What stage of Alzheimer's is sleeping a lot?

Oct 29, 2025 3 min read •

caregiving Alzheimer's Disease Sleep Disorders

While disrupted sleep patterns can begin in early Alzheimer's, excessive sleeping is a hallmark of the later stages of the disease, when widespread brain damage causes frailty and exhaustion. Understanding what stage of Alzheimer's is sleeping a lot is important for caregivers, but it is also crucial to recognize other contributing factors like medication side effects, depression, or underlying infections.

Quick Summary

As Alzheimer's progresses, patients commonly sleep more, particularly in the later stages due to brain damage and reduced energy. Other causes include medication, depression, and disruptions to the sleep-wake cycle.

Key Points

Late-Stage Symptom: While sleep changes begin earlier, excessive sleepiness is a common feature of late-stage Alzheimer's due to extensive brain damage and physical decline.
Beyond Progression: Excessive sleeping may not always be due to disease progression; it can also be caused by medication side effects, depression, or underlying illnesses.
Disrupted Body Clock: Alzheimer's damages the brain's internal clock (circadian rhythm), leading to reversed sleep patterns with nighttime wakefulness and daytime sleepiness.
Exhaustion from Daily Tasks: In advanced stages, even simple activities like eating or communicating become mentally draining, causing fatigue and a greater need for sleep.
Warning Signs for Caregivers: A sudden and significant increase in sleeping should prompt a visit to a doctor, as it could indicate an infection or other medical problem.
Sleep and Brain Health Cycle: Poor sleep can accelerate the buildup of toxic proteins in the brain associated with Alzheimer's, creating a cycle that worsens both sleep and cognitive function.

Late-stage Alzheimer's and excessive sleep

Excessive daytime sleepiness becomes particularly common in the late stages of Alzheimer's and other dementias, as a person's physical and cognitive functions decline significantly. The widespread damage to the brain at this point means that even simple tasks like communicating, eating, or understanding their environment become profoundly exhausting. The body's biological clock, or circadian rhythm, becomes increasingly impaired, leading to a reversed sleep-wake cycle where the person is often awake and restless at night and sleepy throughout the day. This continuous cycle of poor sleep quality further contributes to daytime fatigue.

Caregivers often notice a significant increase in the amount of time their loved one spends in bed or napping. While this can be a difficult sign of advanced disease progression, it is important to ensure the individual is comfortable and safe. Lying down for long periods can lead to physical complications such as bedsores, so attentive care is necessary.

Other potential causes of increased sleepiness

While late-stage disease progression is a common reason for excessive sleep, a number of other factors can also be at play. A sudden increase in sleepiness is particularly concerning and should be evaluated by a doctor to rule out other medical issues.

Medical conditions

Sleep apnea: This condition, which causes pauses in breathing during sleep, is more common in older adults and can lead to poor quality sleep at night and fatigue during the day.
Restless legs syndrome (RLS): RLS causes an uncontrollable urge to move the legs, especially at night, disrupting sleep and leading to daytime tiredness.
Infections: Illnesses, such as urinary tract infections (UTIs), can lead to increased fatigue and confusion.
Pain: People with Alzheimer's may not be able to communicate they are in pain, which can disrupt sleep and cause them to withdraw and sleep more.

Psychological and environmental factors

Depression: It is common for people with Alzheimer's to experience depression, which can cause them to sleep more as a form of social withdrawal.
Lack of stimulation: A monotonous environment with little activity or stimulation can lead to boredom-induced napping and a confused sleep-wake cycle.

Medication side effects

Certain medications: Antipsychotics, antidepressants, and antihistamines, which may be used to manage other conditions, can cause drowsiness as a side effect. A medication review by a doctor can help determine if a change is needed.

Sleep patterns across Alzheimer's stages

Sleep disturbances are not exclusive to the late stages but manifest differently throughout the disease's progression.


Feature	Early Stage	Moderate Stage	Late Stage
Daytime sleepiness	Occasional napping may occur, but not usually excessive.	Napping becomes more frequent, often a result of disturbed nighttime sleep.	Excessive sleeping is common; the person may be tired throughout most of the day.
Nighttime sleep	Insomnia, waking up frequently, and difficulty falling or staying asleep are typical.	Fragmented and disturbed sleep patterns worsen; sundowning may occur.	Sleep cycles are often completely reversed, with the person sleeping for long periods during the day and being restless at night.
Underlying cause	Disruption of the brain's internal clock and early tau/amyloid plaque buildup.	Progression of brain damage; fatigue from navigating increased confusion.	Widespread brain damage and physical frailty; neurons regulating wakefulness are lost.

Impact of sleep disturbances on cognitive function

The relationship between Alzheimer's and sleep is complex and appears to be reciprocal. Poor sleep can disrupt the brain's ability to clear the beta-amyloid and tau proteins associated with the disease, potentially accelerating its progression. This creates a vicious cycle where Alzheimer's disrupts sleep, and poor sleep, in turn, worsens Alzheimer's pathology. Caregivers can help manage sleep changes by establishing a consistent daily routine, limiting excessive daytime napping, and ensuring the person gets plenty of natural light exposure.

Conclusion

While excessive sleeping is most characteristic of late-stage Alzheimer's, it is a complex symptom influenced by multiple factors, including brain damage, other health conditions, medication side effects, and environmental issues. For caregivers, a gradual increase in sleepiness often signals the natural progression of the disease and an increasing level of exhaustion from daily life. A sudden or dramatic change, however, warrants a doctor's evaluation to rule out other medical issues. Thoughtful, responsive care can help ensure the person's comfort and support their overall well-being as their needs evolve.

This article is for informational purposes and should not be considered medical advice. Always consult with a healthcare professional regarding specific medical questions. For comprehensive resources and support, you can visit the Alzheimer's Association website.

Frequently Asked Questions

Yes, it is very common for a person with Alzheimer's, especially in the later stages, to spend a lot of time sleeping. This is due to the extensive brain damage that makes daily activities profoundly exhausting and impairs the brain's ability to regulate the sleep-wake cycle.

While excessive sleeping is a feature of advanced Alzheimer's and may indicate the disease has progressed significantly, it does not always mean death is imminent. Other factors like illness, medication, or depression can also be responsible.

Aging typically involves some sleep fragmentation, but Alzheimer's-related sleep changes are more severe and progressive. In Alzheimer's, the brain's sleep-regulating centers are directly damaged, leading to reversed sleep-wake cycles, excessive daytime sleepiness, and nighttime restlessness.

Evidence suggests a reciprocal relationship between poor sleep and Alzheimer's. Research indicates that the brain clears waste proteins, like beta-amyloid, during sleep. Insufficient or poor-quality sleep can lead to an accumulation of these proteins, potentially accelerating the disease's progression.

You should consult a doctor if the increase in sleep is sudden or dramatic, especially if it is accompanied by other symptoms like fever, increased confusion, or refusal to eat. This could indicate an infection or a negative reaction to medication.

Caregivers can help by encouraging a consistent daily routine, ensuring plenty of natural light exposure, limiting daytime naps to short periods, and engaging the person in light physical activity. Checking for signs of pain or discomfort and reviewing medications with a doctor can also help.

Excessive sleepiness is most common in late-stage Alzheimer's. However, people with Lewy body dementia (LBD) often experience excessive daytime sleepiness even in the early stages, along with agitated, disturbed nights and vivid dreams.

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.