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Topic Nightmares Go to previous topic Go to next topic Go to higher level

By susger8 On 2010.11.16 08:05
Dad has been waking up really early, which seems to be improved with melatonin. But he also has a problem with nightmares -- he yells out and wakes up his health aide, but he is not awake when he does that. He doesn't remember anything in the morning.

I know other people have problems with nightmares. What has helped, if anything? Seroquel? We have an appointment with the neurologist coming up and I can discuss it with him then.


By Emma On 2010.11.16 08:27
I don't know about nightmares in general but I do know that a lot PWP have REM sleep disorder where they talk, yell and act out dreams, sometimes violently. This happens in their sleep and they have no awareness of it. My husband has this disorder and it is the reason that we no longer share a bed. It can be dangerous for both the person who has it and anyone in the immediate vicinity. I have been kicked, pinned to the bed and punched, slapped, hit with a lamp and choked among other things. Our neuro suggested Klonipen (not sure if I'm spelling that right) to control it which is a drug used for seizures. We decided not to add that to the arsenal of medications he's already on and just continue sleeping separately.

Please do discuss it with your neuro.

By karolinakitty On 2010.11.16 10:08
My guy has vivid nightmares also, the yelling out, crying Help...He acts out, arms swinging has even had me in a few holds now and then.... The dreams we discussed with the Movement doc and he thinks it's twofold....his requip and the PD.... as far as drugs... we have opted out for that...
Since his dreams are mostly there when stress factors are high, we felt no need for them. When he starts physically acting them out, i SLOWLY, wake him up to avoid any injuries.

By Pick On 2010.11.16 10:22
This is a really big problem for us and the reason we now pay someone to sit with Dad at night. It's a huge expense but otherwise nobody in the house would get any sleep (and even still, I'm often up anyway, helping out with the night time aid).

My dad takes 125 mg Seroquel at bedtime and we have Ativan prn for when things are really bad (like when he's violent). Recently we stopped his bedtime dose of Sinemet which I know is not something every neuro would recommend but in our case it helps. Over the years we have also tried Klonopin, Trazodone, melatonin, Remeron.....a few others I can't remember right now. Remeron caused daytime delusions, the others didn't seem to do much of anything. My dad also had an overnight sleep study and they recommended CPAP but he tried it only once and never again.

As I'm sure you already know, one of the problems with treating sleep problems in PD is that most of the traditional meds increase dizziness, ataxia, etc. and therefore many physicians are reluctant to prescribe them. So great, the patient is less likely to fall but more likely to end up in a skilled nursing facility (where he will be loaded up with Ativan or something anyway) b/c he has burnt out his caregiver! I wish I had more helpful suggestions to report. Hopefully your experience will be different from ours. Good luck!

ETA: I'm really concerned by the level of violence some of you are experiencing. After much thought and discussion with my dad's neuro, I've adopted a "zero tolerance" policy towards violence. If my dad is violent, he gets Ativan. If he refuses (or we cant sneak it in applesauce or w/e) or if the Ativan doesn't work I am calling 911. This isn't easy for me, as the last time Dad was hospitalized he almost died from a med error. But I will no longer tolerate violence towards myself or towards these hardworking caregivers who are just trying to make enough money to support their families back home.

By susger8 On 2010.11.17 07:54
Fortunately, Dad hasn't been violent, just noisy! In some ways the early awakening has been more of a problem, because he tries to get up and sometimes falls. But the poor aide is just not getting much sleep, and he has enough of a difficult job without that.

Thanks for your suggestions, everyone -- I'll talk to the neuro about this next week.


By susger8 On 2010.11.23 07:34
I really like this neurologist -- he listens. He prescribed Klonopin, which might help both the nightmares and the early awakening. And he's going to gradually cut down the Sinemet to a slightly lower level. I think this is a good thing, because when we increased the Sinemet earlier this year it didn't help his mobility much, but it seemed to adversely affect his thought processes.

Worth a try, anyway!


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