Nightmares?

Ann Mac

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Oct 17, 2013
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I have had a search, but I can't find any other reference to this problem - just hoping someone has some experience/ideas - Thanks :)

Mil, for over a year now, even before moving in with us, frequently mentioned having 'nightmares/bad dreams'. Whilst she was still living independently, if we visited in the morning, it wasn't unusual to find her still in bed, or just heading downstairs, and she would be visibly upset, tearful and often need reassurance that it was just a dream she had had.

When she moved in, she had reached the stage where hallucinations and other behaviors sort of 'masked' these nightmares, and it was only just before Christmas, when medication had helped to take the edge of the worst of the sundowning and hallucinations, that I realized that she was having these dreams nearly every night. At the same time, I was concerned that she was depressed, and consulted with the CPN. The CPN agreed that Mil probably was 'down' (She has a history of depression, going back to when she lost my late Fil), and the anti-depressants she was on (which apparently do become ineffective over time, and were a very mild dose anyway) were changed, as the CPN felt the dreams could be part of the depression. The new anti-depressants also have a sedative effect, and the CPN said they are a 'very effective' as a sleeping medication too. Initially, for about 2 weeks, no mention of bad dreams. But over the last couple of weeks they are making a reappearance - and getting to be more and more frequent.

The odd thing is that Mil tends to wake at any time between 4am and 5.30am - I can hear her, moving round her room, and it seems that she spends this time packing her clothes and odds and ends into various bags. If she emerges from the room, she is generally confused about where she is, but not unduly distressed, and its a usually simple thing to chat for a few minutes, maybe make her a cuppa, and settle her down in bed again. Now and and again, she is noisy, just thumps and clatters as she busies about the room, and I tap on the door to remind her that its very early and suggest she goes back to sleep - which she usually does, and then sleeps through till usually around 9.30 - 10am, sometimes later. During the early 'wake up', she NEVER mentions having had bad dreams.

However, when she wakes for the second time, often she is really upset. She comes down, anxious, shaky, sometimes very tearful, and straight away starts on about the dreadful nightmare she has had. Usually she has been 'chased', e.g. by 'dragons', by 'bulls' or by people with guns. Often she says that she was scared she was going to be killed. She says that she feels like she hasn't slept because she has been 'running away, all night long'. About half the time, she seems to really struggle with separating the dreams from reality - she will peer out the window, making sure that there are no dragons, or repeatedly ask me if I am sure that she isn't going to be shot if 'they' catch her. Sometimes, It can take up to an hour to settle her - occasionally, it can take a lot longer, and she will refer to the dream now and then throughout the day - and always when that happens, she is inclined to forget it was a dream and think that whatever it was really happened.


Anyone else had experience of this please, and any suggestions for stopping them - they really distress her :(
 

Pookie

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Dec 29, 2011
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I suffered from very bad nightmare s and my ss worker got in touch with my memory clinic.TheDr gave me new tablets now I still dream but nightmare s are not to often. Would it help if you talked to the gp.I am so sorry that your mum is in distress.
Peter has reminded me my ss worker told me to practice a sleep (forgot tje name)but to switch off all stimulating noise. a cup of horlick or cocoa.and bed with a soft light on and easy to listen music . Don't take the pet as they steal the space.
Peter&Jean Ugly
 
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Ann Mac

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Oct 17, 2013
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Thank you Jean x

The CPN recommended a change in anti depressant meds, which seemed to help initially - but I will speak to her again :)

I've tried the milky drink and the gentle lighting - not worked so far, sadly :( It seems these nightmares happen only once she has gone back to bed after her 'first' wake up in the morning. I have tried getting persuading her to get up, when she wakes first, but she is then exhausted by lunchtime, and we are then more likely to see a more 'extreme' sundowning - she is invariably more confused and more likely to sundown, if she has a day time sleep, too :(

I think speaking to the GP as you advise is probably the best next step - thanks :) xxx
 

Grannie G

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Apr 3, 2006
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There have been quite a few people with dementia who have posted about terrible nightmares. Some were helped by cocoa/drinking chocolate before bed.
 

MReader

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Apr 30, 2011
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essex
My husband has bad disturbing dreams. His counsellor said about milky drink, low lights, no stimulus etc but also suggested eating a banana before bed - apparently to do with the potassium it contains.
Can't vouch for this as he does esdnt like bananas but who knows what might help.
 

Rageddy Anne

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Feb 21, 2013
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Cotswolds
I hope you find a way to make the frightening dreams stop. Sometimes I dream vividly, and I have noticed it almost always happens after eating cheese.

I used to have the same dream, over and over, always I was having to look after my husband and do everything for him. They were long before he had Dementia! I think dreams are often the brain's way of struggling with a worry or fear. I wonder if the running away is running away from her dementia, and all that it entails.
 
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Saffie

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Mar 26, 2011
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Near Southampton
Coffee in the evening will cause me to have nightmares.

My husband has bad dreams - similar to your mother's in that he is always being attacked or has to kill someone because they are after him. He has these in the day time too. Sometimes I think the TV might be causing them but it might also be the pain relief or it could simply be the dementia.He is terrified.

I often have more vivid dreams - or at least, I remember them more - in the time I return to sleep after waking very early. Perhaps it is a lighter sleep.
 

LadyA

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Oct 19, 2009
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Ireland
It's just a thought, but perhaps the nightmares are incidental, and nothing to do with the dementia? My sister has suffered some sort of "depression" (the doctors referred to it as a clinical depression caused by a chemical imbalance of some sort) long term, but it doesn't manifest as actual depression - she has the most horrific nightmares. Well, actually, since she was diagnosed and got on medication, she doesn't - but she has tried a couple of times over the years to come off the meds, and within a month the nightmares are back.

I would talk to your MIL's GP and emphasise how upsetting she is finding these dreams, and how ever-present they are.
 

Ann Mac

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Oct 17, 2013
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Thanks Sylvia - I did do a search, but obviously not very well, lol. I have suggested hot chocolate , and she has tried it twice - but usually refuses as she really isn't keen.

Saffie, Mil will very, very occasionally have a milky espresso - but is a devout tea drinker in the main, doesn't touch coffee . I think you are right about the 'lighter sleep', though - as I said, she never mentions 'bad dreams' during her 'early' wake up. I have worked out a couple of times that things on TV have become part of 'confabulated' events and memories - a conviction that she had spent the day before picking strawberries (In January?) was I think linked to the Coronation Street storyline where a dying character developed a 'yen' for them. An account about her son's wedding (where he apparently married a family friend, not me !) contained a detailed description of the brides wedding dress - which came from a program she had watched where Lady Diana's wedding dress was discussed. So far, I haven't managed to link anything she has reported about a dream to the TV, but given that it obviously influences, you could well be right :)

Rageddy Anne - I'd wondered if the running away, which is usually the theme, was 'running away' from her situation :( So heartbreaking, because I guess, it just can't be escaped from.

MReader - she LOVES bananas - thank you, I will try that :)

LadyA, I thought they could be perhaps associated with depression, and they did ease when the CPN changed the medication she had been taking. Trouble is just not being sure what is causing them - she is less tearful and down since the change in meds, so they have helped in that respect - but as I said, I am going to talk to both the CPN and her GP again.

Yesterday, the dream was forgotten within a couple of hours - my son saw her yawning, late morning, and asked if she had slept well - she told him she had slept like a log, no mention of dreams, no mention of the 'early wake up' - I honestly don't think she remembered either. That is often the case. Its the days where I guess the 'memory' of the dream lingers, where she keeps returning to it during the day and is confused about whether it was a dream or reality, are the toughest days - the 'fear' of the dream events is very real and so distressing to her - I hate to see it :(
 

CollegeGirl

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Jan 19, 2011
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North East England
Perhaps if she slept right through the night without this early morning wake up, the nightmares might stop?

Have you tried getting her up earlier on a morning, limiting daytime naps (if any), and going to bed slightly later in the hope that she will sleep right through? Or, last resort - a sleeping tablet?

I dare say you have already tried these tactics, so apologies, but I just thought I'd mention it.

Good luck.
 

Ann Mac

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Oct 17, 2013
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Perhaps if she slept right through the night without this early morning wake up, the nightmares might stop?

Have you tried getting her up earlier on a morning, limiting daytime naps (if any), and going to bed slightly later in the hope that she will sleep right through? Or, last resort - a sleeping tablet?

I dare say you have already tried these tactics, so apologies, but I just thought I'd mention it.

Good luck.


Hi CG, and thank you :)

Last week we had 2 days where the early morning wake up didn't happen (I've always been an early riser, around 6 a.m. or earlier, and since Mil moved in, my body clock has quickly set 'wake up' for me at 5.15a.m., at the latest, so I am pretty sure she didn't stir on these days :) ) and on both days, there was no mention of nightmares, so I am pretty sure its during this 'second' sleep only that they occur. I did try encouraging her to get up rather than going back to bed, but by lunch time she was exhausted, insisted on going for a nap - and afterwards, the sundowning was a whole lot worse - we really discourage the napping for this reason, all the time :( Day center mornings, I have to wake her at 8a.m. at the latest - and that doesn't seem to make any difference to the following night.

Bed time is an issue we have struggled with - some evenings, she wants to go at 7pm - we manage this by telling her that she has to leave it 3 hours between tea time meds and night time meds, which means she has to stay up till at least 9pm. But its a regular battle with her, and sometimes, she will get very cross and tell us she doesn't care, she is going to bed and we can just wake her for the meds if we have too :( On these nights, in addition to the 'first' wake up, its more likely that she will be up sometime between 12am and 2a.m, very confused, not knowing where she is or looking for her late husband.

I think sleeping tablets might be something to discus with GP/CPN - although the CPN did say that her anti depressants are effective as sleeping medication too.
 

LadyA

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Oct 19, 2009
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It's all such a "swings & roundabouts" thing isn't it? - Seems if you gain something in one area, you'll lose it in another. Same with medications - it's often a trade-off. A benefit for a downside. Put them on the scale, to see which outweighs the other! I remember for a few years, with the meds my husband is on, the doctors were always anxiously asking me if he was becoming "too sleepy" especially during the day, as that was an unfortunate side effect of the meds, and one they had to monitor carefully! I used to always answer - "Chance would be a fine thing!" For years, he was revved up like a hamster on speed, even with the meds - it's only now that he's reaching the advanced stages of the disease that he is starting to sleep a bit more, even taking naps during the day.

And the funny thing is - before he was started on anti-psychotics, when he was having horrendous hallucinations & delusions, I used to calm & comfort him by telling him that it was "only" a nightmare he had had!! I do hope you are able to get some help for your mother in law Ann Mac. Not very pleasant, poor woman, being so frightened so regularly - and not pleasant for you either.
 

Ann Mac

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Oct 17, 2013
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It's all such a "swings & roundabouts" thing isn't it? - Seems if you gain something in one area, you'll lose it in another. Same with medications - it's often a trade-off. A benefit for a downside. Put them on the scale, to see which outweighs the other! I remember for a few years, with the meds my husband is on, the doctors were always anxiously asking me if he was becoming "too sleepy" especially during the day, as that was an unfortunate side effect of the meds, and one they had to monitor carefully! I used to always answer - "Chance would be a fine thing!" For years, he was revved up like a hamster on speed, even with the meds - it's only now that he's reaching the advanced stages of the disease that he is starting to sleep a bit more, even taking naps during the day.

And the funny thing is - before he was started on anti-psychotics, when he was having horrendous hallucinations & delusions, I used to calm & comfort him by telling him that it was "only" a nightmare he had had!! I do hope you are able to get some help for your mother in law Ann Mac. Not very pleasant, poor woman, being so frightened so regularly - and not pleasant for you either.

Thanks LadyA,

Swings and roundabouts is spot on - I worry myself silly about possible side effects, with the meds she has been prescribed for the sundowning and and the aggressive, manic behavior she was experiencing. But before she was on them, I worried myself silly about the potential for her to get hurt, by placing herself in danger (which we avoided by the skin of our teeth a couple of times!) or about her getting worked up to the stage where she had a bad angina or asthma attack. No win situation, it felt like - though one friend said something to me that helped - she said, in her right mind, if she was told that she could be aggressive, always unhappy and angry, put huge strain on her family because they were constantly worried about her, and be putting herself in danger on a regular basis OR (and I quote) be 'Blissed off her t**s on some nice medication', even if it carried some health risks and could possibly make her dopey, she knew which option she would take - the second one. Put that bluntly and clearly, it made me feel a little better, I guess.

Yesterday, when she got up for the second time, after the more or less usual early morning up and pottering at about 5am, she came down a bit tearful because she had been 'running all night' - this time she said she was trying to get somewhere, in her dream, and would only be 'safe' when she arrived - but she couldn't get there. After about an hour, she thankfully seemed to have 'shaken' off the dream and it wasn't mentioned again. This morning, no signs of the 'early wake', so I am hoping no bad dreams.
 

LadyA

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Oct 19, 2009
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Thanks LadyA,

Swings and roundabouts is spot on - I worry myself silly about possible side effects, with the meds she has been prescribed for the sundowning and and the aggressive, manic behavior she was experiencing. But before she was on them, I worried myself silly about the potential for her to get hurt, by placing herself in danger (which we avoided by the skin of our teeth a couple of times!) or about her getting worked up to the stage where she had a bad angina or asthma attack. No win situation, it felt like - though one friend said something to me that helped - she said, in her right mind, if she was told that she could be aggressive, always unhappy and angry, put huge strain on her family because they were constantly worried about her, and be putting herself in danger on a regular basis OR (and I quote) be 'Blissed off her t**s on some nice medication', even if it carried some health risks and could possibly make her dopey, she knew which option she would take - the second one. Put that bluntly and clearly, it made me feel a little better, I guess.

.
Yes, exactly. My husband's consultant felt too that the risk of him having a stroke or heart attack because of the stress his hallucinations had him under outweighed was at least equal to the risk from the anti psychotics, in his case.
 

Sue J

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Dec 9, 2009
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Dont know if this is a feasible suggestion, depending on what your MIL abilities are.

I have terrible nightmares which are very real and mean that I don't get restful sleep much at all. I lose initiative when I go through my bad phases and feel quite helpless and wake disorientated and not knowing what to do with myself. On days when I am better it helps me to think about things I want/need to do and to write them down the night before as I may forget by morning. I try and leave a visual reminder in the kitchen so that I know what I had in mind to prompt me to action.

Would it be feasible to give your MIL a little task to do in the morning when she wakes e.g. 'if you are up before us in the morning could you peel the potatoes' type thing and leave them ready in a prominent place with a note reinforcing the request.

I find when I am able to engage in an activity another one soon follows and helps bring me back out of the bad or disturbed phase and where I may have been 'held' by this state into thinking I will just go back to bed I dont and can have quite productive days on occasion which surprise me - it doesn't always work.

Sorry if not feasible but hope you find something that helps
best wishes
Sue
 

Ann Mac

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Oct 17, 2013
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Thanks Sue and Jean x I'm always up before Mil, and she doesn't respond to 'notes', even if right in front of her she 'can't see them' - but I do use distraction in the form of trying to get her to do tasks that she is able to manage, at other times during the day, so maybe it would be worth doing that when she wakes distressed x

Well, my belief that if she doesn't do the early first wake up, she doesn't have nightmares was well and truly blown out of the water yesterday :(

At 7.15am, she came downstairs, in tears, telling me she had been dreaming that she was 'back in that college' all night long, and begging me not to send her there today - and no, no idea what this college was. In between sobs, she told me that she was in a dormitory, all by herself with a bed, a cupboard and a gas ring for cooking and she had spent all night shouting for someone to come and get her. She seemed to realize that this was a dream, but at the same time was convinced that this 'college' existed and that for some reason, she was to be sent there. And I know that doesn't sound like a 'scary nightmare', but my poor Mil was really frightened and really distressed :( I cuddled her, and reassured her, and eventually the tears stopped - but she was agitated and fearful/nervy nearly all day, yesterday. It wasn't helped by her having a hospital appointment (poor love has now been diagnosed with cataracts), which is something always certain to stress her out, and we had a day where she hallucinated (not scary ones, just several times asking about the 'young lad' she was convinced was with us for most of the day), and was more than averagely agitated and shaky.

The CPN phoned me, late yesterday afternoon, and said she has been thinking, and wondered if Mils 'dreams' are actually a type of hallucination, and happening after Mil first wakes up, but before she gets out of bed. I said I had no idea, but explained what an awful day she had had and how scared she had been. The CPN said she would contact Mil's GP, and see if they could come up with something, advice or medication wise, that might help - I should hear either from her or the GP today, and I just hope that they can come up with something that might help. Heartbreaking to see the state she was in yesterday morning, I just want to spare her that distress if its at all possible :(