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Hi allmy dad is in an AL, and has for the past couple years tended to go into a nocturnal pattern. He feels like he "has things to do and must get them done before sleeping", and so ends up staying up until 2AM, or as late as 5AM at night. These things that he thinks he needs to get done are generally meaningless things, and he gets confused, goes back and forth from one side of the room to another, wasting a lot of time. Needless to say, none of these late night awake activities are needed. The "things that need to be done" quite well could be done the next day. (moving clothess from one place to another, etc. ) However, he stubbornly insists to continue this pattern. Consequently, he then sleeps until noon - or up to 2PM, sometimes later. He always missed breakfast. He usually misses lunch, fortunately if they miss lunch the dining staff bring it to the room on a tray (extra fee each time), but then it sits there and gets cold by the time he eats it at 2PM or later. THen he is barely dressed and ready by 4:30 PM, and his first activity out of the room is going to dinner (sometimes he doesnt even go). At least he gets 2 meals a day, but the lunch usually gets cold by the time he eats it. So his nutrition is ok.
The staff have tried endlessly to get him to wake up in time for lunch at least, but he stubbornly refuses, often yelling at them to get out of the room. So there is nothing really they can do except let him sleep until 2PM and leave his lunch tray.Sleeping meds at night have not worked. He refuses to take them at a reasonable time, (say 8PM) saying he does not want to be groggy until he is ready to sleep. So he refuses anything . He does get up from sleep at times anyway to go to the bathroom, and has had falls, so the doctor did say anything strongly sedating in the evening might worsen his falls. So medication has not helped this issue and anything sedating likely would increase his falling.When he has doctors appointments, I take him. I usually schedule them for as late in the afternoon as possible. But it often is a struggle, and despite his well intentioned plan to get up on time, I find him still asleep at 2PM when we need to leave asap to go to the doctors!Any ideas to getting an elder with moderate dementia to change this type of a sleeping pattern? His dementia is too far along to try reasoning.I dont have time to visit every day in the day and try to force him to get up, and he likely would yell at me too if nothing particular is scheduled that day. The staff have also run out of ideas. Should I just let this pattern be and let him continue the sleeping pattern? Its not optimal with fitting in with the AL lifestyle, where most things occur in the day, but yet its not dangerous.

I don't think you'll be able to fix this issue because dad lives in managed care. But here's a possible fix:

How to Reset Your Circadian Rhythm and Keep It on Track
Avoid eating and physical activity later in the day. This is especially important in the two hours before going to bed, Wright says.

Reduce exposure to artificial light at night. ...

Get outside in the morning. ...

Ask your doctor about melatonin supplements.

https://www.everydayhealth.com/sleep/everything-you-need-know-about-your-circadian-rhythm/

Good luck.
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AlvaDeer Dec 21, 2024
I would ask about melatonin as well. Interestingly new studies are showing it has a more profound effect on all our body than we thought. Now has, for IBS sufferers, a connection to brain-gut connection phenomenon that is being studied and recognized. For me I think it is helping with that issue.
Should be taken an hour before sleep; pass it by the doc, but kept within reasonable doses I cannot see a reason not to at least give it a try.

Sleep pattern issues are VERY COMMON to all dementias.
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I would just leave well enough alone. Your dad is now in a place where he's being looked after 24/7, and his schedule for now works for him.
And how does the facility know how late he's staying up anyway? I'm sure with the night shift usually being the most short staffed, that they don't have time to check on him all the time.
You have to remember that as dementia progresses, the person with it will typically sleep a whole lot more as well.
So don't look for trouble where there is none and let your dad sleep.
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