Non-drug options for dementia-related sleep problems

The Bottom Line

  • Dementia commonly causes issues with sleep, which can worsen symptoms.
  • Non-drug options, like physical activity and social activities may help improve sleep problems for people living with dementia, but more research is needed.
  • If you are carer for a person living with dementia who is experiencing sleep problems, consider trying non-drug options to help with sleep in consultation with the person and their healthcare team.

Dementia, which can stem from a variety of diseases, impacts memory, thinking, and how a person is able to perform daily activities (1). It is estimated that about 1 in 4 adults aged 85+ have been diagnosed with dementia in Canada (2). For people living with dementia, experiencing problems with sleep can be all too common. This can be highly stressful not only for the individual, but also their carers.

Difficulty sleeping can transcend into worsening wandering, cognitive issues, restlessness, and accidental falls (3).

There continues to be a lack of evidence supporting the use of medications to address sleep problems for people living with dementia (3;4). This has led researchers to investigate non-drug options that might be helpful in reducing or preventing sleep disturbances. A recent systematic review comparing non-drug options to usual care, mostly in nursing homes, sheds light on this very topic (3).

What the research tells us

The non-drug methods evaluated in the review include a wide range of strategies, such as: light exposure programs like light therapy, physical activities like walking and leg and arm exercises, social activities like talking with others, slow-stroke back massage, transcranial electrostimulation involving the use of electrodes on a headband to deliver electric pulses to the brain, approaches including carers like carer training on how to execute non-drug strategies, and multi-component strategies.

Low certainty evidence found that physical activities, social activities, approaches that involve carers, and multi-component strategies may help improve sleep by slight to moderate amounts in people living with dementia compared to usual care. There is uncertainty on whether the other non-drug options looked at are helpful for sleep problems. More high-quality studies are needed to better understand the effectiveness of these non-drug strategies and how they compare to one another.

Even with the need for more research, the review still encourages healthcare professionals to opt for non-drug options as a first line of treatment for sleep issues in dementia. This is because drug therapies may come with more risks and the currently available evidence does not clearly show that they are better than non-drug options (3). If you are a carer for a person with dementia experiencing sleep problems, you may want to discuss non-drug options with your loved one as well as their healthcare team.

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Author Details


  1. World Health Organization. Dementia. [Internet] 2023. [cited July 2023]. Available from
  2. Canadian Institute for Health Information. Dementia in Canada: Summary. [Internet] 2023. [cited July 2023]. Available from
  3. Wilfling D, Calo S, Dichter MN, Meyer G, Mohler R, Kopke S. Non-pharmacological interventions for sleep disturbances in people with dementia. Cochrane Database Syst Rev. 2023; 1:CD011881. doi: 10.1002/14651858.CD011881.pub2.
  4. McCleery J, Sharpley AL. Pharmacotherapies for sleep disturbances in dementia. Cochrane Database Syst Rev. 2020; 11: CD009178. doi: 10.1002/14651858.CD009178.pub4

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.