People with severe dementia sometimes begin to sleep more by day, only to awaken at night. The day-night mix-ups can disrupt an entire household.

Some tactics to cope:

  1. Always mention changing sleep habits to the doctor. You want to rule out causes other than the progression of dementia (such an infection or depression), since this change doesn’t happen with everyone.

  2. Beef up the bedtime routine. Habitual events like drinking warm milk, listening to soft music, and so on can provide sleep “cues” even if the person has slept earlier.

  3. Use “wake cues” to shorten daytime naps. These include not closing shades in the room, not keeping things extra quiet, and letting the phone ring several times before answering.

  4. Don’t let naps take place in bed. The sofa or a recliner will usually ensure shorter naps. If you have paid caregivers, ask them to strip the bed in the morning and make it up again at bedtime.

  5. Make sure that your loved one is exposed to daylight. In later dementia, people tend to be more bedbound and housebound. Getting morning light is important to help regulate the body’s internal clock, so try taking a walk (or pushing the person in a wheelchair) or sitting on a sunny porch.