How do you manage sleep disturbances in patients with Alzheimer’s disease without relying heavily on deliriogenic medications?

Sleep disturbances are common in older people and in those with Alzheimer’s disease (AD) in particular, and there are often multiple etiologies. Whether sleep disturbances increase the risk for AD, or are a result, metanalyses have suggested that the magnitude of sleep impairment correlates with the...

Doxepin is always frowned upon because, at higher doses, it is all anticholinergic. At low doses, it’s highly selective for H1 and no other receptors. I go to doxepin a lot. Same thing with hydroxyzine. These are perpetuating myths in psychiatry where old-school thinking doesn’t match up with eviden...

Great discussion! As a hospitalist, I usually start all patients with dementia on 2 mg melatonin at 7 pm plus a gram of Tylenol at bedtime, barring contraindication. I spend a lot of time working with nursing and bedside caregivers to discourage long daytime naps, ask for folks to be up in a chair f...