My DH gets up multiple times a night , especially when we are away from home. It means I get up too to show him to the bathroom. Last time we were away I gave him an Advil PM before bed and it worked great. He didn't get up until 6 am for his first bathroom break. He was no more confused than usual in the morning. I'm wondering if it's ok to use this on a regular basis.
According to WebMD, drugs like Advil PM help you sleep by including (a) a pain medication (in this case, ibuprofen) and (b) an antihistamine, an ingredient in cold medicines that may also work as a sedative. The ibuprofen isn't a problem at moderate dosages.
However, according to the National Institutes of Health, the effectiveness of antihistamines as a sleep aid is not well established and they can have side effects such as daytime drowsiness and decreased cognitive function. These drugs are not for long-term use even in healthy people.
Antihistamines can be a particular problem if your husband is on a cholinesterase inhibitor (aricept, exelon, razadyne, etc.)
Dr. Murray Todd is a well known and well respected neurologist specializing in Alzheimer's Disease. I have heard him speak at conferences at least 3 times, and he always emphasizes that Alzheimer patients should not be given those PM medicines - Advil or Tylenol. He is adamant about it.
My husband is 60 and diagnosed as early stage 4 and he also sleeps so much more, he averages 10-12 hours per day. He watched TV for hours and his Dr. says it is because of the apathy that comes from loss of function in the frontal lobe of the brain. He has such extreme difficulty initiating anything even though he does pretty well if I am there to work with him. It is frustrating when I am used to him doing so much around the house and now he does not do much at all unless I am there doing it with him. Sandy
Hildann, I have seen a glass of wine suggested for helping AD patients sleep. Again, talk with your doctor. We were posting about this earlier somewhere -- several studies have found that moderate alcohol consumption can slow down the progression of MCI (Nikki found that study) and AD.
...here we go, the thread is:
So Confused-angry, hurt, depressed-what now? Please Help!
Jayne, your husband's sleeping habits mirror Claude to a "T" except he is doesn't take Seroquel. He's on Exelon, Namenda for Alz and Sinemet for his Parkinson's. Also, BP meds and a blood thinner. I mentioned the excessive sleeping to the neurologist last time and he said it's part of the disease and not to worry about it. He is mid stage 6.
It's hard not to worry about it and I go in frequently to check to see if he is still breathing.
P.S. Forgot to mention, he started the "sundowner" pattern a couple of months ago. He didn't do it all the time. The neurologist put him on Depakote which is suppose to help. I don't see much change and think I'll stop it and see what happens.
Sunshyne and bluedaze, Trisinger said "THE RESISTANCE" of a bull elephant. He was not comparing her to one! <grin> That is different. I'm sure that a lot of us fit in THAT category! <grin>
huh. As I mentioned, Lynn hasn't been on any medication for well over a year, but he will sleep 20 hours a day if I let him. He is now on seroquel, but it hasn't changed his habit. I have tried getting him up several times today. He did come eat twice, but then said he wanted to go back to bed. I asked why? Don't you want to something? and he said "when I sleep, it doesn't hurt to think" Well, what can I say to that! Poor bugger *sigh
Nkki, I've often been told I'm as stubborn as a mule...<grin> Sorry if anyone takes offense - resistance is strength, and we all need that - I meant it as a compliment.
Poor Mary, reduced to giving yourself compliments ... and of such a nature, too. Can't you come up with something a teeny bit more flattering?
Let's see ... I've been called an "attack dog" by the dear relatives trying to bilk my husband out of his money (what vanishingly small amount there is left of it.) I must admit, I was enchanted. A very clear sign that my efforts to protect him were beginning to really get to them.
We can't go with the wine. He had a serious alcohol problem prior to his AD diagnosis. He is very proud of having quit drinking. However, I may give it a try.
OK, trying to redeem myself by helping Hildann, since I've failed bluedaze so miserably ...
First, Hildann, is your husband getting up at night because he needs to relieve himself? Does he also need to urinate frequently during the day? If so, you should speak to his doctor, he may have an enlarged prostrate, which may or may not be a serious health problem. It may be possible to soothe the "urge" to urinate with a prescription medication, or with a "natural" OTC product such as saw palmetto berries.
If your husband is getting up because his sleeping cycle is disturbed -- which is very common in AD patients -- then he may need a sleep aid.
According to the Alzheimer's Association, most doctors tend to avoid prescribing traditional sleeping pills for older adults with dementia, as the drugs can have serious side effects, including incontinence, problems with balance, falls or increased agitation. One widely used alternative is the antidepressant trazodone (Desyrel), which tends to make people sleepy. Anti-anxiety medications are also sometimes used.
Doctors also recommend that individuals with dementia avoid over-the-counter sleep aids. The active ingredient in many of these medications is diphenhydramine (Benadryl), an antihistamine that makes people feel drowsy. Diphenhydramine further suppresses the activity of one of the main brain cell messenger chemicals whose activity is reduced by Alzheimer’s.
It has been suggested that "natural" sleep aids such as melatonin and tryptophan might be useful. Evidence suggests that stress and/or a dietary lack of tryptophan may make deficiencies of serotonin and melatonin common, even in healthy people. In addition, older people have a reduced ability to synthesize melatonin. Disorders of melatonin levels and rhythms have been suggested to be a cause of affective disease, abnormal sleep, Alzheimer's disease, and some age related disorders.
However, as far as I could determine, there have been few studies to determine whether melatonin or tryptophan would be effective in AD patients. It has been reported that natural melatonin levels are altered in people with Alzheimer's disease. However, it remains unclear if supplementation with melatonin is beneficial. Efficacy in treating circadian disturbances in AD patients has been reported in individual cases, but needs to be verified in large-scale clinical trials. There have also been anecdotal reports of AD patients who do not respond to melatonin (in addition to trisinger's wife.) See:
Tryptophan has also been studied for treating AD in clinical trials, but for improving cognitive functioning. As far as I can tell, it was not found to be effective for that particular application. I gather that researchers are developing chemical analogues of tryptophan as possible AD drugs. Tryptophan *has* been found to be effective for treating many mood disorders, including depression. Depression is known to be associated with deficiencies in neurotransmitters such as serotonin. Tryptophan is a precursor to serotonin and is usually converted to serotonin when taken alone on an empty stomach. Therefore, tryptophan can induce sleep and tranquility and in cases of serotonin deficiencies, restore serotonin levels leading to diminished depression. Ergo, it may be useful in AD patients with depression.
Tryptophan has been studied for treatment of chronic insomnia in otherwise healthy patients, and found to be effective. Animal studies (rats) found that an analogue of tryptophan, 5-hydroxytryptophan, is significantly more effective than tryptophan for improving sleep. I haven't had a chance yet to see if 5-HTP has been tested in humans.
Here's an excellent article on the use of melatonin and/or tryptophan while taking antidepressants. It explains how they work, some possible drug interactions, etc.
In addition to medications, there are other things you can do to try to improve your ADLO's sleep cycle.
* Keep the patient on as regular a schedule as possible. Get him out of bed at the same time each morning, and put him to bed at the same time each night. Try to discourage him from taking multiple naps during the day—one nap in the afternoon is all right, as long as it lasts no more than an hour. During the day, keep the patient as active as possible.
* It's also important to get the patient to eat his meals at a regular time each day. In fact, the more routine there is in the schedule, the better the patient is able to cope with the effects of Alzheimer's.
* It is important to expose the patient to as much bright light as possible. In a nursing home, most patients are exposed to bright light for only 10 minutes a day. Generally in the community, patients are exposed to about 30 minutes a day. Even this is not enough. It would be better if the patient were exposed to bright light for several hours a day. Take him outside whenever possible, especially in the morning. Morning light offers the best exposure, because in a patient with dementia, their circadian (biological) rhythm is out of sync with the rhythm of the environment. Bright light improves their functioning and makes them more alert.
* It is also important that the environment be dark at night. If the patient tends to wander at night and you are worried about him falling or bumping into furniture, you can keep a nightlight on. But understand that bright light interferes with circadian rhythms. Otherwise, keep the patient's bedroom as dark as possible. You should also keep the environment as quiet as possible during the night.
* Avoid caffeine products such as coffee, tea, chocolate or soda, because they interfere with the circadian rhythm.
* Exercise is very important. Have him do whatever he is capable of doing: for example, take the patient on a short walk every day on a regular basis, and engage him in throwing a beach ball. Even if he has to use a wheelchair, encourage him to do arm exercises.
One of the characteristics of dementia is sleep disordered breathing. More than 80 percent of dementia patients have sleep apnea. If the patient can be treated successfully for sleep apnea, it may improve their sleep at night and their alertness during the day. Speak to the patient's doctor about this possibility.
I found a very recent news article (news articles are not to be believed until thoroughly checked out) reporting that a study conducted by the Netherlands Institute for Neuroscience concluded that exposing the patient to bright light during the day (either 1,000-lux bulbs in overhead lights -- about the brightness of TV studio lights -- or 300-lux bulbs -- similar to office or retail lighting), the brighter lighting was associated with decreases in cognitive deterioration, depression, and functional decline. When melatonin was added as a second treatment, it improved sleep patterns and decreased aggression.
Note that an earlier small but well conducted study evaluated the effect of bright light therapy in combination with melatonin or a placebo on restless behaviour. Bright light therapy was found to help restless behaviour, but the addition of melatonin negated the effect.
5-Hydroxytryptophan use in healthy patients -- see http://www.thirdage.com/healthguide/5-hydroxytryptophan
Bottom line: The primary use of 5-HTP is for depression. Several small short-term studies have found that it may be as effective as standard antidepressant drugs. Since standard antidepressants are also used for insomnia and anxiety , 5-HTP has also been suggested as a treatment for those conditions, but there is only very preliminary evidence as yet that it works for them.
No significant adverse effects have been reported in clinical trials of 5-HTP. Side effects appear to be generally limited to short-term, mild digestive distress and possible allergic reactions.
5-HTP should not be taken in addition to prescription antidepressants (including SSRIs , MAO inhibitors , or tricyclics ), the pain drug tramadol , or migraine drugs in the triptan family (such as sumatriptan), except on a doctor's advice. When taken with the Parkinson's disease medication carbidopa, 5-HTP might cause skin changes similar to those that develop in the disease scleroderma.
Interesting: in a study to compare 5-HTP and an antidepressant in the prozac family for treating depression, 5-HTP was equally effective but caused fewer and less severe side effects.
Thank you for all the valuable information! My DH was taking 5-HTP that was prescribed by his holistic MD but I discontinued it about a month ago when I read that a common side effect is gastro problems. He spends an inordinate amount of time in the bathroom. It's hard to tell if it's just obsessive behavior or something serious. He has been taking Melatonin , just .5 mg, also prescribed by the holistic guy. Maybe I'll increase the dosage. I'm not too bothered by his getting up at night when we are at home. When we are in a strange place it is bad. Thanks for all of the suggestions! It really is amazing to have people in the same situation respond personally like this.
Sunshyne-all is forgiven. Your info-as always was great. As you mentioned-many OTC meds can cause prostate problems-always best to ask the pharmacist. We have to be so vigilant with our charges. If we took a med for symptoms we would know if a problem was occurring. They will not. It's starting to rain again. I finally got out today and saw an ocean where only last week dry land existed.
I have been reading about sleeping changes and was just wondering if any of you found "sleeping changes" to be one of the early signs. For the last may be two years, may be longer, my DH has been getting very tired/sleepy in the early evening and going to bed earlier than usual. We almost always watched the 10:00 news before getting ready for bed. So it was usually 11:00-ish before bed. Then up about 6:30 a.m. So, if he goes to bed at 9:15 or so, then he wakes up earlier. He is home from the out-of-town job and both mornings this week, he has been up around 5:00 or 5:30. My alarm for work goes off at 6:45. I have tried to break this cycle by making him stay up later but the later he is up the more agitated he gets. He has not been diagnosed, so is on no medicine for it. I'm pretty sure that he is in the very early stages of FTD.
Mary!!, my husband started that about 8 months ago. Just lilke you describe. Now, he sometimes goes to bed at 8:45 p.m., but always wakes up when I come to bed no matter how quiet I am, and lays there watching TV and dozing all night. AND starts to get up between 4 and 5, and I tell him he has to stay in bed until 5:30, because the coffee isn't ready yet, and he buys it, and stays in bed until then, but won't stay in bed a minute longer! They must have internal clocks that change, and I don't think that they can control them any more than we can. I tried getting him to stay up later too. He still got up at 5 -5:30, then by 6:30-7 a.m. fell asleep sitting up in his recliner! <read my irritation here!>
I have been having so many sleep deprived nights lately, that it is making me irritable. I have tried feeding him later, but it doesn't help; nor does music. <sigh>
You may have considered this, but I would recommend you sleep in another bed. I cannot sleep well in the bed with husband not he with I. He claims I snore. I like to read at night and he didn't. You might be waking him in the morning without realizing you are.
We have slept in different rooms for several years. It was one of the hardest things for me to do. Took me a year to adjust.
Imohr, HE wakes me! He's the one who wakes up all night long. When I tried sleeping in the other room, he'd get up several times during the night and come into the other room and turn on the light to "see" where I was! I get more sleep in bed with him. Thank you for the suggestion though. It's just that when you have to get up at 6 a.m. and take care of his needs, then get ready for work and leave at 7:30 a.m., you really hanker for that last hour of sleep! (From his waking up at 4 - 4:30 a.m.) <grin>
Mary, that's kind of what I run into. He usually gets bad heartburn after he goes to bed. Then he gets up twice for bathroom. When he gets mad at me, he always sleeps in the basement bedroom. The last time he did this, he saw a "ghost" and it really scared him. No more wanting to sleep in the basement.
Yea, I'm not ready for the sleeping apart yet. It hasn't gotten to that point, thank goodness. When he was working out of town, I would go to bed around midnight and get up about 6:30 and this was plenty of sleep. Its the waking up during the night a couple of times and then getting up early. I don't know how he can keep going. He must be ready to crash.
I've been known to give my husband a Sleepeze or something when he wakes up around 10-11. (he goes to bed around 6:30 or earlier). Also, see if he'll use a urinal instead of the lights on-go-to-bathroom-lights off routine. Mine knows, from REPEATED corrections, that he can't "get up" before six.
And I agree, it's probably a good idea to train them to sleep alone while you can. Give them a nice soft pillow to hug.
I'm so glad I read this thread. I give my DH tylonol PM every night to help him not wake up because of pain in his shoulder. I guess I'll switch to plain tylonol. No one ever told me that, and you know, the doctors are always asking what they are taking. maybe that's why he sleeps all the time. My stepson said it could be the Zoloft, so I thought I'd try stopping it. For 2 days he cried because he friends (who he had when he was 16) had died. he hadn't seen them for years, but now he's crying because they died.... I started the zoloft again. I'll have to speak to the Neuro about this.
When I had to meeting with the Dr. and the subject of why he always sleeping at home and now not at the NH. The Dr. said that at home he was sleeping so that all the things that he knew that needed done at home and he was afraid to tackle because he would mess them up instead of fixing them was upsetting him. My DH could not figure out what happened to his Mr. Fix-it abilities. Now he doesn't sleep because he is afraid that the nurses will steal his gold bracelet and the man in the next bed is trying to stab him. He hides everything under his pillow. I don't want to start meds just yet since he has been in the NH only 2 months and really has not adjusted to his new home.
Read an article in a mag that SLEEP APNEA is now being found to actually HELP persons live longer ??!!-:) due to the constant lack of oxygen with sleep apnea over many yrs, the brain and coronary system 'adjust' and can withstand much better if they person has a 'stroke' or heartattack...go figure! so many of our spouses has sleep apnea as discussed in comparing early symptoms! divvi
Hi All, was reading this message board during lunch at the office. Was reading about all the sleep problems. Came across the message about the sleep apnea. My husband has sleep apnea and according the the doctors it was probalby a big contributor to his congestive heart failure. He is supposed to wear a breathing mask at night. Has not been using it for the past few days and it is very easy to notice. He sleeps the better part of the day, dozes in his recliner off and on all day ( I work 10 hours a day) and then goes to bed about nine. Then wakes himself and me up all through the night. It used to frighten me when he would stop and then start breathing again but got used to it over the years. Now I am used to the machine and hope he will start using it again. I was told if someone snores, especially loudly, like my husband, they probably have sleep apnea. Oh and on the coronay system adjusting - it never happened with my husband, now only has ten percent of his heart functioning with an eighteen percent ejection rate. Not trying to dispute anyone just stating what I know from experience. This message board is a sanity saver.
Heres the link article's link on sleep apnea and the 4.5yr trials, goto ATS.Org and under news about sleep apnea and seniors.. ATS is American Technion Science from Israel. divvi
When searcing found several threads on sleeping and thought the title of this one best described my question.
Have any of you with FTD spice that sleep A LOT found them sleeping LESS?
Suddenly, after years of sleeping most of the day and all night, DH is now awake almost all day -- maybe just a brief nap after lunch. What do you suppose???
Mine went the opposite direction Weejun. from no sleep in the day to sleeping several long naps during daylite hrs. and from no sleeping at nite to alnight! then some days no naps at all-strange-- again my only explanation in my mind is that the disease has moved into a new area of the brain that controls these features. or out of it:) like some others here, the fullmoon does contribute sleep disturbance as well for my DH. ANd hes been chatty cathy all week something new. fullmoon is friday the 4th. ugh.
Weejun, my DH went from dozing during the day and sleeping at night, to staying awake all day and barely dozing during the night, to staying awake all day and all night, to sleeping most of the day and sleeping most of the night...now he dozes within 15 minutes of getting up for an hour, then awake until lunch, sometimes dozing while eating, then awake for an hour, then napping for a couple of hours, then dozing while eating dinner, then staying awake until 10, when he gets his Ambien so that I can sleep, and he sleeps until almost 4 a.m., then after a bathroom run, will sleep until 6. So, I now get 5 1/2 hours uninterrupted sleep for the first time in two years!!!! YEA!!!
Those wires in the brain short circuit the sleep patterns...it is really different for each one, and it keeps changing...it just gets frustrating!
This is timely as G suddenly started laying down nearly all day long about ten days ago. I thought meds were causing this, but he hasn't anything new. I think it is a way to pass the time as he doesn't do anything else to speak of...tries to read,( not very successfully) does jigsaws on the computer (in spurts). He does sleep most of the night, that is he doesn't get up other than potty breaks, but this new all day thing is a puzzle to me. He isn't really sleeping, just laying there.