Staying up all night and wanting to go home

Al_Butch

My wife has recently been getting up at night and asking to go home. I ask her where she means and it's usually her childhood home that she's been out of for 50 years now. I started her on Melatonin which my doctor said was ok to give her. It worked a few nights but then she had her worst episode last night when she stayed up almost all night. I try to calmly ask her back to bed, but she's insistent that she doesn't live here and wants to go home. She's actually getting a little belligerent about it now and I'm having trouble getting her back to bed.

She is starting to lack mobility so trying to keep her more active in the day has been difficult.

I'm at a loss and lacking sleep. Any help would be welcome.

terei

If Melatonin is not working, I would ask the Dr for something more effective. You will crash + burn without sleep + then where would she be?

M1

welcome to the forum. Seroquel is an atypical antipsychotic that can both dial back her agitation as well as treat the sleep fragmentation, both of which are very common in advanced dementia. Definitely talk to her doc.

ButterflyWings

I agree with all the advice above. FWIW, what amount of Melatonin are you giving? DH's dr approved me giving him up to 10mg, since the initial 3mg did absolutely nothing. I gave the liquid form which took affect immediately, and the 10mg at least mellowed him out so he'd sit down instead of trying to elope — but he never dozed more than 10-15 minutes if that.

Also, maybe a year later, he suddenly seemed totally immune to Melatonin period. I can give it today and there is no indication he's taken anything at all. Weird. FYI, I did read also that Melatonin can cause vivid dreams (even nightmares maybe?) for some people, and can possibly cause insomnia — the opposite of what we use it for.

Something else is definitely needed and given the delusion that she is not at home and wants to get there, you don't want her wandering outside in the middle of the night as my DH did. Seroquel/Quetiapine was the magic pill for us. It is still working well 5 years and 3 stages later. Good luck to you.

SDianeL

can you tell her you will take her tomorrow? Very common wanting to go home. Another is wanting to go to work. Definitely speak to her doctor. She needs it for the agitation too.

​fesk

For some reason, melatonin increased my mother's agitation. It may not agree with your wife. Definitely speak with the doctor. I would recommend seeing if there is something other than an antipsychotic that will help. Then if there isn't, one can be considered. Antipsychotics are needed at times but do carry many risks. That's why I recommend seeing if there is something else that will help first.

fmb

I tried Melatonin when I was also taking 5mg escitalopram (generic Lexapro). Had the worst nightmares I've ever had and had to discontinue the Melatonin. Check for interaction with other medications before taking it.

Al_Butch

update: The Dr allowed for an increase in the Melatonin. Last night it worked well so we'll see how that goes. I like the suggestion of saying I'll take her home tomorrow since she usually doesn't remember the next day. Thank you all for your responses. It helps me a lot.

midge333

Personally, I am not a fan of using melatonin. Yes it is "natural" but it is a hormone that regulates sleep and other circadian functions. We don't really understand melatonin that well. I am surprised that it is essentially unregulated. I would ask your doctor for seroquel or risperidone.

​fesk

That's great, Al Butch.

I hope it continues to work for you. Very safe option. If it doesn't end up working, then you can discuss further with your doctor.

Keep us posted.

Rosanne77

My DH is taking Olanzapine for agitation and help with staying asleep. 5 mg. It has been working amazingly for 7 months. He also takes Busperion 3x a day for anxiety. I recently was noticing increased sundowning between 6 and 9 pm so we were trying 2.5 olanzapine at 6 pm and 2.5 at bedtime. Although it has calmed him....I can't easily get him to bed now. He is falling asleep in his chair or on the couch. Not safe to leave him on the couch. So back to the drawing board. I would recommend Olanzapine though. Good luck

Iris L.

Thanks everyone for the information that melatonin may be responsible for nightmares. I don't have nightmares, but I do have vivid drams. When I awake, I can't remember the details.

Iris

ButterflyWings

https://alzconnected.org/discussion/comment/214214#Comment_214214

I don't disagree with you that it is not a substitute for a long term medical protocol. But much like my weighing (and then disregarding) the black box warnings on Seroquel, the unregulated aspect of Melatonin or anything else was a non-factor compared to my DH wandering (aggressively!), weaponing up when delusional, and making impulsive moves that validation, redirection and outright tap-dancing on my part could not redirect.

We never used or intended Melatonin as a long-term or daily strategy, but as an emergency measure which worked like a charm, many times. Since Alzheimer's is fatal anyway and there were few immediate, urgent solutions at times that I really needed them to keep us both safe — his trusted Dr. greenlighting my OTC choice of Melatonin in a pinch, was a plus.

midge333

https://alzconnected.org/discussion/comment/214663#Comment_214663

I guess in our situations we do not really need to worry about the long term implications of using melatonin. Glad it worked for your DH.