Sleep Disorders

Studies have shown that people with Sundowner’s Syndrome have a tendency to have sleep disturbances. This isn’t uncommon with elderly people who don’t suffer with any form of dementia, but for those with Sundowner’s, sleep problems only make the Sundowner’s symptoms more problematic. A Sundowner’s sufferer will no doubt exhibit symptoms every time they awaken.

Sleep disturbances in the elderly are often caused by the physical problems that go along with growing old and the resulting pain and discomfort, which awakens them several times during the night. Heart ailments, arthritis, Parkinson’s Disease shakes, Restless Leg Syndrome, depression, indigestion, constipation, and sleep apnea can all cause disturbed sleep. While breathing problems like sleep apnea occur in people of all ages, it’s extremely common in people over 70. Depression is also very common in the elderly, and some of these ailments may be addressed with medication that will diminish the sleep interruptions.

The hallucinations and agitation caused by Sundowner’s Syndrome can also cause sleep disturbances.

First and foremost, make sure the Sundowner’s patient avoids caffeine and sugar, especially in the hours before bedtime. It also helps to avoid any liquids for a couple of hours before bed. If your loved one takes any medications that make him or her sleepy during daytime hours, speak with your doctor about alternative medications.

Exercise a few hours before bed may also help to cause fatigue at the right time of night. Massage, soft and soothing music, reading in a soft voice, or even warm milk or sheets warmed in the microwave can help someone to relax and sleep. Of course, quiet is absolutely essential!

Sleep Disorders in the Elderly – Part 2

Sometimes, the elderly can begin to reverse their body’s sleep schedule until they sleep during the day and stay awake at night. This is, of course, extremely disruptive to caregivers. You can try to keep the lights bright during the day and dim them in the evening to get the body’s clock back on a proper schedule. This is the opposite of the instruction to keep lights on during the night to prevent Sundowner’s symptoms. When a reversal of sleep schedule occurs, however, promoting sleep at night becomes a priority, as your own health is also at stake.

The supplement melatonin is also sometimes used to help a person sleep at the proper time. Never give a person with dementia over-the-counter sleep medications, however, as some of these can exacerbate the Syndrome. See a doctor if the sleep issue becomes unmanageable, and you may also want to doublecheck the Physician’s Desk Reference to make sure any sleep medications are not a problem in terms of other ailments and medications.

Better sleep is an enigma for many people, but there are definitely strategies which can encourage it. Elderly people tend to live more sedentary lives and stay indoors more than when they were younger. This means they get less exercise and less sunlight, both of which are important for a good night’s sleep. A walk during the day in the sunlight can do a great deal to help with both of these issues.

If hunger keeps your loved one awake, encourage a light meal prior to sleep. However, the food you choose is very important. Sugar and caffeine work as stimulants, and alcohol also interferes with sleep. Heavy foods may also cause stomach discomfort during the night.


  1. Penny says

    Help my mother-in law is in a resential care fac. she has dementia and bad sundowners we need to find a sleeping aide to let her stayin bed at night or she has to leave. her dr is against adavan or lorazapan which workd for others. he only wand halodol she isnt eating only baby food etc any advice on what to give her.she is walking walking and up and down and up and donw all night

    • Kathy M says

      My mother too has occasional sleep disturbances. Haldol only increases her confusion when she hasn’t been sleeping. If she stays awake 1 full day, 1 full night and the whole next day, I give her 100mg trazadone and .025 morphine inside her mouth. This seems to work every time. I will never give her Haldol again after how it affected her.
      I hope this helps

  2. Triubled says

    My father passed away 8 months ago and during the time he was in the hospital, our family Dr. put our mother (she has alzheimer’s) on zyprexa. It has been wonderful for my mother as far as her sleeping. Her sundowning starts around 4pm everyday and last until 6 or 7. She was much worse before the zyprexa.

  3. donna says

    So glad I found this info and message board. My 88 yr old father started getting out of bed a few weeks ago after 4 years of having assistance morning and night. We have tried bed rails and putting his wheelchair in the way but he seems to have super human strenghth and moves things when we are not there,, then can’t get off the toilet during the day. He has parkinson like symptoms, as does his sister, but when treated with those meds, she almost died.. so we are at a loss for that. He remembers getting up and says someone was calling him?? Hes not sleeping at all and almost refuses to drink fluids at times, yet says hes not ready to go.. He is not alone in the home, but my reletive can not stay up all night to watch him and neither can I.. the nurse has suggested the bed alarm, has anyone tried it? I started him on meletonin 3 mg last night, doctor said to increase dose tonight to see if it helps, up to 10 mg in a week. This is so scarey, but my sister and I can not lose our own sleep worrying, we just pray every night he is safe.

  4. VillaPriscilla says

    I am a caregiver of the elderly for over 30 years. What I see on this board is typical… real consistent solution. This has been my experience, too. If there were a drug of choice we would all know about it and use it. I recommend trial and error under a Dr.’s supervision. The solution can be very individual with different results for different folks. God bless all the caregivers.

  5. Diane Perkins says

    My 95 year old mom turns 96 in seven days. As a child she had night terrors. She is very small and her adult weight has not varied since she was a young adult. 4’11” and 104 lbs. About three years ago she was diagnosed with pulmonary arterial hypertension. Her last emergency run to a hospital in late Feb of this year gave her a diagnosis of end stage congestive heart disease. We made a follow up appointment with the pulmonary specialist which had been called in as a consultant. He suggested in home hospice care and looked me right in the eye and said this woman more than qualifes. So in home hospice was started. She no longer wanted to dress to go to a doctor as it was so exhausting. She has a history of not sleeping well and doesn’t like being alone and has compulsive obsessive personality disorder. I kept her in my home for 5 years. I also have health issues, heart attack, severe sleep apnea, arthritis and artificial knees. In early Sept. she fell and didn’t tell me but I noticed the deep scratch on the underside of her forearm. Within 3 weeks she had a very bad fall in her bathroom during the early morning hours. She looked as if she had gone 30 rounds with Joe Louis. She landed with her head, shoulders right smack in the middle between the door sides on a stone floor. She was bleeding from her nose and a cut on the left outer eyebrow ridge. I had to step over her on the bloody floor taking a chance of slipping myself with my artificial knees in order to get into a position to get her up. The hospice people were called and it was a five hour ordeal. It was apparent that I could no longer keep her safely in my home. THANK YOU GOD FOR THE DOCTOR WHO SUGGESTED IN HOME HOSPICE CARE. The hospice people we used told us because she had a terminal diagnosis that Mom would qualify for a HIC placement. These facilities are regular home residences that can only take two patients. They are a step up from assisted living but a step below skilled nursing home. Medicare continues to pay for all services and meds dictated by her terminal diagnosis but does not cover anything else. Upshot is her insurance has to pay for her thyroid meds, her AREDS supplement and eye drops. SHE IS VERY SEVERELY HEARING IMPAIRED AND HAS SEVERE MACULAR DEGENERATION. I had her placed in a HIC facility by mid Sept. but from the time of the fall she developed a rapid onset dementia and really severe sundowners. So far nothing has worked for more than one or two nights before she goes back to square one. She is very weak but has excellent care. I pray nightly for God to give her peace. My point to all of you is that if you have a diagnosis of long term chronic life threatening disease or terminal disease check out the availability of HIC facilities in your area and see about a doctor’s referral for in home hospice care or HIC placement. It is cheaper than a nursing home. And for all of us who have loved ones whose quality of life has fled, it can be a God send. Since this is medicare paid for I think HIC facilities while not well known should be available in all states albeit maybe not close to where you live. I am fortunate that ours is only 20 minutes away. Our case nurse has forty plus years experience in home hospice care and she and the geriatric nurse practitioner have both ruled out the use of hadol as being unsuitable and dangerous for the elderly. At this stage of the game it is all about providing comfort and support not prolonging life. God Bless all caretakers for ours is a special calling!

  6. tiease says

    Hi I am so tired. my grandma is 77 years old and does not sleep. She can not walk and maybe that’s a good thing because it would be worse. so right now she has sundowners I know that it is getting worse I do 4 night my aunt does 2 and my uncle does 1 plus i am her caretaker. She does not sleep I am at my end

  7. claudia says

    i have an 81 year old father and we have a full time live in caregiver and also hospice help. my dad has dementia and severe sundowners, the only upside is that he is bed ridden so he can not walk away or wander off. many of the stories thtat i have read i also experience. i have found that natural herbals help some as wellas the melatonin, i try to stay away from the prescribed halucinagetic drugs as they have always had very bad side affects on my dad, i feel that we have beenthrough the ringer with agencies, cnas and doctors all of whom have no real solutions . so what ever you can find that works for you is the best choice though i would not reccommend many prescription drugs – try the herbals . its a difficult situation for caregivers, the paitent and loved ones – it sucks.

  8. Sheila says

    Iam the daughter of a Korean vet and this last week we have gone from 0 to dementia in 60 hrs. and now add sundowners. just had 6 days at the VA trying to explain it wasn’t like when I dropped him off. In the morning he up and hates everything , not the right cereal , thinks Iam selling (dope) just so out of touch then after I keep from pulling my hair out, he turns back into my dad at around 3 or 4 in the afternoon. Had a Power of Atty written up but learned today it does not apply to va fed benefits, they of course have there own, who knew. Iam trying to understand so much and I am so tired but he can’t go to a home yet. Bless you all

    • yo says

      With the rapid change, you may want to have them check his blood ammonia levels. My dad had the same issue–rapid onset of belligerence, quickly progressing into unresponsiveness. I was getting all the ‘tough decisions’ speeches, and my dad lay wasting away in a hospital bed. Thank GOD I’d spent the last couple hours since my arrival at the emergency room googling his symptoms; it looked like hepatic encephalopathy.

      I asked if they’d checked his blood ammonia: ‘NO’. Bingo, it was off the charts. Then they gave more speeches, started fights about DNR-or-not among my sister and brother and I, and brandished more papers for us to sign. I asked (this is OVER TWO HOURS LATER, mind you) if they’d started giving him Constulose yet (an indigestible-sugar laxative that absorbs the ammonia and makes you poop it out).

      NO. NO, they had NOT yet given him the lactulose!!!!! Something SO VERY SIMPLE!!! WHAT?! I was irate! I tossed the stupid papers on the table and DEMANDED that they start it IMMEDIATELY!

      Well, the vultures sheepishly scooted out of the room and gave the order…and my dad (unresponsive, basically comatose at the time) was trying to pull out his oxygen cannula by first thing the next morning!

      During that day he started talking to us, and by the next am, he was up out of bed and sitting in a chair!

      And all the hospital folk would have done was try to get us to sign off on his life!

      Sorry to say, but you ABSOLUTELY have to do your own legwork…thank God for Google. And keep in mind, hospitals have very little incentive to keep and care for unprofitable Medicare patients long-term. SAD BUT TRUE–I DARE ANYONE TO DENY IT.

      And stay firm–the hospital vultures had my siblings convinced–they all circled me, insisting I was being irrational and had unrealistic expectations. They were all speechless when he made a full recovery in less than a week. The doctor who’d been my harshest critic wouldn’t even come in the room.

      Just sayin’…

      • Janet says

        I know this was posted so long ago, but I just want to say, I had an almost identical experience with a different diagnosis when my dad was hospitalized. He passed away two years ago. I respect the fight you put up.

  9. Leslie says

    Help my Dad is 90 and has just been moved to a residential home where he is up all night and terrorizes everyone in the house. We have tried Seraquel and that does not work. He is jumping out of his hospital bed and falling even with the rails up. He goes to the bathroom on the floor instead of the in the portable provide in his room. Is there a sleeping pill out there that can regulate his sleeping behaviors?

  10. Katie says

    I take care of mt 91 year old father. Iv’e had him for 9 years now. I work a full time job, take care of my 9 year old and everything else that comes along with your every day things. It is very had to deal with these things my dad has been sick with his mind the whole time he’s been with us. All I can say is god bless all of us, and one day we will all be rewarded.

  11. Michelle T says

    In a weird way I’m so happy to have found this site. I’m taking care of my Grandmother and had no idea how hard it was gong to be. Today she started talking in incomplete sentences so I took her to emergency in case it was a stroke and after a battery of test the doctor and pharmasist at the hospital said to take her off of the melantonin. Melantonin might cause an adverse effect with the parkinsons medication she started last week that can affect the brain.
    I was amazed because the pharmasist that dispensed the parkinsons medication last week told me, Melantonin would not interfer with this particular parkinsons medication. The good news is since she has lived with me she is off all medications except parkinsons meds.

    Now the doctors have her on tylenol for a sore arm from when she fell down three times in two days from a new pair of walking shoes. I need help getting her to sleep a night and if anyone has a herb they can recommend I’m willing to try.
    Thank you and sorry for going on and on.

    • phil says

      Hi, I’m giving my 91 year old Dad Valerian root and melatonin together. Also spraying his bed with lavender and using herbal lotion on his body which has lavender in it. The doctor prescribed 1mg. Of lunexa which didn’t work. The valerian root is helping a lot more . I’m also going to pick up chamomile tea I heard that helps as well. Good luck.

  12. says

    I’m on my second round of being a caretaker of an advanced Alzheimer’s patient. My father has passed on and I am now taking care of his sister, my aunt, who is eighty six. My advice, through experience, give them food when they want it and pick your battles. It is easier to agree than to argue. If you have to tell them they need to go to bed because we have to get up for church in the morning, do it. Every day could be Sunday here. There are times where they have had extreme clarity and times they have no clue who I was. My aunt always wants to go “home”, thousands of miles from my house where she now lives. We have used the term vacation as the reason she is here many times. As well as Alzheimer’s, she is basically a walking, or should I say shuffling, miracle as MRI’s of her spine show that her back is pretty well burnt toast. She is in pain, but yet when I take her to the doctor she states she is not. I have used video to show the doctor that what I am saying about her pain is true. On video she will go from a pain level of 10 to zero in a matter of minutes, but she is in pain. The video was the only way to convince the doctor, besides demanding and MRI. We have “baby” alarms on the doors and when she figured out how to knock the batteries out of them we put on the “baby” door knob covers – these have worked. We take the knobs off the stove at night to keep her from blowing us up as well, and the sliding glass door has a pair of vice grips along the track at the top to keep her in. Double keyed dead bolts where a key is needed to open from the inside and out will also keep a loved one indoors during the night. My opinion, and my opinion only, is that it is my job to take care of her, I refuse to fight and try to find humor in the repetition or demands – it is pretty easy to redirect someone in her condition to change the subject, and it often works. The fact is… she is dying a slow death and I want to make her as comfortable as possible. If the house is Auntie proofed, she can’t hurt herself or get out in the middle of the night and I can get my sleep too. I would much rather have her here with me than in a home. Most homes I have visited I wouldn’t let my dog live in. God bless you all for all you do, you are earning you wings. Good luck.

    • Anne-Marie says

      Mary thank you for your wise words. I will now tell my Mom we’re on holiday! Mom doesn’t sleep. I’ve recently got respite for 3 nights per week here at home, & for one day. I’m still tired, I’ve done this for 10 years. Mom hasn’t slept well for over 2 years. I know some Carers go through worse. So sad. Your witty, wise words also made me smile, thank you. I’ve got pillows along the skirting boards,where Mom has fallen in the past, so that she won’t hurt herself as much. As “Mom proofed” as I can be. Off to polish my wings. Thank you.

  13. Susan says

    My Dad will not get up in the morning-lately. 88 yrs old with dementia – goes to bed at 9:30 and my Mom gets so frustrated and angry with him. He just lays there. He is not sick, he just has returned home after re-hab after a bout with Dingy fever as a result of a mosquito bite. they would not release him till he demonstrated he could get up and shave and shower in the morning before taking a walk. He was fine but since he has been home he just stays in bed all day if he could. We have tried everything, spray him with water, guilt trips, nothing works he just does not care —

  14. Laura says

    This site is very helpful. My husband and I are caring for his 89 year old mother who developed Sundowners syndrome in the last month. We only get a few hours of sleep everynight. We are very tired and at wits end. We are giving her Haldol and Lorazopan. I will mention to him the Taadone with the Morphine. Hopefully that will work better since the other 2 seem to make the situation worse, not better.

    I pray for peace for my mother-in-law. We have been caring for her for 3 years now and want to make sure she is loved and not afraid. She was in labor camps during WWII and was taken from her family by the Nazis when she was 13. We worry many of her night terrors are related to what may have occurred during that period of her life. She never discussed the labor camps but I imagine she was terrified.

    Good luck to all and God Bless.

  15. Gary says

    My mom is 63 years old.She is diabeand taking medicine. She do lot of walking n yoga exercise.
    But she can’t sleep at all during day or night.Tried over counter sleep pills but nothing is working. She gets completely exhausted please help


  16. Joyce says

    HI There

    I read your comment on Melatonin when I ask our Doctor for this for my Mother who has Dementia he told us this would be of no use, can I as what dose you gave your Mother and did you buy this over the counter in a pharmacy, many thanks

  17. donna says

    Your dads symptoms are very much like mine. Hallucinations and talking to people, we have managed to convince him that he is dreaming most times, and he will tell people that he is dreaming. He thinks hes been in bed for days, but we were able to get nursing staff 5 mornings a week to get him up and my sister and I do the other two which medicare pays for. He is a WWII vet and was entitled to 6 hours a week from one of their agencies also to put him to bed 3 nights.. you should be able to get this also if he was a vet. I am doing the family provider option through our state agency so I care for him during the day and get paid for part of the hours I put in otherwise he would have to go to a home.

    I haven’t heard speeches from him as when I am with him he is coherent for the most part, but he uses these long winded, big worded explanations for everything.. he calls his digital clock a hallogram?! sometimes we giggle just to keep our sanity, sometimes sit and cry for the loss of a great man,, he would hate both. I too leave snacks everywhere, and try to keep him on a steady food schedule or he gets upset about it. I too am in need of a vacation and am hoping hospice will be allowed to come for two weeks, the only other option is putting him in a nursing facility for two weeks and he would most likely be gone when we come back. Hoping the meletonin works for him as he has limited kidney function so other meds would make things worse.
    ps. I just noticed the date of your post, it was my dads birthday last year. I hope you and your family are all well

  18. Nan says

    Thanks so much for this. I am now experiencing this with my 95 year old grandma. I didn’t even think about hospice. I am going to speak with her doctor about this! This would be great help.

  19. Leslie says

    I am so glad to see your message. My 90 year old father has the identical problem and is a board and care facility. We have tried many treatments along with meds and nothing works. Next we are trying Hospice. I am now encouraged.

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