It starts as one night. Then it’s most nights. The click of nails on the hall floor at two, a bit of panting, sometimes a bark at nothing in particular. You get up, let him out, he doesn’t want to go out. You put him back to bed. Twenty minutes later he’s standing in the corner of the kitchen facing the wall.
By the third week nobody in the house is sleeping properly, and you’ve started saying “he’s just getting old” because it’s the only explanation on offer.
It isn’t just old age
Old age isn’t a diagnosis. It’s a stage of life during which specific, identifiable things happen, and night-time restlessness in a senior dog nearly always has a cause worth chasing down.
Broadly it falls into three buckets, and dogs frequently have more than one at once. There’s pain, which is by far the most common and the most under-treated. There’s a medical problem making him need to get up – usually something affecting drinking and toileting. And there’s cognitive decline, the canine version of dementia, which is far more common than most owners realise and considerably more treatable than most owners expect.
The reason to separate them is that the answers are different, and the order matters: physical causes first, always, because there’s no point managing an anxiety that’s actually a sore hip. Once those are dealt with or ruled out, the rest is about lowering the anxiety that comes with confusion and rebuilding a sleep pattern that’s fallen apart – a consistent evening routine, light and bedding that suit failing eyes and stiff joints, and evening support such as Relaxing Dog Treats to take the edge off the winding-up that tends to start around dusk.
Rule out the physical first
Arthritis is the headline. Something like four in five dogs over eight have degenerative joint changes, and the majority aren’t on anything for it, largely because dogs are extremely good at hiding it. They don’t yelp and they don’t usually limp until it’s advanced. What they do is get up and down more, struggle to find a comfortable position, and become restless in the evening when everything else has gone quiet and there’s nothing to distract from the discomfort.
An enormous number of “night-time anxiety” cases turn out to be a dog who cannot get comfortable. A trial of proper pain relief from your vet is often the single most useful thing you can do, and the change in a dog whose pain has been properly managed can be dramatic within a fortnight.
Then there’s the drinking and weeing group. Kidney disease, diabetes, Cushing’s and urinary infections all make a dog need to get up in the night, and all are common in older dogs. If he’s drinking more than he used to, that’s a vet visit on its own regardless of the sleep.
Failing eyesight and hearing matter too. A dog who can’t see well in low light becomes disoriented in a dark house, and a deaf dog who wakes and can’t hear the household gets frightened. Both produce exactly the pacing and calling you’re hearing.
High blood pressure and thyroid problems are worth a mention because they’re easy to test for and easy to miss.
Canine cognitive dysfunction
If the physical work-up comes back clear, this is the likely culprit, and it’s substantially under-diagnosed. Estimates vary but a large proportion of dogs over eleven show at least some signs, and the majority are never brought to a vet for it because owners assume nothing can be done.
Vets tend to use the DISHAA framework, which is a useful checklist for owners as well:
Disorientation – getting stuck behind furniture, standing on the hinge side of a door waiting for it to open, staring at walls, going out into the garden and forgetting why.
Interactions – less interest in greeting people, changes in how he is with other dogs in the house, sometimes irritability that wasn’t there before.
Sleep-wake cycle – the one you’re living with. Sleeping much more in the day and much less at night, often with the two more or less swapped.
House soiling – accidents indoors in a dog who’s been clean for a decade, frequently with no apparent awareness that anything has happened.
Activity – either less of it, or repetitive activity like pacing a circuit, licking, or wandering with no obvious purpose.
Anxiety – new clinginess, new noise sensitivity, distress at being left when he never minded before.
Any two or three of those together in a dog over about nine is worth a conversation with your vet.
Why the nights are the worst of it
Two things stack up after dark.
The first is that the light goes. A dog whose vision has deteriorated copes reasonably well in daylight in a familiar house and much less well at two in the morning, and disorientation is far more frightening when you can’t see the layout.
The second is that everything else stops. During the day there’s noise, movement, people, things to follow around – all of which give a confused dog a structure to hang on to. At night there’s nothing, and the confusion has the floor to itself. It’s the same phenomenon that gets called sundowning in human dementia and it behaves in much the same way.
Fixing the environment
Small changes here go a surprisingly long way.
Put night lights in the hall, the kitchen and wherever he sleeps. Cheap plug-in ones are fine. The point is that if he wakes and gets up, he can work out where he is.
Sort the flooring. Older dogs with weak back ends find laminate and tile genuinely frightening, and a dog who slips once will hesitate at that spot for months. Runners, rugs, yoga mats – whatever covers the route from his bed to the door.
Get a proper orthopaedic bed with a low entry, somewhere warm and out of a draught. Memory foam rather than a beanbag he has to climb out of.
Don’t move the furniture. A dog navigating partly from memory does not need the sofa in a new place.
And time the last toilet trip late – properly late, not at nine o’clock – even if he doesn’t seem to need it.
Fixing the daytime
The sleep-wake cycle has flipped, so part of the job is flipping it back.
Get him outside in daylight, particularly in the morning. Natural light is the main thing that sets the body clock and older dogs who spend all day indoors lose that signal. It doesn’t need to be a long walk – twenty minutes pottering in the garden in the sun counts.
Discourage long solid daytime sleeps if you reasonably can. Not by keeping him awake and irritable, but by breaking up the afternoon with a short walk, a bit of food-based enrichment, a sniffing game in the garden.
Keep his brain working. Snuffle mats, scatter feeding, easy puzzle feeders, five minutes of the training he’s known for years. Mental engagement appears to slow the progression of cognitive decline and it makes the days more interesting for a dog who can’t do the physical things he used to.
Keep the routine tight. Same times, same order, every day. Predictability is worth more to a confused dog than almost anything else you can offer.
Diet and supplements
There’s reasonable evidence behind nutritional support for canine cognitive decline, which isn’t something you can say about every category of supplement.
Antioxidants – vitamins E and C, selenium – are associated with slower cognitive decline in ageing dogs. Omega-3 fatty acids, particularly DHA, support brain function and have the useful side effect of helping with joint inflammation at the same time. Medium chain triglycerides give the ageing brain an alternative fuel source and appear in several of the prescription senior diets for that reason.
On the anxiety side, the calming ingredients used in younger dogs work here too, and evening is usually the right time to give them. None of it reverses anything. What it does is take the edge off, which in a household that hasn’t slept properly for a month is not a small thing.
What your vet can do
More than most people expect.
Pain relief, as above, which is often transformative on its own. There are licensed medications specifically for age-related cognitive and circulatory decline – selegiline and propentofylline are the two you’re most likely to be offered in the UK – and they help a meaningful proportion of dogs, particularly when started early rather than as a last resort.
There are prescription diets formulated for cognitive support, and short-term anti-anxiety medication for dogs whose night-time distress is severe.
Go early. The single biggest predictor of how well this is managed is how long the owner waited before mentioning it, and “he’s just old” has cost a lot of dogs a comfortable last couple of years.
The honest part
None of this reverses cognitive decline. It slows it, it makes the dog less frightened, and it usually buys back a decent stretch of ordinary life for both of you.
Keep a note of how the nights go – a line a day is plenty. It’s easy to lose track of whether things are improving when you’re tired, and easy to miss a gradual decline that would be obvious written down.
And be realistic about your own limits. Chronic sleep deprivation is grinding, and it’s entirely reasonable to ask for help, to take turns with someone else in the house, or to talk frankly to your vet about where things are heading. That conversation is easier had early and calmly than at four in the morning after a bad week.
