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I am tired of the term 'sundowners' and suggestions of lighting and scheduling. Habits are developed by learning, or appeal. They must find something appealing about staying up all night, in the early stages of dementia. What are the fears then of the daytime hours? My mother knows who the family is and the difference between night and day, although "I had no idea it was so late!" is a common statement. Yet she continues to sleep from dawn until dusk, after piddling around the kitchen. We have gone on trips, and managed to "reschedule" her routine fairly easily, for that period. She will go to bed at a reasonable hour and wake up with the rest of us. Upon coming home, however it isn't long before she reverts back to staying up all night. There has to be something other than a screwed up internal clock, or confusing night and day. Certainly someone can postulate as to "why" and not just tell this is part and parcel of dementia/Alzheimers, and leave it at that.

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cant help you with the whys of this really but i guess it just makes sense if you are up all night you will want to sleep all day and it seems to be a things many seniors do….my mother goes to bed at 8, she will get ready for bed in pjs as early as 3 30pm…anytime after midnight she is dressed for the day…in and out of bathroom all night, doing her hair, emptying trash cans…she comes down for breakfast by 8am…she can be asleep in the living room chair by 9…the only thing that somewhat helps is waking her all day long…i got tired of verbally doing it so i bought a school hand bell and ring it…she has broken her hearing aids so many times ever her hearing aid dr was shocked…the final straw was when she dropped one on her floor and one of my dogs chewed it to shreds..the bell she hears and it saves me from yelling…i asked her dr about a sedative but he says that will increase her chance of falling from being groggy …he did however say I NEED ONE…no sh**!!
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Teenagers do the same thing. It's all about brain function. The classic phase markers for measuring the timing of a mammal's circadian rhythm are:
melatonin secretion by the pineal gland (or taken as a supplement)
core body temperature (night setback thermostats help)
plasma level of cortisol (helps raise blood sugar levels during stress).
Ambient light is also a factor, and modern living with electric lighting has a way of throwing off the rhythms too.
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Gold! My dad does the exact same thing. Sleeps all day, fidgets in and out of both kitchen and bathroom. Checks the weather at night. Have left front door open during the night. Up to mischief most of the time. Eats and open the fridge door all the time. keeps my sister awake. Exhausting. I take him out for 3 or 4 hours, but reverts back to same habit. And leaves tv on loud in his room. On and on!
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I highly recommend daily activities for them, see the local association for adult day care in your community and they may be able to help. I have seen them change in a matter of days.
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If your mother hasn't been evaluated for medications for this condition, you might want to talk with her doctor ahead of time and then take her in for a visit (assuming you can wake her up enough). Been there, done that and meds were the last resort for the safety and wellbeing of my own mother (AND me as caregiver).
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I'm going through that right now. Except she just doesn't sleep period! Can't get her in bed til almost midnight and she doesn't want to go then. Then in the day, she NEVER even dozes off. How she goes, I have NO idea! I had to wake up early to wake my husband and daughter for work. Thank goodness for alarms on cell phones, they had to get themselves up, because I was zonked from staying up so late........I don't even think she sleeps when she goes to her bed, other than dozing a bit. Her doctor even gave her a sleep aid and told me if this doesn't help, give her two. What a joke, her dementia is stronger than the sleep aid!! Everything we do for relief or to ease it, seems to make it worse. The strange part of this whole thing is she went from sleeping 20-22 hrs a day, to NONE and going to bed at 6 p.m. and now it's midnight. Has anyone experienced this? Thanks!
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They are bored with life and you, imo. Husband here does the same. His hearing is bad (working on hearing aids, and hoping he'll use them). BUT when we are out among people he can be life of the party. I think they need their friends around. No friends, go to the senior center and library (they have all kinds of free programs).
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I feel so bad for everyone going through the rigors of lost sleep. I don't have the answer but I can tell you my 95 year old mother also can't sleep at night but dozes all day, BUT she wishes she could get a good night's sleep. She says her problem is "things" keep her awake all night pinching and poking her and threatening her well being. She sometimes thinks something is giving her an electrical shock so is suspecious that someone in the household has wired her bed. As people age their brains usually shrink and the mnd just doesn't work the same. I just hope we can learn how to preserve ourselves intact until the day we die. As someone once said, "growing old is not sissys."
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Hanforda and Figueirob (2012) J. of Alz. Dis. discuss sleep disturbances as common in persons with Alzheimer’s disease or related dementia (ADRD), resulting in a negative impact on the daytime function of the affected person and on the wellbeing of caregivers. The sleep/wake pattern is directly driven by the timing signals generated by a circadian pacemaker, which may or may not be perfectly functioning in those with ADRD. A 24-hour light/dark pattern incident on the retina is the most efficacious stimulus for entraining the circadian
system to the solar day. In fact, a carefully orchestrated light/dark pattern has been shown in several controlled studies of older populations, with and without ADRD, to be a powerful non-pharmacological tool to improve sleep efficiency and consolidation. Discussed their study are research results from studies looking at the effectiveness of light therapy in improving sleep, depression,
and agitation in older adults with ADRD. A 24-hour lighting scheme to increase circadian entrainment, improve visibility, and reduce the risk of falls in those with ADRD is proposed.
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I would say that treatment of sleep disorders in persons with dementia can produce improved cognitive function and reduce caregiver distress. Treatment of sleep disorders in persons with dementia should include consideration of a broad spectrum of factors that can affect sleep and wake cycles, including caffeine consumption, the effect of medications, and mood. Agitation and delirium can be a sign of obstructive sleep apnea (OSA) and treatment of OSA can produce complete resolution of symptoms in some cases.
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Yes, there is a biological, physiological reason for the staying up at night. Her melatonin is depleted or very low and she will be awake at night. Increase melatonin in a pill form and she will sleep at night. Sleeping in the daytime is not good as the sunlight (through eyes) increases her melatonin. Try that and see if you can reset her biological internal clock.
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Starshine 14, I agree. My dad is bored with everything, us and all those around him. He loves people and when he goes out, he likes taking centre stage when given the opportunity. He was surrounded by a lot of people his whole life. He comes from a big family and married again into a big family. His own, me and my sister have small families and we just don't even have the same 'connection' and interest as he has had. He also lived in a busy environment surrounded by lots of activities, unlike us. Bored....definitely, without doubt.

When he first came to live, he also hardly ever slept.
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Shouldn't let your dad roam around unattended at night or anytime else. He could burn the house down. You should take the knobs off of the stove just for that reason. Supervision is the key at this point. Things will only get worse with dementia not better. Prepare yourself and your house for this. Good luck it is a very tough road.
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My mom started sleeping during the day and awake at night. I work full time and her caregiver (who she loves) was just sitting around reading a magazine during the day while mom slept. I pretty much cured it over a weekend. My mom had been going back to bed after breakfast. I did not allow that and every time she headed for the bed over that weekend I told her she needed to stay awake. I explained that I was not going to pay Ella to sit there while she slept and she did not want to lose Ella. Also, and very important was that I gave her an Advil PM at bedtime. She's 92 and in pain anyway so the Advil part worked for the pain and the PM is basically benedryl so it helped her to sleep. Ella kept her awake during the day and I gave her an Advil PM at night. Mom said she was getting the best sleep she ever had. Great result for me.
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Same thing here w/ my Dad. I have found that like Whipped & some of the others here noted that making him stay awake during the day is the only way he will be tired enough to sleep at night. He wants to eat & nap every 2 1/2 hours all day long. Says, " I need to rest". When I explain that his naps are keeping him up at night, he either doesn't care or doesn't understand/agree. So, I wake him & give him something to do to distract or dissuade him from giving in to the urge to nap. He has always been a narcoleptic type,as I. We may seem hyper to others. But, in truth we are the opposite. We are fine if we keep moving. However, once sitting for more than a couple of minutes, The eyes become heavy and sleep comes extremely easily. When I have had to work nights, I would even be okay with some coffee. But, no amount of caffeine in the world would be enough when I would sit down to write. So, I would often get up & grab a broom, walk the halls, or other seemingly odd tasks at work, over & over as needed to maintain my alertness to complete my paper work. Just a little FYI on Narcolepsy for you to know. But, for most folks, it seems, staying awake in the daytime & having something to do to help tire a person is the answer if you can get them to do comply. blou
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My mom (mild to moderate dementia) moved from my house to assisted living a month ago. Her biggest complaint? Having to get up early for breakfast. When she lived with me she was in the habit of staying up late watching TV and sleeping in until after 11 am most days of the week. When I'd go into her room and get her up and tell her it was time to join the world she'd say, "Why? What am I going to do when I get it up." Now, she's up at 7 a.m. for an 8 a.m. breakfast with the other residents (she's made a couple friends) and she's actually surviving! ;) She's socializing, walking a lot more, and actually helping other residents get around by pushing them in their wheelchairs.......this is great! It's like she has a purpose and reason to be up. She may never get used to getting up early like she did before she had dementia when she lived on her own, but she's dealing with it. That, and she really likes the place!
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I meant to say, "get up", not "get it up"......lol
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Plus I should add that my mom has memory issues from Normal Pressure Hydrocephalus so I could explain everything until the cows came home but she wouldn't be able to remember why she needed to stay awake during the day so she could sleep at night. I had to manage her staying up and sleeping because she could not.
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I wonder if dementia and depression go hand in hand? My mother suffered from depression before the dementia surfaced (hers was only short term memory loss), she has always preferred being up all night - usually watching tv or reading - and then sleeping all day. I suffer from depression and when not taking meds religiously I stay up all night and sleep during day. My thought: when by yourself there is no expectations or demands from friends and family --- I also still prefer working a graveyard or late evening shift so i can sleep all or part of the day. Just wondered if there was a connection.
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Hi,I am taking care of a wonderful women,and I fine that if I get her up early and keep her busy all day,she will go to sleep by 9pm and sleep till 7:30am.I believe even for me that if you are active you will sleep through till 7-8am.Good luck every one.And Many Blessings.
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As I read this I find it a bit epic. The funny thing is I'm sure you as teens did the exact same thing. I recall it all to well..Tired from working the graveyard shift to finally have my schedule changed to only have my teens keep me up by being on the Internet all night , cooking and eating..I must say there are paybacks with mother nature. .
I too have insomnia and fear how I will be treated..Thank God for those abuse hot lines for the elderly. Remember social services might be able to help. .I suggest the melatonin ..im not sure if it legal to lock anyone in for their own room for protection. .Find a senior home if you are starting to have bad feelings towards them..Perhaps you weren't a peach yourself
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I am a 72 year old woman who is beginning to have these symptoms. I can't get to sleep until 2 or 3am. This started after a very stressful year. I get up later and later. If my neighbor sees my blinds closed after 11 am, she calls me. I want to change this pattern but I sleep best early in the morning. I am also up every 2 or 3 hours going to the bathroom. I live alone but my community (over 55) has many activities that happen before I get up. I used to get up by 8 or 9am and went to bed around 11pm. When some sadness entered my life I found that I was changing my routine. Maybe if you give your mother something to get up for, she will feel needed. Us old folks have felt needed all our lives. Now we are expected to sit in a chair all day. Find a job for your mother that you need her to do. My son calls me everyday and discusses some of his decisions or politics with me. He asks for my thoughts on things. When he visits, I get up earlier. Don't give up on your parents. They need to be needed.
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I am lucky, my dad and I both had late night, late morning cycles. When I stopped working late nights to care for him, I had to work to get myself on a more daytime awake schedule, and as he has increased in his dementia, regulating sleep is work for both of our sakes. Blue lights, as in electronics, TVs and some clocks, tend to interfere with sleep. It takes 8 Hours for 1/2 the caffeine to leave your body (longer I suspect as your body becomes less efficient). I got Dad to trade his coffee after the first cup to Swiss Miss Coco (sugar free) and a drink with melatonin with dinner and beyond. The windows are covered in his room so he is not up at the crack of dawn (I get up at 10 am he gets up 10:30-11). We both have Ott Lights by our chairs, so there is full spectrum when we wake. He loves to eat, so I feed him about every two hours (yogurt, eggs, oatmeal, fruit after protein) He loves America's Funnies Videos so I help find interesting TV for him. At night, I have a sleep CD I listen to "Sleepy Rain" by Dr. Jeffery Thompson (Amazon). There are pillows with speakers in them, if your mom does not hear well, I play mine on an old boombox I got from Goodwill. Just rain sounds, no talking, very soothing and consistent use will make is a signal for your body to sleep, same time every day. My dad and I have memory foam to sleep on, and heated mattress pads (He does not wet through the diapers and pad), this helps relax the muscles. Lavender oil relaxes muscles also. Also, the SSRI meds for depression help me sleep better, and he is also on meds. I believe they also help decrease pain for some. Also, and maybe finally, oatmeal before bed and improve sleep. Good Luck.
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One reason may be that they are up running to the bathroom all night so they're tired during the day. Another may be a fear of dying alone in the dark, undiscovered until everyone is awake.
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My mom was going to bed at 7pm and waking up around 2am to prowl the rest of the night. About two weeks after replacing her regular light bulbs with some 'day light' florescents she started staying up later-- till about 9:pm.. and sleeping till 6:30 or so. You guys might try that. You can get the bulbs at Lowes.. and elsewhere.
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When you are not with her is she alone and stays up? If she is alone she may need more stimulation in the day to tire or if she has too much stimulation she may piddle as it allows her to functional and feel okay to her. There are many things going on to check on. I had a friend who had this and come to find out some was depression and not wanting to face her inabilities and she functioned when it was slower at night and gradually got her day and night mixed up. We had to try to get back one hour at a time kinda like you do on vacation and that may be key that she needs stimulation. Things I would look at is her routine and see how stimulating is it? Is she depressed? What is her favorite pasttimes that she can do in day to be engaged? Can you alter her routine an hour a day? Is she staying up late, sleeping a little or none at all. With the disease sleep patterns are altered. You may check her diet and digestive system to see if she is eating substances along with her meds to keep her vitamin B intac. Also her meds need review to see if they may be causing some arousal either by the drug or time of day taken. I know it is a lot but it is often a checklist to research and see what factors influence and what you can do to help. If able you might start collecting the above info coupled with h good geripsych behavioral review where you get her seen and have for them her 24 hour schedule of activities, sleep observed for amount and time, mood and times of changes along with sleep and meds. .
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Iam lucky mum who is 82 dementia goes to bed between 7 and 8pm only gets up to go to the bathroom and I coax her back to bed and awakes on the morning between 7And 8am
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The doctor thinks my mom has vasular dementia due to her heart condition. She wakes us every hour during the night with her call bell to take her to the bathroom (she is not mobile due to severe hip arthritus). I am her caregiver and she is also in hospice in our home. The hospice nurse visits once a week, I have an aide with her from 8:30 am to 4:30 am during the day. I have brought the night restlessness up to hospice...however they will provide only palliative care (medications to mask the symtoms not cure them). Since mom is in end stage renal failure as well, I hesitate to add more meds to the list. I am curious to understand more about the light therapy as I would like to try it. She will sleep during the day and be awake during the night. My husband and I alternate staying awake to assist her. It is extremely exhausting. We both hold executive level positions and need to be able to function during the day...which is becoming increasingly difficult.
Mom is not typically highly agitated at night, although there have been some nights where she appears nervous and snappish...mostly extremely restless, wanting to sit up and go to the rest room every hour. She is also dealing with itching due to the renal failure which annoys her when she is resting.
Any further information on the light therapy would be greatly appreciated.
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lifeasasenior has very good advice. Our parents have taken care of us and then, not only are they no longer needed, we are taking care of them because they cannot. Mom said many times that it was not supposed to be this way and I think she felt bad that she was living with me and my husband when she should have been taking care of herself. I give my mom "jobs" to do during the day when there is nothing else for her to do but watch t.v. Her memory isn't good enough for her to read anymore (which was always her entertainment). She can fold washcloths, dish cloths and hand towels and several times a week I give her a small laundry basket with these items (she folds the same ones over and over) but she seems to have a sense of accomplishment and makes her feel like she is contributing to the household.
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GayleinJaxFL, oh memories! I bought 100 towels and brought them to adult daycare when Mom was there. She folded them, thought it was her job, and felt so good! They threw them in the dryer and gave them back to her, she never remembered already doing it. That was 4 years ago, she can no longer fold or go to daycare but you are right. I had her put away silverware, sort socks, etc at home also. enjoy!
About the night awakenings, I went through it for a year with my Mom. I cut her door in half and locked the outer side. She would rest her arms on it saying "hi? hi? helllllllo?" all night long but was safe. I could only put a few things in her closet and drawers to play with or everything would be on the floor. Finally I took her and the neuro gave her depakote sprinkles rx to calm her brain at night, worked like a charm. good luck everyone, this stage does pass.
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