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.
{ 18 comments… read them below or add one }
Please if you have any ideas for me to help my mother she keeps me awake from 11PM until about 2AM at least 2 or 4 nights a week. She has sundowners and she lives with me and has for about a year. She is 84, I want to help her and I can’t put her in a home. I am all she has. If you have any idea’s I am willing to try them. Thanks from Alabama.
rpswann@yahoo.com
Rhonda,
I’m sorry, I can’t help you. My father who is 82 has completely reversed his sleep cycle, to the point he is awake all night, goes to bed at 6 am and gets up at 3 pm. I am looking for ways to get him back to somewhat normal sleep patterns.
Kurt
well i don’t think that you can change his sleep cycle all at once….just start waking him up a little early every day…he will be a little sleepy at first, but try to keep him awake as long as you can by talking to him ,, and he will start going to bed at 5 ,4, 3, 2, 1, and then 12 and etc…..then he won’t sleep so late in the p.m……hope this help
Rhonda & Kurt…My mother has sundowners as well. I tryed benadryl but it caused swelling of her hands(she has renal issues),Xanax didn't help at all, the hospital gave her Haldol that almost killed her..she developed Parkinson like symptoms.I finally tried Melatonin and it worked.I bought the liquid and slowly increased the dose until I found the least amount that worked,then bought the pills. Melatonin only, no extras like valerian root or B-6,just in case that would have caused problems. I think this supplement is safe as long as they are not on any MAO inhibitors or other drugs that have a CNS affect.Good luck.
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
You have to keep in mind that the medical field really doesn’t want to deal with dementia,alzheimers or sundowners.Our society says that they are helping and caring for these people,but in reality it’s just suspended animation.
The medical field does not care, the government does not care..they are number crunchers only. The have drive a Mercedes Benz,have beautiful homes in the suburbs and would be appalled if someone treated their children they way they treat our parents.Drug ‘em..feed ‘em..and put ‘em to bed.
My 102 year old granny has sundowners now for 2 months, i have tried to keep her up and it just doesn’t work, this is tearing me down now, cannot sleep due to watching her. My granny’s symptoms started about 3 months ago, i know that when my mother passed my granny started doing alot of crying, moaning alot and now here comes the sundowners. Can anyone help me, i am tied i went from taking care of mom to taking care of granny. Help.
Dear Sandra,
First, my condolences. You are suffering a great loss and are unable to take the proper time for yourself. Frequently caregivers become ill and die from the undue strain. Have you considered respite care or an adult day care? These are short term solutions so you could at least get some sleep, take a short vacation etc. Getting informal help in the home is also an option. I hate to say this but, the time to consider placement may have arrived.
All the best,
Meg
Dad is 90 and has full blow sundowners. His neurologist prescribed 1mg of Haldol at bedtime as well as many more meds for Parkinsons, dementia and urinary frequency. The Haldol makes him sleepy for less than one hour but it does help with negativity and bathing issues which have been a real problem. We tried Valerian root and Melatonin to lengthen his sleep cycle. He was up every 2 to 40 minutes from 1030 pm to 630 am last night (this is typical)t.
He refuses short walks, any type of exercise or going outside (even in a wheel chair).
He has also suffered from intermittent visual and audible hallucinations. Often he will sing, talk and lecture night and day to his visual hallucination friends. The real clincher is that he has periods of stark clarity so its hard to tell who is in there (the real Dad or the confused one.)
He has had 3 visits to the hospital in 6 months. The last time he was talking with imaginary friends with his eyes closed. 2 orderlies came in and informed him they were going to take him to radiology. He didn’t respond to them so I bent down and repeated what they had said. Dad responded to me by saying, “I know he just told me that”.
My brother and his wife are on a month vacation away from this situation due to mental and physical stress. Sundowner’s alone causes family sleep deprivation and decreases coping skills. Its important to get out and do something “normal” on a regular basis.
Dad is fixated on food and since he also has dementia forgets he has eaten by the time he has left the room. We get frequent day and night requests for meals of which he usually only takes one or two bites. We supplement his diet with Ensure and make sure he drinks plenty of fluids. My brother also places a couple of bananas on his walker to he can have them during the night.
. One last tidbit. When Dad was hospitalized the last time his neurologist requested Hospice. It is a God Send! No money involved. They will bathe Dad twice a week, send a respite caregiver 4 hours a week and once a month for a 12 hour period. They also send a nurse once a week, plus if there is a problem they will send a nurse any time, day or night.They also have a doctor who comes to the house to monitor Dads condition and prescribe medications as needed.
Sorry I got carried away. I know there are many many families trying to cope with elderly loved ones with multiple diagnosis. Good luck to you all!
P.S. As I sit here at 1230pm Dad is in bed giving another speech
.
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
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.
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
thanks
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.
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.
I am a caregiver of the elderly for over 30 years. What I see on this board is typical…..no 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.
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!
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
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.