Sleep disturbances are a common challenge for people living with dementia — especially when the brainstem is affected. In fact, around 40% of those with dementia experience disruptions to their sleep-wake cycle, often tied to changes in the autonomic nervous system.1
When sleep is poor at night, it frequently leads to increased napping during the day, particularly in chairs. While this might seem harmless, sleeping upright in the wrong chair can actually lead to serious health complications.
Inappropriate seating or poor posture — such as slouching or sliding down in a chair — can cause:
- Compression of the chest and abdomen, making it harder to breathe
- Shallow inhalation, increasing the risk of fluid pooling in the lungs
- Breathlessness and fatigue from inefficient breathing
- Reduced digestive efficiency, leading to reflux, constipation, and pain
- Heightened risk of aspiration or choking due to oesophageal obstruction
- Poor bladder emptying, increasing chances of UTIs and kidney infeections.2,3,4
Dementia and sleep issues go beyond restlessness. Sleep deprivation in dementia can contribute to:
- Daytime fatigue and reduced alertness
- Increased risk of falls
- Agitation, confusion, and behavioural changes
- Higher susceptibility to psychosis and insomnia
In addition, when brainstem damage impacts the autonomic nervous system, residents may face:
- Irregular heart rate and breathing
- Trouble regulating body temperature and blood pressure
- Decreased appetite and digestive disruption
Why proper dementia seating matters?
Clinical seating plays a key role in helping manage the health impacts of dementia and poor sleep. At Seating Matters, our chairs are purpose-built to support people with dementia — promoting upright posture, improving comfort, and reducing the risks of sliding, slouching, and associated health complications.
By encouraging better positioning during rest or naps, our chairs help reduce energy expenditure, support easier breathing, and improve overall wellbeing.
To learn more about how seating can make a meaningful difference for someone living with dementia, please see here.
FAQs: Dementia & Sleep
Yes, especially in the later stages of dementia. A disrupted sleep-wake cycle and reduced cognitive function can cause people with dementia to nap frequently or spend more time dozing during the day.
Sleep disturbances — such as restlessness at night or staying awake for long periods — typically appear in the middle to later stages of dementia. These may be due to changes in the brain that affect circadian rhythms and the ability to feel sleepy at appropriate times.
Sundowning refers to increased confusion, agitation, or anxiety that typically occurs in the late afternoon or evening. It can make it difficult for people with dementia to settle down or sleep through the night.
Maintain a regular daily routine
Encourage light exercise and exposure to natural light
Limit caffeine and alcohol
Ensure the sleep environment is quiet, dark, and calming
Use supportive, postural seating during the day to reduce fatigue and discomfort
References
1. Webster, L., Powell, K., Costafreda, S.G. and Livingston, G., 2020. The impact of sleep disturbances on care home residents with dementia: the SIESTA qualitative study. International Psychogeriatrics, 32(7), pp.839-847.
2. Osborne, L.J., Gowran, R.J. and Casey, J., (2023) ‘Evidence for 24-hour posture management: A scoping review’, British Journal of Occupational Therapy, 86(3), pp.176-187.
3. Heslop, P., Sinclair Blair, P., Fleming, P.J., and Hoghton, M. (2013) The Confidential Inquiry into Premature Deaths of People with Learning Disabilities, University of Bristol; UK.
4. Katz, S., Arish, N.A., Zaltzman, Y. and Marcus, E. (2018) ‘The effect of body position on pulmonary function: a systematic review’, BMC Pulmonary medicine, 159, https://doi.org/10.1186/s12890…
