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I am the 62 yo sole caregiver for my 94 yo mother who has moderate/severe dementia who has been living with me for 4+ years. As her dementia/health worsen, it seems that as soon as we solve one problem, another one presents itself. An ongoing, up and down problem has been getting her to sleep at night so that I can sleep. Getting up once or twice a night to help her go to the bathroom is bearable, but it's gotten worse. Last night she called me to help at least 8 times until I finally gave up on getting any sleep at all. So here is what we have tried so far: Melatonin slow release 3 mg which works maybe 2 nights and then doesn't. Trazodone (doc prescribed 50 mg) which I have broken in half to 25 mg. Why? Because she's tiny and I'm afraid to over drug her. I've tried this on two separate nights when I'm desperate and it only makes her more awake and delusional.


I've read that Tylenol PM, Benadryl and ZZZQuil are no-no's for dementia so I've avoided those.


Anyone have any experience with magnesium? Or have any other suggestions? (She's almost blind from macular degeneration and has hypothyroidism.)


I've now been awake for almost 24 hours and I literally cannot go on with insufficient sleep. I am getting her into palliative care and a social worker is coming over on Wednesday to see what the best options are, but I would like to keep her at home if at all possible.


Thanks.

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Why don't you try the Trazadone at the prescribed strength?

Start there. If that doesn't work, call the doctor.
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Check the Trazodone container or paperwork: if it says "do not break or crush" then don't do it as this ruins the time-release mechanism of the drug.

Also, what is her "activity" level during the day? Can she do tasks like folding kitchen towels or sorting items by feel? We give my 99-yr old aunt with mod/sev dementia large piles of kitchen towels to fold, poker chips to sort by color (and she usually puts them in patterns), and plastic utensils to sort. This burns both mental and physical energy and gives them a sense of purpose. We were able to take her off Melatonin and Tylenol PM and she sleeps through the night 99% of the time. We also have her doing a mini exercise pedal machine (for her arms and legs). She does this for 15 min each every day (or more if she's willing). You can put some music on while she's doing it. Medicare might pay for it if her doc can find a reason to order it, or you can find used ones on the internet.

I agree with BarbBrooklyn, do not change or add to her meds (with supplements) without first discussing with her doctor. There can be interactions. I hope you can find a solution and get enough sleep!!
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Meds like trazadone come in different strengths, the doctor will have chosen the dosage they fell will be most appropriate and the pharmacist is a second pair of eyes who would have alerted you if they felt it was too high. Be aware that the side effects of many medications are much more pronounced during the first weeks and fade over time as the body becomes accustomed to them.

A different antidepressant option if the trazadone remains unhelpful is mirtazapine, that was very helpful for my mom.
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