Dad has Parkinson's, dementia and doesn't sleep well at night. Any suggestions?

My Dad had PD and PD dementia and the family doctor (with the neurologist's approval) prescriped a small dose of Elavil to, as he put it, "take the edge off" and let my Dad sleep. He was highly anxious and fearful of lying down to sleep and also suffered from sundowning at like 2 a.m. The dr. said some old folks don't like to lie flat because they get the feeling like they are lying in a coffin. I don't know if he knew what he was talking about, but that's what he said. The dose he prescribed was to cut a 10 mg pill in half. It did seem to help.

Ironically, when my mother with Alzheimer's started getting worse with getting up several times at night for these phantom urges to pee, a different doctor prescribed a different pill, Seroquel, and we do the same thing--it's the lowest dose, which we then cut in half. It's just enough to take the edge off. She usually sleeps 6 hours straight through. Anything stronger and it's zombie time.

Both of these medications were prescribed "off label" and are not actually intended for the use these doctors prescribed them. Seroquel, in fact, has very stern label warnings about not being suitable for persons with dementia. Yet I have watched for side effects like a hawk and have not noted any. At one time a few years ago they tried another one on her (could probably look it up if you are curious) and it didn't work at all so I was grateful that the Seroquel did work.

Again, 1/2 of a 10 mg pill isn't very much medicine at all so maybe if you do want to try it you could ask the doctor about Elavil (amitriptyline hcl) which is basically for depression, which a lot of PD patients have anyway.

As for OTC, let me say upfront that I prefer natural aids or OTC to pharmaceuticals and did try them first. To anyone with a dementia patient using melatonin, be watchful for reactions to it. I read somewhere that it can make some people violent. Google "can melatonin cause aggression" and you will find lots of articles on it. I don't know about the whole Nyquil thing... sounds promising. Some say that Calms Forte, a homeopathic OTC medicine, works well but I never tried it on my Dad (who had PD dementia); did try it on my mother (Alzheimer's) and it didn't work.

I am an RN and now helping with my father in law who has Alzheimer's. In the elderly even without dementia I have generally assumed pain. Pla,in old Tylenol and a warm lotion back or foot rub works much of the time. We also use Melatonin, Benadryl at times. There are studies about using dextromethorphan (the dm in cough syrup) in some dementia as it works on the same brain receptors as Nameda and may reduce imflammation. It has a great sedative effect as well.

I am an RN and now helping with my father in law who has Alzheimer's. In the elderly even without dementia I have generally assumed pain. Pla,in old Tylenol and a warm lotion back or foot rub works much of the time. We also use Melatonin, Benadryl at times. There are studies about using dextromethorphan (the dm in cough syrup) in some dementia as it works on the same brain receptors as Nameda and may reduce imflammation. It has a great sedative effect as well.

Thanks for the research but I have a chemist, Neurologist and her primary doctor that said it is okay and she has Lewy Body Dementia. Is Wiki wikipedia? I'm going to stick with the Dr.s and chemist evaluation. Again I would never give anyone anything based on the internet but under a doctors observation only.

Thanks Pam for doing the legwork in Wiki... The common thread is that Benadryl, Zzzquil and Nyquil all belong to the family of anticholinergic drugs that are not advised for those with LBD and other forms of dementia as they affect functioning of the brain.

Bear hug, read the ingredient comparison in Wikipedia. zzzquil is just diphenhydramine aka Benadryl. Nyquil has a triple knockout with dextromethorphan (opiod mimic) and doxylamine (hypnotic) in an alcohol laced syrup. I'm surprised it's still legal, it works so well.

Nyquil is for colds and coughs the sleep aid in nyquil is zzzquil w/o that medicine. My brother is a chemist and my doctor also said there is absolutely nothing in it that would harm her. She has Lewey Body Dementia and high blood pressure and sleeps very well and it does not raise her blood pressure which is a very huge issue for her. Please check with a doctor before giving any kind of medication to your loved one however. Everyone is different and on different medications

Actually, antihistamines like zzzquil will likely raise his blood pressure. And Nyquil works better than zzzquil for sleeping.

Thank you for giving me some feedback I really appreciate it. My dad took melatonin but doesn't seem to work anymore. We can try zzzquil or maybe flexeril? I know he jst got prescriptions for some sleeping pills but they don't seem to work as much and we don't want him to hullicinate or be totally "out of it" or his blood pressure drops and he faints a lot.

Talk to his doctor and see if he would benefit from 5 mg. of Flexeril which is a mild muscle relaxer. He will sleep and your mother will get some rest as well. Good luck!

Can Lewy Body Dementia be diagnosed with a brain MRI. Just starting work up for mom. She has these sleeping symptoms. Thank you!!

I saw a question about melatonin on another thread from this site. I use it for my mother and it works wonders! I only give her about 1/3 of the dose of the one pill because she was drowsy the next day, but boy, is it a winner.

My Mother who is 87 and has Lewey Body Dementia with some Parkinson's symptoms was not sleeping through the night. Her primary care physician has allowed me to give her the non-habit forming Zzzquil. She has been sleeping like a baby. It gets her through the night and she only gets 2 tbsps at bedtime. My brother is a chemist and has advised there is nothing in it that would harm her and we all get our much needed rest. Mom does much better during the day and she is not so exhausted.

PD and dementia is typically known as PDD, Parkinson's with Dementia. Parkinson's is caused by Lewy Bodies in the movement control area of the brain (substancia nigra). The Lewy Bodies can spread to other areas of the brain. In the case of dementia, they are in the cortex (outer shell). PDD is one of the Lewy Body Dementias (LBD). The other is DLB, Dementia with Lewy Bodies. The Lewy Body Dementia Association (www.lbda.org) has a wealth of information for caregivers. Also, www.lbdtools.com has a bookstore for books on dealing with both forms of LBD and other forms of dementia.
Regarding sleep issues; most of the Parkinson's meds will work as you indicated. Also, another Lewy Body problem is REM Sleep Behavior Disorder. You can Google it or find info in the previously mentioned books. As a 'last resort' antipsychotic meds such as Clonazepam or Seroquel could be tried. Bear in mind that whatever has been tried and not worked may be an indication of high drug sensitivity. That is, when a patient takes a normal dose, the body sees it as an overdose, sometimes a huge overdose.
You didn't mention the type of doctor your dad has been seeing. For PD, it’s usually a movement disorder specialist. Typically, they know very little about dealing with dementia so it’s best to find a Lewy-savvy neurologist. Most of the time you have to ask about their Lewy qualifications.
Lewy Savvy

Actually, the best cure is to keep them awake during the day. Snoozing off after meals leaves them wide awake just as you need sleep. NO coffee after dinner helps. Finally the Rx meds come in after all the above does not work, and the bedtime meds must be carefully selected. Parkinson's disease medication like levodopa/carbidopa (Sinemet, Atamet, and Parcopa), and amantadine (Symmetrel, Symadine) can cause intense nightmares that disrupt sleep.
Bear in mind that as PD changes and progresses, different medications are used, so it is important to let the MD know what has changed to he can modify the drug regimen.