Sleep Issues with Alzheimer's: What Time Is It?

Since sometime around February or March last year, time lost most of its meaning. For many of us, our schedules went out the window. The school calendar, weekends, workdays ... all were disrupted. Business casual was exchanged for a robe and slippers. Daytime and nighttime became how we measured time. For some, the days and nights merged as there was no end to the work to be done. When you have Alzheimer's disease, time gets extra tricky and elusive.

Mom has always been a night person. Dad was the early bird. Opposites do tend to attract. She used to make a nice dinner, fall asleep on the couch, wake up to catch up on the soaps she had taped; then, in the wee hours, tidy up after dinner, and only then go to bed. Dad, on the other hand, would go to bed a few hours after dinner and then get up at 4:00 am to get ready for work, putter around the house before heading to the office by 7:00am. Mom would be going to bed about the time Dad would be getting up. Maybe her sundowning has a long history.

Sundowning, naps, and bedtime routines

While Mom doesn't have some of the classic symptoms of sundowning, like agitation, anxiety, or aggression, she definitely gets confused.

She gets so sleepy during the day. If she's not “harassed” by her well-meaning daughter (me) and grandkids, she will sleep the afternoon away. She can be really hard to wake up. When she does wake up, she doesn’t know what is going on, what day it is, what she is supposed to be doing. It becomes difficult for her to find the right words. Communication is very difficult. She is definitely much better when she is well-rested.

Before I go to bed, I check to make sure Mom has taken her pills, brushed her teeth, and is alert enough that I think she will do it if she hasn’t yet. I’m used to her staying up late. It started becoming a problem when I found out that she didn’t go to bed until the sun was coming up. This started happening more regularly. She would watch TV or usually reading a book and get wrapped up in it and didn’t get sleepy. I always get sleepy reading, but not her.

When not sleeping can cause more harm than good

It scared me, one morning, when I checked on her to see what her blood sugar reading was and if she had taken her pills. It was about 9:30am. She said she was just about to check it. I looked at her log book, and she already had. She didn’t remember doing it. I checked the memory on her meter, and she had checked her blood sugar and taken her pills at 2:30 in the morning! She had taken her nighttime meds just four hours earlier! She is supposed to take them twelve hours apart! If she had taken them again at 9:00am, that would have been really, really bad.

I talked to her doctor about it and asked if I can give her melatonin at night to help her sleep through til morning. He was fine with that because it is a natural occurring hormone. But, he said it won’t help unless we can keep her up during the day, hence the “harassing” part. We need to do that for a few days until her days and nights can start to be straightened out. Also, he suggested keeping her meds with me and not giving her access to them.

We decided we didn’t want to do that quite yet. Instead, my son found a really good $50 digital clock on Amazon that has, in big letters, the day of the week, time of day (after midnight it reads "before dawn”), time, and date with the month and year. It is helping her much more than her analog alarm clock. So, if mom makes up and it’s still dark, she can know what time it is and what day or night. The difference has been night and day. Hopefully staying in that order.

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