What is causing my mother to moan and shout, for no apparent reason, in the middle of the night?

Hi all. I'm a critical care nurse. Oftentimes medications like Ativan, Xanax, etc can cause behavior changes. There's a syndrome "sundowning" which manifests as confusion/delirium that starts at dusk. Sudden trauma, illness, new diagnoses, can make the fear worse. It is a challenge and medication isn't always the right answer... Sometimes just adds to the problem

She does not live with us, at present, but in her own "senior" apartment, where she has plenty of stimulation with comrades, etc. She loves it! You know, she really does have some physical symptoms, such as COPD, so we have to take her for medical care. And she was referred to a Geriatric Assessment Clinic, who recommended a pain specialist (for back pain and headaches), and she just had a sleep study. They are watching her, and monitoring her health. I don't think it's all whim, but she was limping, so I had to take her to have it checked out. She has RLS, and her legs move constantly, so that has to be monitored, as well. She blacked out behind the wheel of her car, due to long term narcotic use (Fentynal and Codeine) mixed with alcohol, and those she has been weaned off of, thanks to much diligence and several consultations with her physicians on my part. And thank God they removed those from her, as one physician told me if she had continued on them, she would be dead. She's had operations on her veins, feet, wrists, back and knees. Would some one make all those conditions up? I mean, the doctors took Xrays, administered lab tests, etc., then found Cancer. I don't think she's imagiining those problems, but some, brought on herself, due to her lack of self care and poor choices. The COPD and Emphysema was borne of her 50+ years of smokiing. Her PCP told me she'd be right back to where she was (using narcotics) if left to her own devices. Whims? I just follow through with her doctor's orders, and feel a whole lot of compassion for her. I'm hoping the consultations cease soon, unless she really needs medical care. She's also on oxygen for her breathing difficulties brought on by OCD and OCPD and anxiety. She will not take the medications prescribed, or follow their orders, but at least I did my part by taking her. I can't force her compliance. I just get to deal with the consequences of her years of poor choices. Lately, she's been forgetting things: appointments, instructions, conversations, etc. Sad. And she's mean, hateful and spiteful. Bummer. I can't fix that. But I can see she gets the best care possible. Right now, she's in Radiation Therapy for Cancer 5 days a week. Fun, fun, fun.

I do like your idea of intervention. I think that was what the Geriatric Assessment Clinic was all about. We met with a Physician, Social Worker, Pharmacist and Nurse. They diagnosed her as having a Severe Personality Disorder, and said she definitely needs a Guardian. That's me. She's been an addict all my life, (her entire adult life) and my job is to see she never again receives the drugs she seeks, unless a Physician thinks they are essential to her treatment. That day may come somewhere down the road.

The hoops I've jumped through have helped me to understand the extent of her mental illness, how it's affected me over the years, and her current level of need. I feel empathy and compassion for her I wouldn't otherwise. She's just so compelled to do what she does, say what she says, and act as she does. How sad, and how difficult, at times. I can't change that.

So far, Mom can remain fairly independent, with someone overseeing her finances and checking in with her from time to time. I provide her groceries, spending money, and transportation (since she lost her license), and I sold her car. I pay her bills, and make sure her needs, and some wants are met. I resist her demands that I perform instantaneously, unless she has a medical or physical need. Thank God for my patient, and wonderfully supportive husband, who is right beside me every step of the way.

Any other type of intervention? Too late for a dry out clinic. She's not on any harmful medications. And she's no longer drinking alcohol, to my knowledge. So what else should we do?

Her Court-appointed attorney contacted me today, asking me about her. He used the word, "hypochondriac," too. (I'm not offended by the truth.) Oh well. He asked my synapsis. I told him, "She's needy, dependent, and not trustworthy. She is difficult to deal with, but she's my Mom. I have no plans of abandoning her, punishing her, and no longer have a illusions of trying to change her." Whims? I deny plenty. It makes her angry, but I need to set limits and boundaries, as she has no idea of the rights or needs of others. A very wise Social Worker told me to set the boundaries she cannot. Not fun, but necessary.

Somehow, this got far off subject, but I wanted to answer dear Tusconlady's response and suggestions. (Thank you, by the way.) Concerning her "Nighttime problem," I only wish there were a way to help mom with hers. Too bad I desire it more and she does. Don't think that will help either of us... but I'm still open to suggestions. A miracle, perhaps?

I so admire those of you who are in the trenches, as well. What a challenge to care for our loved ones! Bless you, dear ones. Take care!

Does she live with you? Does she consume a lot of caffeine (even chocolate can affect sleep)?. I'm no expert. Maybe it's time for an "intervention" with her PCP and you. And maybe it's time for some "tough love".....no more wild trips to every doctor unless she starts and keeps on one program of treatment. Otherwise this seems like a vicious circle with you all jumping through hoops for a, dare I say it?, hypochondriac and possible addict. There's only so much you should be expected to do, and that shouldn't include trying to go along with every whim, IMO.

This was a good thread to run across. Mom saw her Sleep Study Specialist today for a follow up. She was once doing "better" when she followed his suggestions, but since decided to take herself off several medications, and went against his orders and suggestions, and now is doing terribly again. It seems she thrives on making herself as miserable as possible, and "forgets" what her many doctors tell her to do. She doesn't test positive for dementia, but I am amazed that diagnosing her is so difficult. Every time they try to help, by prescribing some medication or treatment, she finds reasons why they won't work. I don't know about mom, but I am getting frustrated. I wonder if her doctors are getting frustrated, as well?

Mom says she's "sick of going to all these doctors," but goes very often, in spite of her claims otherwise. I think she's "drug seeking," and hope they understand that, too. So far, they have weaned her off, and resisted her demands for the narcotics she took for years. She used to use those with alcohol, as well, lying about her intake. She told her Physician today that she "didn't sleep at all for the past two days." She told me recently, "I realized at midnight that I had to make dessert for a morning coffee hour, and stayed up all night to make it, only getting 1 hour of sleep." Who in their 'right mind' would do that??? I hope her PCP and her Sleep Study Physician can help her. This behavior is affecting my family's quality of life, as well. We are desperate for help! So far, it's just been running from doctor to doctor...and it's making us all exhausted.

Glad to hear it. There's nothing like a good night's sleep! Good luck and hang in there!

The sleeping problem is so much better now that the doctor changed her meds and put her on an antipsychotic at nightime...except for the past week, because she's had a cold, she's been sleeping so much better...as have I!

Thanks....I've been caring for mom for 16 months...seems even longer sometimes...I have lots of support from my husband and two teenage boys, but it is definitely wearing on us...don't know how much longer we can continue providing this much care...it's hard to keep up with my full-time job too! Good thing is I work from a home office...I'm glad I can be there for her for now though...We love her very much but are feeling quite tired and wondering how much longer we can go on...may need to use a nursing home in the not too distant future in order to keep sanity and family together...very hard decision. Thanks for your input...I'll let you know how the music works...I know it cheers her up during the day! She still has a beautiful voice and sings every day to her opera music! I'm glad to hear it too.

I do wish you luck and let us know if the music worked. Anything is worth a try at this point.
I had my mom with me for 8 months before she died, and I do remember that it was gratifying, and yet very frustrating and lonely. Looking back, however, it just seems like a "blip" on the radar screen. You'll get through this. I just hope you can get some sleep! Hang in there.

She can't get up on her own so I don't worry about her roaming during the night...I tried the monitor early on too but gave up as it kept me awake all night hearing every sigh or mumble. It is just so strange because her anxiety is so much better now during the day...she is on an antidrepressant abd, we keep her pretty busy...caregiver or senior center while I work in my home office during the day and she only takes 1 hour nap in the afternoon...if she is left to sleep much longer she becomes depressed and very moody. It seems like all the anxiety comes out at night...she is missing my Dad and feeling so bad about all of her infirmities...and the moans and groans and noise she makes...well, she is often very unaware that she is doing this and it is not really a nightmare. The nurse at the neurologist said it happens because people with dementia cannot contol what would make you or me have restraint and not cry out...but she is often asleep or nearly so when she is crying out...I am going to try the soft music...already got some Cds and will get a Cd player for her room...wish me luck.

good morning , woke up at 5 am , hearing dad hollaring . end up puttin him in the shower and now he is eating his b-fast . he will sleep all day if i let him . i think im takin him out for a ride today .
yes dad likes to hear his old time music , i put his favorite pasty cline disk in and play it till he falls sleep . bless pasty clines heart she always puts him to sleep . but he wakes up after 2 hrs finding himself all wet . clean him up and play that good ole pasty cline again . :-) he is 86 yrs old , diabete , heart pblms , dementia otherthan that he is a sweet old man .
always very polite , says thank you everytime i help him . bless his heart ...

Oh sorry...I jst reread your post about the doctor's advice. Perhaps a second opinion? You need YOUR sleep!

What does her physician have to say about this? I definitely remember my mother being very anxious starting at about dusk after taking lorazepan. She's had a stroke and couldn't speak but she did groan a lot, though never during the night.
Perhaps some soft music, or soothing sounds (ocean...rain...) would help your mom calm herself and go back to sleep? This sounds terrible for you. Do you think you need to "stand guard" all night? Does you mother try to get out of bed and is therefore in danger of falling? Can you drown out her yelling somehow and sleep through it, or do you need to always go in and check on her? This reminds me of when my children were little...that it was better to ride out the crying for awhile so they could learn to go back to sleep. Has your mother gotten used to your attention during the wee hours and that it's now a habit? Just brainstorming here. I would ask the doc if there's something else she could take for sleep. I used to keep a baby monitor next to me at night so I could hear my mother. After a couple of months, I turned it off...it drove me crazy to hear every little noise.

Hm....thanks...not encouraging, but at least I know I am not alone in this...and that it is not so uncommon....well, off to bed...hopefully to sleep...at least for a little while.

My mother used to shout, groan, moan and she's awake most of the night before a stroke in March. She now can't talk and eat by mouth. As she can't talk, she cannot do what she used to before--shout, groan, and moan. But she still is awake most of the night time. The doctor can't give explanation but says this is typical of old people.

nothing helps elders to sleep . believe me my father is takin tradazon and it s strong enough to put a horse down . oh not my father , he still wakes up a hollarin , moaning . i just let him hollar out and he will fall back to sleep . he too dont know why he does that for ..
dementia over powers all drugs they take . thats how thier mind works . alz is the same way too .
i just keep on giving him his bedtime meds and let him wake up all he wants thru outy the night and i wake up to lol .

She is taking Ativan (lorazepan) at night to help her anxiety and to help her sleep...she had the problem though, before she was taking this...it was one medication prescribed to HELP her sleep...it seems to help her sleep for the 1st couple of hours...but the problem crops up after it wears off...the docotr is aware of the problem and has told me to stop one of her pain pills, tramadol...but so far (2 days) it has not helped...

What meds is she taking? Certain sleeping medication....even Nyquil!....can give people bad dreams or cause them to act this way. My mothe was vey sensitive to Lorazipan (sp? a tranquilizer, I think).