NOTHING is working for FIL Sundowing!!!!

Mturn

Can anyone offer any suggestions on how to get your LO to sleep when they have sundowners?  My FIL has Alzheimer's and we have had ongoing problems with him sundowing.  My MIL is his primary caregiver and we have been dealing  with both of their lack of sleep for months now.  FIL is pretty quiet during the day and will sometimes take a very short cat nap.  Then sometime between 7-8:00 pm he gets revved up and is up chatting and pacing all night long.  MIL does get him into bed but he's there a very short time and then gets up and wants to talk ALL NIGHT.  We are hoping that an overnight caregiver will be avail next week so MIL can get some sleep.  In the mean time we have tired Trazadone, which didn't work.  Melatonin didn't work. We tried Olanzapine , a couple of different dosages and that didn't work.  We reduced the Olanzapine and added 1 Tylenol PM and that didn't work.  We are now at 2 Tylenol PM's (all of this is Dr. prescribed) and that isn't working.  We have tired keeping him awake during the day, adding a beer to his nighttime routine, taking away caffeine in the afternoon, giving him a late dinner so he has a full stomach and NOTHING works.  It's really quite unbelievable.  How can one go one such little sleep.  Is there anyone that has gone through this and can offer any suggestions on what worked for you.  Thank you so very much!

HeartOnSleeve2210

I haven't gone through this with my LO, but I myself struggle with insomnia. Of course, it's quite different to Sundowners, but I would be on on medication, and eventually I'd get used to it, then I'd have to switch to another, and so on and so forth. When I was in college and having a horrible time sleeping, my on campus nurse told me to take one Melatonin and one Benadryl before bed. It worked like a horse tranquilizer for me! Of course, I suggest talking to your FIL's PCP before doing this, but that's what worked for me.

harshedbuzz

Mturn-

It happens. This lack of sleep is a big reason many families seek placement. The stress on caregivers can impact their health and ability to function. 

If you aren't working with a geriatric psychiatrist, and I suspect you are not- Tylenol PM for a PWD- it's a great idea to see one. Geripsychs are the experts in managing psychoactive medication in the elderly and for those whose brains are damaged by dementia and may not react in a typical manner.

Diphenhydramine HCL (aka Benedryl the active ingredient in Tylenol PM) is associated with risk of developing dementia and also seems to make existing dementia symptoms worse. He may need something different to calm the agitation- often a neuroleptic is prescribe in the form of a lower dose of Seroquel or other antipsychotic.

HB

MN Chickadee

You need a geriatric psychiatrist prescribing. Or at least a psychiatrist with experience with dementia. A geriatric psych is the best trained and experienced to tinker with meds for the most challenging behaviors associated with dementia. It sounds like this has gone beyond the scope of other physicians. My mother takes Mirtazapine for sleep, but some PWD need something stronger. Whoever prescribed Tylenol PM probably doesn't normally work with dementia IMO, that is not usually a go-to for dementia. It's great you are hiring help for the overnights. Lack of sleep will quickly take its toll on mom's health and compromise her ability to care for him.

jfkoc

Lack of sleep is a game changer.

Until you can get in with a geriatric psychiatrist I would try some physical exercise...long walks?

Jen M

My father's Neurologist prescribed Mirtazapine for mood and insomnia when his symptoms were mild to moderate.  We increased the dose twice.  Now the doctor is gently encouraging him to try Seroquel (which seems to have a relatively rapid onset compared to other options).  This would be for sundowning as well as increased aggression / agitation.  My father hasn't agreed to it yet, unfortunately.

MattyBoy

LIQUID MELATONIN was a HUGE GAME CHANGER for me in dealing with my MOM's SLEEPING...

i administer it SUBLINGUALLY !!!

i buy mine on AMAZON !!!

try it...

DrinaJGB

A study done on Melatonin for improved memory was conducted Tokyo, and the results were positive. It is a natural substance that is produced by the pineal gland and diminishes as we age. I give my DH 5mg a night and it has helped him sleep better.His short term memory has also improved.

A dementia patient should never be given benadryl which has already been addressed here.

My DH got home after 4 months in hospitals after brain injury from infectious encephalitis and NEVER slept at night only during the day in short spurts---for a solid year. Nothing worked. It was so exhausting I thought we might both die from it. I have never been through anything so horrific---along with the hallucinations and other bizarre behaviors it felt as though we were both in hell.

Good luck. It is a painful position to be in and over time tends to make even the caregiver feel completely nuts.

sunnydove

Have you tried white noise? You can get an app for it or get a little white noise machine. This works for both mom AND me! I turn it on and think how annoying the sound is and how I'll never be able to sleep and that's always the last thought I have. It has sort of a hypnotizing affect and at the same time blocks out other audible disruptions. Worth a try.