Is it ok to give over the counter medication such as melatonin or benadryl to grandmother who has sundowners syndrome not sleeping at night?

Hi, sounds like you are on the right track with the meds. I use ativan to control my mom's agitation up to 4 times a day, if needed but don't usually have to more than twice a day. I use 3mg of melatonin at night at bedtime. And my mom uses trazodone too but at 300mg to get the desired effect of sleep. We tried 50, 100, 150, 200, etc. But 300 is what works for her. DO NOT INCREASE HER DOSES WITHOUT PHYSICIAN APPROVAL. It could be very dangerous. My mother is under the care of a psychiatrist who prescribes and manages these meds. My mom's primary care doctor refused to prescribe these drugs without a psych consult. So I found her a psychiatrist that works with the elderly and she got mom on a regimen to help her. If you don't have a mental health provider for your loved one I would suggest getting her one. It helped tremendously...she sleeps normal hours....I sleep normal hours & I can always call her doctor with behavior changes, etc. And get advice. The sundowning is inevitable at some point and drugs may or may not help. In my mom's case they do little when she is really agitated but the trazodone always helps her get to sleep. Good luck...hope some of this was helpful.

Imho, I would not dose her with any medication, even OTC without speaking to her neurologist.

The trazadone may take a little while to take effect. Prior to giving any over the counter medication, I would speak with her physician. Benadryl may not be a good idea for an older adult with dementia. Have you tried a diffuser with lavender? That often is soothing for older adults. Have you considered having her evaluated by a geriatric psychiatrist for medication management? Sleepy time tea or warm milk may help too. Additionally, as best as you can, try initiating a sleep schedule. (same bedtime and arising time). Good luck.

The more psychotropics and narcotics an elderly person gets, the higher the risk of falling and confusion. Although melatonin is over the counter and touted as being safe, know they have side effects that can linger throughout the day.
They can also adversely interfere with medications such as blood thinners (clot inhibitors) and seizure medications, for example. Melantonin can also cause DEPRESSION. There is a depression linked to excess of melantonin which is due to decreased daylight, also known as "Seasonal Affective Disorder" or SAD. See this article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/

some drug interactions
https://www.drugs.com/drug-interactions/melatonin.html

Side effects--
https://www.drugs.com/melatonin.html

daytime drowsiness, dizziness, weakness, or confusion
vivid dreams, nightmares
feeling depressed, anxious, irritable
headache
loss of appetite, diarrhea, nausea, stomach pain
blood pressure changes
joint or back pain
elevated risk for seizures


So nothing is totally safe and consists of risk..and all these meds she's taking increases risk of drug interactions. please consult your pharmacist regarding drug interactions with melatonin.

This sounds a lot like my father in law. He to is on trazadone 50mg and xanax at bedtime to help him sleep. We consulted his Dr and she told us to use the 5 mg of melatonin at bedtime for a week and if that didn't help, go to a max of 10 mg. It helps some. I don't know how much. He just has his dementia spells and will be up all night for as much as 2 nIghts, but then may sleep all night fine for 2 weeks. I can feel for you . It's hard when you are battling things day at night. We ended up having to put him in a nh. But it's hard! Prayer for all!

Since she is on other medicines best to have her doctors suggest something. My mom(92)s doctor suggested Midnight which is melatonin not sure what else but I took her off of the zzzQuil and other meds like that and it helped. But you never know about interactions and hopefully her doc has a long enough relationship to suggest something appropriate.

AAdkins38,
You may need some overall advice about your grandmother with Alzheimer's, and I see that you might be very busy from your profile.
Please help yourself to the topics right here on the website.
Always check with her doctor.

Additionally, Dr. Kernistan, a geriatric specialist, has given good advice on this forum.
She covers the specifics of many medications for the sleep issues and Sundowners Syndrome. Dr. K can be found at:
https://betterhealthwhileaging.net/medications-to-treat-difficult-alzheimers-behaviors/

There are other ways to approach her symptoms in addition to medication.

Do not give Benadryl. It, along with most OTC antihistamines products and sleep aids contain diphenhydramine. It has been linked to dementia when taken long term. For those already living with dementia, it can exacerbate the problems.

Sundowning, sleepnessness and hallucinations are all common with Alzheimer's. Grandma1954 offers some great advice for sundowning. Her comment about Benadryl "fogginess" is right on, even for a healthy person. When you're with g'ma, walk. Eliminate naps as much as possible.

Please call your grandmother's health care provider. I have given seniors Benadryl in the evenings as a sleep aid when I was working in the hospital as an RN. But, it would be wiser to let the HCP know that trazadone is causing problems before adding Benadryl.

Try to keep day time napping to the minimum so she will be tired and sleep better at bedtime. Also, try turning on more lights in the evening because the decrease in light tends to trigger Sundowner's syndrome. Keeping to a regular schedule in the evenings may help lessen some of the agitation as well.

Alzheimer's medication gave my granny night terrors and hallucinations. Talk to the pharmacist about the meds she is on, it could be a reaction to that one.

We cut granny's in half and it helped for a while, then we needed to discontinue because the cure was soooooo much worse than the disease for everyone.

Great big warm hug! Nothing was more traumatizing than being awakened by a blood curdling scream and being told someone is in the house trying to kill her. It was true, that nasty disease was the stranger trying to kill her.

Edit: I would speak to her doctor about adding a magnesium supplement and zinc. This combination causes our bodies to naturally produce melatonin and they are so vital to other functions, especially nerves. I have seen every person that has started this combo benefit greatly. Do some research for yourself, I would take it with her, you'll be resting better the 1st night.

I had given my Husband Benedryl to help make him sleepy when he had problems sleeping. He had taken it previously so he/I knew the effects. (He had a lot of seasonal allergies) Then I took it once. I could not believe how "foggy" my brain felt the next morning and how "out of it" I felt. I thought if this is how I react and I don't have dementia I can not imagine how messed up his mind with the dementia must be. I never gave it to him again.
Melatonin worked well, the "problem" with it as I have been told is if you turn the lights on to go to the bathroom the effects of the melatonin are greatly lessened.
I would wait and see how the new drug works, it may take a week or so to get the full effect.
As far as sundowning, try to keep lights as bright as possible. Change bulbs to LED's they are brighter. Close curtains so there is no "mirror" effect when she looks out to a dark outside and sees her reflection in the window. Keep her busy during the day so she is more tired a walk in the late afternoon or after dinner might help. (even if she is in a wheelchair getting her out for fresh air and some outdoor stimulation can make one tired.)

Melatonin is okay - but Benadryl is NOT. It can have psychological side effects in many people - but especially in the elderly.

The trazadone may take some time to "kick in" her system. But it's a fairly sedating drug, so this might be enough to help her sleep.

I disagree with some others who said to switch her BP med to the evening. It all depends on which BP med she is taking, and if she is taking a few different ones. Sometimes they must be taken at certain times of the day to achieve good BP control.

At any rate, all of this should be "run by" her primary care MD.

I vote for the "switch to evening bp meds with her doctor's approval" option. And while you're speaking to the doctor, report the hallucinations.

How mobile is she? How active during the day?

What would the Benedryl be for?  

I took it once decades ago, and had double vision problems.   I took no other medication at that time, so the double vision had to be Benadryl induced.   I never took it again.

Try giving her turkey for dinner.   It contains tryptophan, which is sleep inducing.   (Think of how many people nap after Thanksgiving dinner!)

In addition, if she's a coffee drinker, don't serve coffee, or any other stimulant, in the evening.

And I agree that I wouldn't add anything w/o checking with her doctor.

Agree that anything you add to your grandmother's regimen needs to be passed by her doctor first. Melatonin does not make you sleep like a sleeping pill. Melatonin's main job in the body is to regulate night and day cycles or sleep-wake cycles. Darkness causes the body to produce more melatonin, which signals the body to prepare for sleep. Light decreases melatonin production and signals the body to prepare for being awake. Your body associates it with sleep, so it is just giving a signal that it's time to sleep. I hope you can find a solution that works.

Aadkins, at one time I use to take blood pressure meds in the morning, but found it made me very tired. So I starting take the pill in the evening. What a difference.

Check with your Grandmother's cardiologist to see if it is ok to switch taking the pill in the evenings.

I agree with cwillie; if she's been on trazadone for just 2 days, give it more time. Ask the doctor who prescribed it or pharmacist how long it's effects should start to work.

Monitor your grandmother's sleep in the daytime.

Benadryl tips:
Stand up slowly when going from a sitting or lying down position. Benadryl may cause a drop in blood pressure which may cause symptoms such as dizziness and increase your risk of falls. Remove any fall hazards in your home (such as rugs) and talk to your doctor if you are experiencing severe dizziness every time you stand up.
Seek urgent medical advice if you experience any symptoms such as agitation, hallucinations, a fast heart rate, dizziness, flushing, muscle tremor or rigidity, nausea, vomiting or diarrhea.

Talk to your doctor or pharmacist before taking any other medications while you are taking Benadryl.

She could already be on too much medication for her condition.
A medication review is in order. Especially if the prescribing doctor is different than a doctor who has known her case for a long time.

I would give the trazadone more time to see if it was working before adding in anything else. And if after a few weeks it is still doing nothing ask about discontinuing it not just adding on another med.

Ask her pharmacist or doctor imo.