Why are people with dementia attracted to staying up all night and sleeping all day?

okay.after reading gerojohnson it was confusing, we need more "down to earth terminology".....but I can tell you that my father, 91, is doing the same thing. He might have a good day where he is up most of the day, goes to bed around 11 or 12, but as soon as my mother thinks she is getting some sleep, he is up roaming around. she comes out later to find all the kitchen cabinet doors open, all the lights on, he has even opened front door/looked out and so far has closed the door. then the next day he is sleeping pretty much all day even though he says he is "just resting his eyes" and hasn't slept good in weeks. But if my mother tries to wake him up, he gets to swinging his arms around and is "ticked" off, so she doesn't bother. We have an appt in July but I think it will be bad news for him cause my mother can't handle this much more and he will be going into a home. It would be better for both of them, she can get her rest and maybe they can get him into a better schedule and maybe he will have other people to talk to (he enjoys talking).

I'd like to know how you control the "24-hour lighting scheme", practically speaking. The only thing that we've found helps is taking Mom for walks. The more restless she is at night, the longer a walk I try in the day., Waking her from her daytime sleep makes for a mean, grumpy person (as they say, let sleeping dogs lie). Getting up and feeding her a little when she gets up in the night seems to help, also keeping hidden the things she fools with (ie the electric kettle). She doesn't drink much caffeine. Sleeping pills have the OPPOSITE effect, and make her speedier! Definitely exhausting. Mom has Alzheimers & vascular dementia, and is pretty far down the line.

I also forgot to mention that if the person with the staying up/roaming issues doesn't walk well, you would not want to give them something to help them sleep (did that before, doctor made it too strong and we ended up one night at 1 am with my husband helping my father off the floor) and we surly couldn't take them for a walk, it would take forever with the shuffling of the feet only moving about 1 inch at a time. I think there are reasons for why things like this happen, maybe to test our patience or to give us the opportunity to learn patience. (but that dont work well with my mother, she loses it too often). good luck to all of us who deal with these issues.

I certainly understand the issue with getting him to walk in that case! Luckily, my mother is in great shape physically, though walking still takes forever because she has to stop and pick up every dead leaf she sees. Definitely works on my patience. If it were a toddler, we'd pick them up & carry them; that will definitely not work here.

I am not a professional, but I think it is an illusion thing...
WHY because if they are up all night and we aren't, they can fool themselves into thinking they do not have the forgetfulness that is so apparent when they are awake during the day, there are no rules at night...our 87 year old did not like being alone, she did it for such a short time.

my mom has Alzheimer's and her sleep is so confusing, some days she is up all day and pacing and refuses to go to bed. Then there are days when she does sleep, but due to her turning the stove on at night to cook for the dog and she wandered once, we now have a child gate on her door to keep us all safe at night so the rest of the house can get some sleep. There is a commode in her room, a drink and a snack. The doctor did offer a script, but not only the doctor but the druggist stated that it would make her more confused then she already is.

When my mom was in danger of turning on the stove unattended, we started turning off the breaker in the circuit box, just for the stove. We left the oven light on to remind us when it was turned off at the breaker box. Worked pretty well. Does your mom put up a fuss about the child gate?

Keep in mind that feeding someone at night keeps giving them reward for staying up at night. The kitchen should be "closed" after bedtime. Have a water bottle in the bedroom that will not spill. Also, it might be worthwhile to pay for a nighttime aide, who will respond to mom. Use a baby monitor(instead of the bell), with the aide on the receiving end and both you and your husband can sleep. Also, don't let mom sleep in too late, just wake her gently, a light, 10 later remove the covers. She will be hungry and more willing to get up and get going, and tired earlier. Keep little snacks coming during the day, and give her "chores". Some books, like the "Cat Who...." books (lillian Braun I think) are simple but interesting plots with the same characters in each book. Also, my dad has started to enjoy People (short articles with pictures) along with his Time, Forbes etc. It doesn't matter if he remembers. Mom was a avid reader all her life, but couldn't remember the facts of the book she was reading toward the end. She still enjoyed reading it.

I'm always amazed at what Mom reads and enjoys. The "Smithsonian Magazine" goes over better than "People", for her, and she avidly reads the newspaper, i.e. the same article over and over and over... "Chicken Soup for the Soul" went over well, too, as they are quite short. Plot? she doesn't remember the last paragraph. But she still appreciates good writing.

I'm not sure that eating at night is rewarding her at this point in her decline, as there is zero memory of anything, thus little chance for developing a new habit. She just responds to hunger pangs or as something to do, I imagine.

We wake our 87 year old every day, as on her own she would never get out of bed, the latest test to date was one pm (when we just couldn't figure that through the noise she stayed in bed. One day I banged the pans in the kitchen and she said to me from the B-room, I know your calling me...

I have found a similar pattern with my mom, but if woken too early she is extremely surly and just wants to go back to bed. Other times I think it's just easier for her to lay there.

I think pamstegman and gerojohnson have the correct answers. I do think part of it is fear as well. When we are sick even with flu we may feel better during the day but come evening and night we seem to feel worse, it is because everyone is asleep and God forbid anything happen, no one is awake to know. Now that I have developed severe panic and anxiety, I have noticed some of the same exact things like getting nervous come evening that Mom was suffering with...sundowners. I get nervous, I want to go to sleep but there are so many things that seem to need to be done first or things I need to tell others, maybe in case I die or have some "attack" during the night? I don't know for sure but I have found out what it is like from the "other side."

I'm 54, "sane," and function better at night; when most of the Bronx is asleep. Without those worldly distractions, I actually enjoy reading, watching Lifetime movies, raiding the fridge whenever I want to. Don't have to answer to anyone if I feel like strolling down to the nearest pub at midnight. My ex used to nag about why I can't go to bed like a "normal" person. ... She had to go.

Instead of trying to figure out what's "wrong" with someone else, let's put ourselves in his/her shoes; and take it from there.

I am also a nightowl. I always have been. I function much better at night for some reason. I find I can barely function at all during the day anymore but am ready to roll during the dusk to dawn phase. Maybe a large part of it is that is when I finally have things settled down around the house and Mama is able to sleep, but that is when I am wide awake....I guess everyone is just different.

Very good point, Eddie. Less distraction at night is something to look at. But, for those who wander off, hide things, & for those w/ sun downing symptoms, I'd say it's is definitely NOT a good time to be unsupervised. If the care-giver has to stay up at night, how is he/she supposed to take care of this person all day & all night AND go to work on time AND care for his/her kids, take all to drs. appts., etc....etc...?:

I worked nights and appreciated the quietness of stores, no one there, enjoyed the quietness of my days, but taking care of someone on top of that that also stayed up at night, oh no way...my only experience was when my 87 year old was jacked up on breathing treatments, thank God she pretend reads in bed, no wandering yet...

It is not part of having dementia. Not at all. I think you are the one that has to set her hours. If you allow her to stay up all night and sleep all day then that will be the way it is it seems. If that is not convenient for you and your family then you have to just get her up early and stick to it and she will adjust to those hours. Possibly a trip to the doctor can help with some meds to help her sleep in the beginning. And "sundowning" has nothing to do with sleeping habits.

To RCW6532: I beg to differ, but it is part of dementia, their timing of day and night can be confused due to changes in their chemical makeup. I am not an expert but my mother has tried to get my dad to go to bed at a normal time, which he does, but to only get up about 1/2 hour later and start wandering around (sundowning), if she gets up to address the issue, he gets mad/upset and its not worth her to fight with him. so it does have some things to do with dementia. if they don't do it in a nursing home, thats because they probably sedate them.

My grandma has alzheimers I moved in with her to care for her fulltime. I have the same issue, she is nocturnal and sometimes can go 48-72 hours without any sleep. She believes she is going on holiday with the queen she packs all of her clothes and just waits at the window. I manage to get her in bed but within an hour shes back up and dressed :( it is worse of a nightime but recently its happening through the day also. She is on the highest dose of amitripyline but she seems immune almost now. Its very hard and draining and the doctor always states it is part and parcel of the disease. Infact as I speak she is packing more bags and having a full blown conversation with herself. Patience is the key but we're only human and naturally find it tiresome and challenging at times. Horrid disease x

My mum hasnt done this yet but she takes a sleeping pill every night although she is getting up to pee alot more?
Mum goes to bed at midnight and gets up at noon which is causing huge problems for her diabetes as shes fasting too much and her mood swings are getting worse.