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Question: my father is 93 years..healthy..howver he does not sleep through the night and is extremely active..he keeps walking up and down and moves around entire house..any obstacle he throws or removes..this has been on for last 2 months....even occasional calmpose does not help. doctor suggets NEXITO 10 mg...will this help without any other probs pl guide
Brief Answer:
Possibly not helpful for sleep disorder.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Nexito is usually prescribed for depression. With the above symptoms, I do not think he is depressed. Sleep hygiene is necessary. Hope he does not have any pain, which is disturbing his sleep.
2. If he were my patient, I would advise the following to improve his sleep:
a. Avoidance of caffeine, alcohol and nicotine during second half of day. Last should be atleast 6 hours before sleeping time.
b. Maintaining a regular bed time and wake time eg: 10 pm to 6 am. Other time, avoiding sleep. Afternoon nap - XXXXXXX half an hour.
c. Relaxing evening routine, avoiding contact with tv or phone or other disturbances, atleast two hour before sleep.
d. Use of bedroom only for sleep. Not to watch TV or others. Should not be in bed at other times.
e. Regular moderate exercise, only in mornings.
f. Reduced fluid intake after 6 pm to avoid disturbance due to urination.
g. Reduced noise or light in bed room.
Worrying about whether one will get sleep is the commonest cause of sleep disturbance. Relaxation is essential. Warm bath and light meals, atleast 2 hours before sleep will be helpful.
Need to maintain atleast for a month, to see some progression.
Medications like calmpose (benzodiazepines) or zopiclone or zolpidem can be taken for severe sleep disruption. You can take prescription from your doctor.
Without depression symptoms, unwise as disturbed sleep is on the adverse reaction you see in Nexito.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Possibly not helpful for sleep disorder.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Nexito is usually prescribed for depression. With the above symptoms, I do not think he is depressed. Sleep hygiene is necessary. Hope he does not have any pain, which is disturbing his sleep.
2. If he were my patient, I would advise the following to improve his sleep:
a. Avoidance of caffeine, alcohol and nicotine during second half of day. Last should be atleast 6 hours before sleeping time.
b. Maintaining a regular bed time and wake time eg: 10 pm to 6 am. Other time, avoiding sleep. Afternoon nap - XXXXXXX half an hour.
c. Relaxing evening routine, avoiding contact with tv or phone or other disturbances, atleast two hour before sleep.
d. Use of bedroom only for sleep. Not to watch TV or others. Should not be in bed at other times.
e. Regular moderate exercise, only in mornings.
f. Reduced fluid intake after 6 pm to avoid disturbance due to urination.
g. Reduced noise or light in bed room.
Worrying about whether one will get sleep is the commonest cause of sleep disturbance. Relaxation is essential. Warm bath and light meals, atleast 2 hours before sleep will be helpful.
Need to maintain atleast for a month, to see some progression.
Medications like calmpose (benzodiazepines) or zopiclone or zolpidem can be taken for severe sleep disruption. You can take prescription from your doctor.
Without depression symptoms, unwise as disturbed sleep is on the adverse reaction you see in Nexito.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thanks a lot Doc..delighted to see your soothing and lucid response..
Thank you..As you know it is difficult to bring change in old age response..He takes bath 3 times a day without knowing the time/without any necessity..He has lost day/night orientation..Tv he will watch for 2o mts and then get bored..He will ask to be switched off..He wants light all 24 hrs in his room..The main problem is lack of sleep...even in day he sleeps only for XXXXXXX 2 hrs... i.e on 24 hrs cycle his total sleep is only for 22 hrs..The less he sleeps the more he gets irritated..His appetite is fine.occasionally he talks normal..most of other times incoherent way!!No sugar problem/no cholesterol/no cardiac issues!! only lack of sleep..He has lost his wife my mother 34 years back and hence getting into depression happens often enough..would you like to review your advice???thanks...warm regards XXXXXXX bala
Thank you..As you know it is difficult to bring change in old age response..He takes bath 3 times a day without knowing the time/without any necessity..He has lost day/night orientation..Tv he will watch for 2o mts and then get bored..He will ask to be switched off..He wants light all 24 hrs in his room..The main problem is lack of sleep...even in day he sleeps only for XXXXXXX 2 hrs... i.e on 24 hrs cycle his total sleep is only for 22 hrs..The less he sleeps the more he gets irritated..His appetite is fine.occasionally he talks normal..most of other times incoherent way!!No sugar problem/no cholesterol/no cardiac issues!! only lack of sleep..He has lost his wife my mother 34 years back and hence getting into depression happens often enough..would you like to review your advice???thanks...warm regards XXXXXXX bala
Brief Answer:
Can give trial run of 15 days.
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Depression since 34 years is a long period. Presently, lonely feeling or aging could have also depressed him and nothing wrong in giving a trial of anti-depressants. Within 15 days, an idea would form, about it being helpful or not. Watch out for any adverse reactions.
He might become more numb or agitated, as response varies with various individuals.
The loss of day/night orientation, agitation, and in-coherency will require evaluation. If his memory is also reduced, he will require a dementia evaluation possibly for Alzheimers.
If the symptoms do not improve with NEXITO, meet a neurologist or a psychiatrist, to evaluate for dementia. If it improves, then well and good. Sleep disturbance can affect people variously, and agitation is very common. Sleep study might be necessary later on, if NEXITO does not help.
However, along with NEXITO, try to include other changes, as we discussed earlier. Try to get him back onto usual schedule and involve him in as much as social activities as possible.
Hope it helps.
If you have any further queries, happy to help again.
Dr. Prakash HM
Can give trial run of 15 days.
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Depression since 34 years is a long period. Presently, lonely feeling or aging could have also depressed him and nothing wrong in giving a trial of anti-depressants. Within 15 days, an idea would form, about it being helpful or not. Watch out for any adverse reactions.
He might become more numb or agitated, as response varies with various individuals.
The loss of day/night orientation, agitation, and in-coherency will require evaluation. If his memory is also reduced, he will require a dementia evaluation possibly for Alzheimers.
If the symptoms do not improve with NEXITO, meet a neurologist or a psychiatrist, to evaluate for dementia. If it improves, then well and good. Sleep disturbance can affect people variously, and agitation is very common. Sleep study might be necessary later on, if NEXITO does not help.
However, along with NEXITO, try to include other changes, as we discussed earlier. Try to get him back onto usual schedule and involve him in as much as social activities as possible.
Hope it helps.
If you have any further queries, happy to help again.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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