Confusion in transition from sleep to awake

SPin-need

I have been searching for information on this site, but cannot find much about this.

My DH is developing a pattern of confusion or ??? During the period of coming awake. The duration varies, from a few minutes to half an hour. During that time, he does unexpected things like needing to empty the dishwasher unclothed, or needing to take all the covers off of me in bed, or using the filter basket of the coffee maker to make his breakfast. He is sometimes aware that he is out of control, but not always. He is often giggly during these episodes.

He appears to be in the middle stage but the way things flip around, I cannot be sure and the neurologist is little help other than reminding me that everyone prigresses differently.

This need I have to understand, or name what is happening, is probably my need t feel some control over an uncontrollable situation.

Does anyone have experience with this or any insight?

thank you.

charley0419

Wish I could help but thats a new one for me

Goodlife2025

Hi I don't post often but my DW is 49 in late stage 4/early stage 5. She often spends the first few minutes to hour upon awaking demonstrating disconcerting behaviors. She also has no idea if it is day or night or any concept of time. It occurs with both naps and after a nights sleep. I have taken to heart what SDianeL has often said. It is not on purpose, their brains are broken and we can't reason with them. We must find the ways to adjust, I try to laugh to myself at some of the more absurd. Redirection and reassurance work well I hope they will for you as well. Regarding the giggling. Sometimes PWD do go back to more childlike behaviors and responses. My DW currently thinks it is funny to spit water at me when we brush our teeth, laughing hysterically. (I need to be there to help her stay in her routine) It's so funny, not. 😂 Hang in there.

Bailey's Mom

My HWD does the same thing. He will be ok and then take a nap only to wake in seemingly a dream state that lasts about 15 minutes…really bizarre things like he needs to spray the inside of his pants to fight covid…things are coming out of his nose that I need to stop or it will cost of hundreds of thousands of dollars…the flashlight is after him and he'll have to pay a huge ransom if he doesn't destroy it, etc. Usually he is very frightened and gets mad at me because I can't understand what he is saying. It is very disconcerting and every time he goes to sleep I'm in a state of anxiety worrying about what will happen when he wakes up. If anyone knows about this, I'd appreciate any advice…

trottingalong

mornings are often difficult for my DH. He’s generally just overall confused and can’t figure anything out. Because of his copd he’s not as mobile as others might be. That can actually be a blessing. Usually it takes him a couple of hours to be more of his normal self.

Chris20cm

https://alzconnected.org/discussion/72090/confusion-in-transition-from-sleep-to-awake

I have concluded, after eight years of 24/7 caregiving for DW of 61 years, that the only thing you can predict with certainty is that they will be unpredictable. There will be new surprises often and we can't make sense of them. Every day is an adventure.

SDianeL

Bizarre behavior is very common depending on what part of the brain is affected by the disease. My husband also had weird behavior on waking at night. He didn’t take naps but would wake up about 3am with hallucinations or a zombie like state almost like sleep walking. He would get fully dressed and sit in his chair. They don’t understand time of day. I would get up before him in the mornings and fix his breakfast before I woke him up. I woke him up at the same time every day. I calmly said it’s time to wake up your breakfast is ready. That seemed to distract him enough for awhile. As others have said every person with dementia progresses differently. I would make a list of his behaviors and send them to the doctor. Maybe medication will help. Also one drug the Neurologist prescribed Mertazipine? Caused extreme bizarre behavior and she took him off it right away and tried adding Risperidone at night in addition to the morning dose. That helped him sleep. I found this info that might help:

1. Think of behavior as a form of communication. If the person with dementia acts out in an angry or irritated way, it’s a way of telling others that they may be overwhelmed, in pain, confused or frightened.
2. Try to identify what is causing the behavior change. Was there a trigger or something that happened right beforehand? For example, was there an unexpected visitor that disrupted the person’s normal routine? Does the behavior occur at bath time?
3. Consider whether the behavior is risky and hazardous, versus annoying and frustrating.Risky and hazardous behavior might be when the person gets angry and tries to walk out of the house in an unsafe manner. You may have to respond in an active way, such as walking with them, distracting them and then installing locks on the door. Annoying and frustrating behavior may require a softer response. For example, if the person paces about the house but is calm and doesn’t try to leave, it may be best to work on accepting that the pacing is okay.
4. Try to create a daily routine that is structured and predictable for the person with dementia. Routine is an important source of comfort.
5. Foster an attitude of acceptance. The behavioral changes are due to real issues and are not because the person is deliberately trying to be difficult.
6. Try to be calm and patient. This means you will need to take breaks. Walk into a different room. Count to 10.

SPin-need

UPDATE It seems that the morning confusion MAY be a sign of disease progression. It is now happening much more often and occasionally lasting 3 or 4 hours. DH has no memory of what happened when he snaps out of whatever this confusion may be and it scares him. This has happened very quickly.

Quilting brings calm

As mom progressed, even a nap would result in a period of increased confusion upon waking. My son commented that’ every time she wakes up, it’s a brand new new day’.

trottingalong

https://alzconnected.org/discussion/comment/238937#Comment_238937

it’s happening to my DH more often as well. Almost daily. Mornings are his worst part of the day. Now I’m noticing confusion after a nap. He will even ask me if such and such happened or did he dream it.

SPin-need

I have been trying different things and have found that keeping the drapes open and letting the sun stream in seems to reduce the length of confusion time. I was reading about sun downing and trying to reverse advice to morning.