Excessive Sleeping and Managing Hydration & Nutrition

shark_guy

My wife is progressively sleeping longer and longer. She was diagnosed with Alzheimer’s in 2020, but was afflicted before then. In January 2024 she was sleeping about 12 hours per night. In September we began logging her daily activities in a Day Planner and that has been very useful to allow our care team to communicate and to capture metrics. She was sleeping an average of 14.5 hours per night in September and now in February 2025 she is up to 17 hours average and the increase seems to be accelerating. She normally goes to bed at 6:30pm more or less and we wake her up at Noon if she does not awaken on her own. Our concern is having her awake enough each day to get Nutrition and Hydration, she tends not to drink enough fluids. Some nights she only gets up to unrinate once. She normally doesn’t nap during the day and a few days has slept 20 hours.
Any constructive feedback or thoughts on this or experience with these issues would be welcomed.

cdgbdr

Is she receiving hospice services? I wonder if this how her disease progression is manifesting?

midge333

Has she lost significant weight? Sleeping 17-20 hours a day is a symptom of end stage dementia. Have you consulted hospice?

BPS

My wife did that for a while and sometimes more about a year and a half ago or more. I would wake her up a couple of times to give her medication and a drink and would have a snack for her that she would sometimes eat a little. That lasted on and off for several months then got a little better. She still sleeps a lot at times. I think it is normal progression.

BPS

SDianeL

you can ask hospice for an evaluation. If she’s not eating or drinking and has lost weight that may mean end stage. Please keep us posted.

Carl46

My wife typically sleeps from 7 PM to 9 AM or later. I serve her two good meals a day (protein, carb, 2 veggies or fruit). Since she is not very active, that is plenty.

Carl46

The fact that your wife doesn't urinate frequently at night isn't necessarily a problem, because our kidneys pretty much stop working when we are asleep. Then they kick back in when we wake, which is why we need to urinate soon after waking. The best way to tell if she is dehydrated is urine color. If it is straw colored, she is OK. The darker yellow it is, the less hydrated she is. I encourage my wife to drink whole glasses of water when taking her morning and evening meds, to supplement the tea she drinks with meals and the Sprite she likes in the afternoon.

Some people make a point of eating all their meals in an 8-hour period. It is called "intermittent fasting" and some think it has health benefits. I don't know about the benefits, but it doesn't seem to hurt anything. My FIL skipped supper for years, so he could eat gravy twice a day without getting fat. He died of coronary artery disease and I don't recommend gravy as a dietary staple, but he was active and healthy otherwise.

shark_guy

Thanks to all who responded. She is in stage 7a on the FAST Scale. I have consulted Hospice but not retained them as of yet, I have private caregivers most days and we are managing. We monitor her weight, blood Ox, sleep hours and activity daily in a day planner. I expect that late 2025 might be the time for hospice, we will see… I plan to consult with her Neurologist soon if the sleep cycle continues to accelerate. Thanks again for your advice and concern…

midge333

Better to ask for hospice a month too early than a month too late.

terei

There is no downside to having hospice come in + no reason to delay an assessment.

SDianeL

https://alzconnected.org/discussion/comment/236472#Comment_236472

please don’t wait for hospice. I did. People on this forum told me it was time and I waited I guess because was in denial. My DH progressed rapidly and passed in August before hospice arrived. The VA facility he was in was wonderful and implemented hospice protocol but it was very stressful. So sorry you are at this stage. Prayers for you both.