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Dad is very foggy during the day and wants to sleep all the time. Some of this is his newly diagnosed anemia (we are seeking treatments) but he has always gotten up at 3 or 4 in the morning and gone to bed around 7 pm. Now he is up and down starting at 10 pm through 5 am and he watches tv and gets into candy, cookies, anything sweet. If he can't find candy or cookies, he'll eat sugar straight from the bowl. His sugar is very high because of this. He is then very sleepy for extended periods all day. He'll be a couple of hours in bed, then a couple hours dozing in his lounger and back to bed and back to lounger all day, even if we get him up, washed and dressed and give him is OJ and tea and some breakfast at the usual time. During the day, it is nearly impossible to get him to eat anything, but he will drink Glucerna shakes or eat pudding and sometimes a deviled egg or a bit of chicken. He has recently started using a walker and had very limited strength due to the anemia and the lack of solid food and we are very concerned about his ability to handle himself at night now. Any suggestions would be very much appreciated.

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When my mom had Alzheimer's, she'd have a.m. p. m. confusion. We got her a clock that would specify a.m. and p.m. and I explained to her what that meant, and at the beginning of things she understood, but she moved in with us shortly thereafter. I even wrote a book about our travails called, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." I have a chapter entitled " I a.m. confused," because she could get confused about time, all the time. For her, even 2 teaspoonfuls of banana pudding, slightly sweet, after dinner, could keep her up for hours, as we learned after 1 serving. I agree with the other posters: maybe limit or remove sweets, perhaps keep him as engaged as possible during the day, so he'll be tired at night. Hopefully once the anemia is under control, his overall health will improve. Best of luck.
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Circadian rhythm is screwed up is what my mom’s nurse called her staying awake all night and sleeping all day. Good advice given from other posts such as getting him out in the sunlight for 2 hours, limiting naps at least 4 hours prior to bedtime, limiting sweets at bedtime especially, and keeping him actively engaged during the day. I use a sun lamp during rainy days to trick my mom’s body into believing it’s a sunny day. Try to keep him on a set pattern each day so that his body becomes accustomed to normal daily routines.
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Dear Redhead1950,

I hear your concern for your dad. It's very hard to see these changes in our parents and trying to understand what is causing this. I wonder if this could be a side effects of medications he is on. I know you mentioned the anemia and his sugar levels. I found this post:

Why do old people stay up all night and sleep all day?
Around 20% of older people experience excessive daytime sleepiness, which may be a sign of an underlying health condition rather than merely old age. Excessive daytime sleepiness in older adults may be a symptom of health issues like sleep apnea, cognitive impairment, or cardiovascular issues.Oct. 23, 2020

Have you talked to the family doctor? Have they done some bloodwork?

I hope others will come forward with more suggestions.
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Maybe he has a UTI? This is common sundowning behavior. Is he seeing a geriatric care MD? If not, change docs.
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My dad had AZ and for the last five years he struggled with being up at night and then sleeping off and on throughout the day. He too loved sweets and would snack on them. His hospice nurse said AZ is like diabetes of the brain.
She encouraged us to cut any sweets out after lunch, and get dad more exercise. We offered healthy snacks. He was in a wheelchair, but we took him for walks encouraging him to use his arms more and help propel himself. He did! We got him outside to watch the birds, water and clean the flower pots, and be out and watch people go by. He was 90 and lived with 24/7 help in an apt. We had him go to bed between 9 and 10:00 each nite. It really helped! We sort of retrained him into a schedule.
Dad still woke & needed potty breaks sometimes, but they were quick and then straight back to bed- no refrigerator stops for sweet things. He was less restless & agitated, more rested the next day and seemed clearer. I’d encourage you to try it out. Good luck!!
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It is not unusual for Alzheimer’s and dementia people to have erratic and inconsistent sleep and awake cycles. I suggestion for you to try maintain a consistent schedule mostly for the benefit of yourself and your family. I would also suggest that you keep all your windows uncovered so your Dad can visually observe daylight and night times as much as possible; including his bedroom. It also would be helpful to have outside daylight activities with him during the day. A large clock should be present where he will notice it whether he cares about the time or not. These things may not solve his problem, but maybe helpful.
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Seems he has gotten into a "bad sleep pattern." It can be turned around either gently or fast.

Gentle (for him) method - have Dad go to bed at a reasonable time.
Night Shift: Somebody must be willing to get up with him every time. This person will keep redirecting back to bed and will keep him from eating. A drink of water and helping him to and from bathroom is OK. Do not allow him to do anything else and keep the lights dim.
Day Shift: Do not let him doze for more than 30 minutes. Keep on brighter lights. Get him into the sunshine. Feed him regular meals with plenty of iron and vitamin C to build up from anemia. Have doctor check his B12 levels. If low, he will need to get shots. Do not allow "junk food" and try to limit glucerna to "scheduled snacks". The goal is to get his blood sugar levels in normal limits and to get him "awake" during the day.

Fast Method: Same plan for night shift.
Day Shift: No naps during the day. He will be tired in the evening and probably crabby, but he will sleep.
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M mom is 98 and has been doing this for the past year. However, when I tried to keep her more on a schedule she started getting upset because she wanted to sleep during the day. I have always been one to go to bed early and get up early, so I am staying up a little later and watching tv with her and reminding her that I need to go to bed and she can play her computer games on her phone or watch tv. She accepts it but she does complain about not sleeping at night. I haven't found a win/win. yet. I did buy her a clock - states weekday and morning or pm.... she looks at it once in a while. I wish you the bets.
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Interrupt his napping -- keep him awake all day. He will be so tired the first night he'll sleep right through. Then follow through every day getting him turned around. It's not really unusual for seniors to get days and nights mixed up. But it doesn't work because we can't schedule medical appointments in the night hours. It's not that hard to turn him around -- just keep him up and put him to bed after a long day of no sleep and he will adjust. PS Shutting off the TV at least an hour before bedtime and not letting him look at phone or other device screens, an evening bath then brushing his teeth as part of routine to wind down and settle him in for sleep will help, too. Start getting him ready for bed about 8pm with no TV, bathtime, brush teeth and read a little (but NOT with e-reader!) to make his eyes tired. Lights out. ZZZZZZZZZZZ
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My husband did this until the doc prescribed trazodone an hour before bed and a dissolvable melatonin at bedtime. No more an issue for us.
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