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Posted May 24, 2005

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Elderly Behavior: When Dad Won't Sleep

Q. My father is in an assisted living home and has a condition referred to as "sundowning." He's pretty normal during the day (considering he has senile dementia), but turns into a monster around 8 p.m. He stays awake all night, and I'm at a loss as to how to help him get to sleep. None of the medications have helped; in fact he has opposite reactions to them. I have sitters with him around the clock because he's very weak and may fall. He doesn't realize he's so frail. Should we just let him stay up and find activities for him or continue to try to get him to sleep?

Clara E.

A. Sundowning is very often related to medications. You might want to get a physician who specializes in the care of the elderly - a geriatrician- to see your father as a consultant to review the medications he is on. Medications affect the elderly very differently than younger patients. Routine is also an important aspect of controlling sundowning. Try to provide your father with the same routine each night. The routine should be quiet and without unnecessary stimulation. Sometimes an herbal tea or hot milk is relaxing. If all this is not successful, by all means keep the companion there and have her provide quiet activities. Don't try to force him to sleep. If the environment is non-stimulating, he will probably eventually sleep a bit.

This answer has been provided by Dr. Tara A. Cortes, the Senior Vice President for Patient Care Operations and Chief Nursing Officer at Bridgeport Hospital in Bridgeport, Connecticut, and Clinical Professor at Yale University in the School of Nursing doctoral program. Dr. Cortes is a published author and consultant in the areas of geriatric care and nursing administration and leadership. She can be reached at

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