I just spoke to my dad (82) who is the primary caregiver of my mom (86) who is in late stages of ALZ. The problem he is having at the moment is that mom sleeps all day long. He can barely get her up to eat, etc. She usually wakes up about 6PM. She then goes back to sleep. The problem is that she then wakes up about midnight and is up until about 6AM. She has sleeping pills from the dr. that dad gives to her about 9PM but she is still up all night. The dr thinks she is depressed (as if) and doubled her Paxil dose but it hasn't helped. She is also on Aricept and Namenda. Dad is doing a wonderful job with her care but he has just been diagnosed with MDS and is undergoing chemo. He needs his rest. I live too far away to be much help at the moment. Any ideas on keeping mom awake during the day? My heart goes out to him and all caregivers. I don't know how you do it. Love for them sees you thru. Lauren

I've heard that Aricept can cause insomnia in some people if it's taken late in the day. Seems as if it's time for more help from your mom's doctor.

Meanwhile, till it gets solved, any possibility of a night caregiver so your dad can get a good night's sleep?

I've also heard that as AD progresses, some people just can't stay on the same sleep cycle as most of us. There are even night-care centers (with lots of activities all night) in a few places -- which seems like a terrific idea but doesn't help most of us now. If nothing the doctor prescribes can get your mom's sleep cycle to match your dad's, then a night caregiver might be the only way to help.

One last thought -- have you tried melatonin? It doesn't work for everyone, and the dosage can be tricky. My partner's doctor suggested starting with 1 mg about half an hour before "bedtime" but I found that about 2/3 of that (two 0.333 mcg tablets) works better for her.

You can also get melatonin in liquid form, which you squirt under the tongue so it gets into the bloodstream fast. A similar option is a flavored tablet that you let melt under the tongue. I've used both occasionally when my partner just can't get to sleep as usual.

Of course, check with you mom's doctor before trying any melatonin, and be aware that too high a dosage can backfire. I can't remember the problems -- hallucinations and/or agitation, maybe? Like most of these drugs, in some people it has opposite effects from the ones we hope for.

Good luck with this! Sleep problems are really top priority in my book.

Hi, Lauren. Welcome to the boards. I'm glad you found us.

What about enrolling Mom in an adult day care program? Most run about 9 am to 3 pm and have lots of activities and goings-on. That would keep her awake during the day, which might help her sleep at night, as well as give your dad some time to himself (for a nap, if nothing else)?

One word of caution, since you are new here: It's not always the best idea to post your email or any other potentially identifying information here. We have thousands of members and even more who browse without ever registering. Some of those may be spammers harvesting email addresses, at the very least.

Thanks to both of you for the suggestions. I told dad about melatonin last night. I also told him to keep the lights all on in the house in the afternoon and evening until bedtime. He has made sleeping easy for mom. I wish we could get mom out of the house but she pitches a fit about going anywhere. Oh course, according to mom, we never ask her to go anywhere so a AD catch 22. I have talked to several friends with -usually moms-a LO with Ad. Most are now in NHs but dad says not as long as mom knows him. She is definitely late stage and wants to die. Anyway, I was wondering about just stopping the aricept and namenda. It's not like they are doing much good at the moment and most of my friends LOs are off the meds now also. Just a thought I'll have him ask her DR. Anyway, thanks again.

Lauren,
From the first time it was prescribed in 2004, Aricept would keep my Mother awake all night too. With her doctor's consent we tried giving her Aricept in the morning and it made all the difference! She began sleeping at night. She takes her Namenda in the morning and again at night. As her disease has progressed she sleeps much more during the day, but she still sleeps well at night.

Just a thought you may want to discuss with your Mom's doctor.

Sleep disturbances are very common in ADLOs, and the others are right, that the cholinesterase inhibitors can cause insomnia if taken in the evening. There are lots of other things to try, too:

http://alzheimers.boomja.com/A...turbances-61711.html

Hi Lauren,
My mom is probably mid to late stage 6. She was not sleeping at night, rummaging around until all hours and I thought a night attendant might be necessary. However, her doctor prescribed Trazadone. It is an anti-depressant; however, it really is prescribed to cut the anxiety my mother was feeling at night which inhibited her from sleeping. It did the trick. It's safe; it's been effective. My doctor told me that pills like Ambien and other meds that are prescribed to non-dementia patients often have the opposite effects for those with dementia. My advice would be to see what your doctor recommends. I might not be knowledgable enough, but I have never heard of people taking both Aricept and Namenda.

To keep her awake during the day, a day care facility might be helpful or maybe a part-time caregive could come in to give your dad time to rest. I find my mom will do things for the caregivers that she won't do for me. Maybe a caregiver would have better luck at getting her out of the house.
Hope it helps.

Hi Lauren,
I can sympathize with you and your Dad about your Mom.
My Dad lives with me. He too sleeps all day and is up all night. He was also diagnosed with depression. Dad takes seroquel and trazodone just to get him to sleep at night. It seems to work most nights. He does have his few where he is up all night. These nights are usually proceeded by sudden change in his mood from happy to angry and agitated.
He also goes to daycare, and it does help. He's active during the day, and tired when he gets home. The daycare helped a lot, more than the meds. His all nighters seem to be on the weekends when he hasn't been to daycare.
Hang in there.

Again thanks for the ideas. I told dad to switch her aricept to the AM and see how that works. The dr upped her paxil dose so we shall see. Between up all night and now hallucinations dad is getting upset that he might do something wrong. He needs his own sleep pattern stable so he can stay well for her. He is trying which is all we can ask. I have offered to go on family medical leave but he says not yet--I may need you more later. I have also told him to keep the lights on longer. We shall see.

quote:

I might not be knowledgable enough, but I have never heard of people taking both Aricept and Namenda.

There are two basic categories of AD drugs: the cholinesterase inhibitors (aricept, exelon, razadyne/galantamine) and the NMDA receptor antagonist Namenda (memantine). Since they work via different mechanisms, they are often prescribed as a "cocktail". Aricept (donepezil) plus Namenda are typically more effective than either drug by itself.

http://alzheimers.boomja.com/C...zheimer-s-30753.html