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I think dementia is part of the problem but he is able to carry on an intelligent conversation, read, and do his word puzzles. He is almost total care at this point with care givers around the clock. He seems to have his days and nights confused. He is a delight to be around and rarely complains. He and his wife drink coffee (albeit very weak) all day/night - they say it helps their breathing.

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Because we expect our own "sleep at night" pattern, we night interpret sleeping during the day as "his day and nights confused". But I wonder if he might be sleeping just as erratically around the clock. In other words, somewhat randomly distributed with no 6 or 8 hour stretch at any time.

But chances are that at that age, there might be a number of prescription drugs involved, many of which have insomnia as a side effect. If so, that plus caffeine explains a lot.

What might be worth trying - if you haven't already - is prolonged release melatonin. Fact-wise: A - it is beyond question that we lose our ability to produce it with age, and B - mice get a 20% life extnsion from it.

There is a lot of info on "PubMed", and one study concludes:

"PR-melatonin results in significant and clinically meaningful improvements in sleep quality, morning alertness, sleep onset latency and quality of life in primary insomnia patients aged 55 years and over."
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My mom lives with me and is bedridden. She has nurses that come out 1-2 times a week. We've tried many things to help her sleep because she tosses and turns most if not all night. They either stop working after a short time or they make it worse. I've been told by the nurses that if she's safe why fool with it. She can sleep during the day if she needs to and she seems fine. So my advise is if FIL is safe and happy why try to change it?
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I so agree with Jeanne and NancyH. If it isn't broke don't fix it. So what if they eat and sleep according to their personal schedules/preferences. Wouldn't we all, given the choice. If they have round the clock care givers, who are being paid for their time and efforts, let your parents live according to their internal clocks. If they are happy and well cared for, that's the goal. Don't mess with it. Cattails.
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When and if I were to get to the ripe old age of 101 yrs, I think I'd want to be left alone to sleep, eat & do whatever I wanted. I'll catch ya in 40 years and see if I'm right. :)
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Why does he need to sleep better at night?

If the schedule he and his wife are on suits them, and they have round-the-clock caregivers, what is the problem? I would just try to schedule appointments at a time they are usually up and alert.

I have Delayed Sleep Phase Disorder myself, and I have been working with a sleep therapist to shift my internal body clock to somewhat more "normal" hours just for the sake of convenience. It is very hard work to make this shift! I would not bother if I were not working and did not have a spouse who needs caregiving.

If there is some benefit to "fixing" the timing of FIL's sleep, there are several good medical internet sites with suggestions. Try the Minnesota Regional Sleep Center, or Mayo Clinic. And giving up the weak coffee or switching to decaf might help. But it might also cause other problems, if they think it helps their breathing and it is eliminated.

Is FIL getting his medicines and pills OK inspite of his sleep schedule?
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