sleep after a stroke

my mom had a stroke (blood clot) and damaged 2/3 of her right side.  she was very coherent during and after the stroke and was administered the tpa within 2 hrs.  She was accepted by the Baylor/Dallas Inst for Rehab which is rated #1 in the USA but was just too weak to participate 3 hrs/day as required.  she transferred to a nursing rehab facility and she has so much trouble with sleep and anxiety.

she has always had a problem with sleep.  Alot of the pills prescribed during the 70's and 80's caused her to sleep walk and eat.  for the past few years she has taken valium, but only occasionally when she just cannot go to sleep.  she lives alone and would just get up at 3am, take a valium and watch tv until she got sleepy.

at Baylor they were giving her restoril for sleeping and ativan for anxiety, and she simply would sleep all day during her rehab sessions, dozing on and off 24/7.  at the nursing facility, she would sleep for 3 hours and then wake up, disoriented, and wanting another sleeping pill, that ended up in her also sleeping continuously during her therapy sessions.

it has been a little over 30 days since her stroke, and i am trying to get her into a routine and have discontinued the ristoral and tried to depend on the ativan to help her.  she is getting more disoriented and her whole focus is on getting her sleeping meds.  any suggestions.... PLEASE

[Gregg D Jacobs, Ph.D.]

You should discuss the 10 most important sleep tips that I posted on 12/16 as soon as possible with your mother. At the same time, it is the responsibility of her prescribing physician to mange her sleep medications.  Ativan and Restoril are habit forming and can cause daytime sedation that can exacerbate confusion.  When two sleeping pills like these are combined, these side effects are even more problematic. Better choices for sleep aids are Ambien or Lunesta but, no matter what medication is used, it should be in the lowest possible dose and not in combination with other sleeping pills in the elderly. You may also need to consider a consultation with a sleep center.

Dr. Gregg D. Jacobs
www.cbtforinsomnia.com