What are preferred sleep aids in elderly patients with dementia?  

The disrupted nighttime sleep of a person with dementia translates into the unsustainably disrupted sleep of a caretaker. Those stoic caretakers among us will not admit that they are also concerned about how their loved one's sleep disruption also affects their own sleep. Let a caretaker know that b...

Melatonin 3-6 mg because of their loss of melatonin-secreting potency with age. Doxepin 10 mg because of the cost of 3 and 6 mg versions. If restless legs or limb movements during sleep, gabapentin or pregabalin. Pregabalin can be better tolerated with less next-day sedation (also can be an issue wi...

For myself and colleagues that I work with, we tend to start with trazodone, usually starting at 50 mg with a dosing range of 25-150 mg. I recall some literature supporting this, though I can't cite anything from memory.

In terms of lifestyle measures, the best physiological driver for setting circadian rhythm is direct sunlight soon after awakening. I counsel patients to eat outside or go for a walk soon after waking up. Older people need more time (up to 30 min) as lens opacification can reduce the amount of light...

Dual Orexin Antagonists are probably the best.

I do not, especially in the elderly. Long term safety is unproven.