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We brought her to live with us in January when she became bedridden and under hospice. It has been difficult, but much worse since she quit sleeping and rambles all night long, often yelling for help. This awakens the entire household including my young children making it hard to go to work and school. The NP keeps adding more variety of pills when I report her lack of sleep but it seems there would just be a better pill as opposed to adding more and more pills that don't work. After several days, she crashes from exhaustion for 1-2 days. At bedtime, she takes trazodone, haloperidol, methadone, senna and newly added seroquel. Please help as we are committed to care for her in our home.

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Try lowering the temperature. Studies have found that lower temperatures both make it easier to fall asleep and promote sleeping longer. Which makes sense since body temp drops to initiate sleep and it tends to be colder at night. Even a warm bath works because it leads to a body temperature drop. It dilates blood vessels at the surface when allows heat to radiate out and thus lower core temp.

As for medication I'm a science based, clinical trail and FDA approved kind of guy. Those a tend to smirk at supplements that have no evidence that they work. Having said that, try melatonin. I was a non-believer. My mom's psychiatrist warned against using it on the elderly. I reviewed some studies and it was inconclusive at best with concerns about use in the elderly. But my mom had a episode that was not explainable and in the hospital they gave her melatonin to help her sleep. Under a new neurologist we have continued to give it to her. The results have been remarkable. She is better now than she has been in a long time. All her FDA drugs for mood and memory, at best, just took the edge off a little. Since starting melatonin, she has had a much better appetite and memory. Weight loss was a major problem because she wouldn't eat. Some things she hasn't been able to do on her own in years, like work the seat belt are easy for her again. I think it's the better sleep that accounts for all this.
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Try a lava lamp - see if you can get her to 'watch it' for you? It is hypnotic and soothing music may help.

I agree with the turkey and warm milk (may be a hot toddy)
I, personally, have not tried Melatonin but if it works........... then go for it.

Sounds like her meds are a right mix? Would an emergency department in a hospital sort them for her/you? (Just a thought)

Can you get 'respite care' may be once, or twice a week, so you can all get some sleep?

I wish you luck and peace. hugs
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You can try soothing music and some people like Melatonin . Though personally it doesnt agree with my Mother at all
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Thank you all for the input thus far. She will go for several days not sleeping in the day or night and then crash for a full day/night. The hospice team has been all over the board and has been an emotional roller coaster from telling me she was down to the end to telling me she is boarder line not qualified for hospice. The problem with hospice as good as it is in many cases is that they don't approve PT or new diagnostics to see of any changes good or bad and moms condition is not clear cut (stent blockages in abdomen that restrict blood flow to bowels as well as ischemia of other arteries). Re-stenting could help but the massive drugs have caused her to get weak and immobile to her current state of being completely bedridden making it hard to find a doctor wanting to work on her (at least locally). It does seem the medications could be a bad mix and making things worse but the NP's solution is to add more and tells me we should do whatever it takes to make her comfortable but my prayer is to find less, more effective meds.
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Are the medications she is already taking giving her any benefit? IMHO I would explore discontinuing meds that have no positive effect before I would try adding anything new. And a NP is perhaps not the best person to be prescribing these types of meds.
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I know I’m weird, but even though “sleep experts” advise a pitch dark room and total silence, that works just the opposite on me. I have to have some light, if even a street lamp or a full moon, and traffic noise. While trains bother some people, they relax me.

Have you checked Mom’s bed, pillow, etc.? Maybe one of those white noise machines would help. I agree—she certainly is on a pharmacy of meds. What about just Ambien? And, my husband is bedridden and sleeps all afternoon. He’s up most of the night too.
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She certainly is getting a LOT of meds, but it seems they're not working, or perhaps the combination isn't right.

I personally abhor just adding another medicine w/o further investigation and specific need. I would have a heart to heart discussion with the hospice NP and discuss this mass of meds.

Also ask her or the hospice doctor about herbal teas, or melatonin. If they don't interfere with the NECESSARY existing meds, consider these. My nurse sister recommended melatonin; I found it very helpful for me, with absolutely no after effects like some of the more powerful and less natural meds create.

Is she able to eat, and if so, consider turkey for an evening meal. The tryptophan is sleep inducing; but don't get the pills, get the real turkey meat.

I would also discuss whether this is to be expected given whatever other medical conditions she has, and if it's a stage in the dying process.
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Is she sleeping too much during the day maybe?
She is already on a slew of medications.
Warm milk before bed? A hot toddy? My BF’s grandmother was from Scotland & had the family make her a hot toddy every night before bed and it worked. She lived to be 93.
Good luck!
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In addition to the medications listed above, we are directed to give her lorazepam if not asleep in one hour and then an itching pill 30 minutes later if still not asleep. These do not work either. Thank you.
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