greater memory loss or deeper swings in mood. It’s crucial to rule out other underlying medical problems, infections or medication effects with a doctor, as these can also play a significant role in excessive sleep or fatigue. 

For more support on knowing when and how to intervene, the NIA’s guide on coping with sleep problems in dementia offers caregiver-friendly checklists and tools.

Care tips for families

Improving sleep quality in seniors with dementia begins with a holistic, supportive approach — something deeply embedded in Cogir’s Connections memory care program, which tailors daily routines, environment, and activities to each resident’s unique needs.

How can you help your loved one get a better night’s sleep at home? Here are some simple strategies that can make a meaningful difference in your loved one’s sleep.

Environment

Creating a dementia-friendly sleep environment is key for encouraging better sleep. A quiet, calm and dimly lit bedroom can reduce restlessness and confusion during the evening hours. Keep the sleeping area uncluttered and comfortable. Use supportive bedding. Ensure the room’s temperature is cool but not cold. Red nightlights can help reduce nighttime disorientation when your loved one wakes to go to the bathroom.

Routine

A consistent daily schedule helps signal when it’s time to wind down for sleep. Encourage your loved one to wake, eat meals, and go to bed at the same times each day, even on weekends. Establish gentle, familiar bedtime rituals: listening to soothing music, reading, or taking a peaceful bath. These rituals reinforce cues for bedtime.

​​Therapies

Therapeutic supports that engage the senses can soothe anxiety and ease the transition to sleep in the evening. Calming aromatherapy, gentle hand massages, or even activities involving music all serve therapeutic purposes to help your loved one cope with dementia and its effects. For more insight into how music supports memory and relaxation, see Cogir’s look at the benefits of music programs for seniors with dementia. 

Encouraging light exercise like walks during the day helps reinforce the body’s circadian rhythm. Proper daylight exposure can also help improve nighttime rest.​ 

Natural supports

Non-pharmacological, natural sleep strategies are trusted first-line options for most families. Limit caffeine, alcohol, and nicotine, especially in the afternoon and evening. Ensure plenty of sunlight and activity during the day. Use weighted blankets or comfort objects for added security at night. 

Melatonin or herbal supplements may be considered, but always with guidance from a healthcare professional to ensure safety with other medical conditions or medications.​

When to seek memory care support

Challenges like persistent sleep disturbances or frequent nighttime wandering could be signs that it may be time for memory care. If sleep issues escalate to increased safety risks, such as attempts to wander outside at night or repeated falls, or if caregiver exhaustion becomes overwhelming, a memory care community can offer meaningful relief.

Specialized memory care services can help ease the load, providing expert support, safety monitoring and evidence-based strategies for better sleep. 

Conclusion

Quality sleep isn’t a luxury. It’s a necessity for brain function, mood regulation and safety,  especially for people living with dementia. With the right information and tools, families can create environments and routines that help their senior loved ones feel safer and better-rested, all while easing the burden on themselves as caregivers. 

At Cogir Senior Living, memory care programs are designed with evidence-based approaches, compassion, and the practical needs of both residents and families in mind.

Ready to take the next step and find a memory care solution? Ask these essential questions as you explore memory care communities.

And remember: caregivers deserve support, too. Explore some essential self-care strategies for dementia caregivers to help replenish yourself in this process.

Learn more about memory care at Cogir Senior Living, or contact us today to schedule a tour and see how our programming can support your loved one’s well-being.