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Hi Toni,   You have my sympathy. Coping with difficult behavior, especially at night, is exhausting. Just when you need to sleep.....   Here are some ideas that may help:   First, two nights following a medication review, presumably by a suitably qualified doctor, is not a good indication of outcome. Give it a bit more time. Drug reactions and interaction with other medications can result in severe behavior difficulties and may cause hallucinations. It is important to try this new regime for a while if you can. Getting medications out of the body does take a while. It will be important for the doctor to monitor progress before possibly introducing new meds.   Keep a brief diary of events such as bedtimes, naps in the day, toilet habits. This will help the doctor and caregivers with their evaluations.   * If someone is sleeping too much in the day it may cause abnormal sleep patterns and can contribute to problem behaviour at night. * Have an active day. Tailor activities to encourage fewer naps if possible. * Look at physical needs as they may contribute to the situation. Try a small snack before bedtime, something that is easily digestible and that your Mom likes, perhaps with a small warm drink, but not too much fluid. Discuss with your doctor if she has a number of other medical diseases or conditions. * Quieten the pace. Have a regular routine if possible. Reduce stimulation, i.e. no TV before bed, perhaps use some soothing music, etc. * A bath before bedtime sometimes helps. * Keep the room temperature comfortably warm. * Good lighting. Complete darkness can be frightening, but lights that cast too many shadows can even contribute to hallucinations. * Talk in a calm soft voice, even in very difficult situations. Brief commands and smiles that can reassure. Hallucinations can be very frightening. Gentle body contact and reassuring statements are good.   Remember. Your Mom is not acting in this way because she wants to. Alzheimer's causes extensive brain damage. Statements of the, ‘she knows what she is doing' variety, often will make caregivers feel worse about the situation.   Keep in regular contact with the doctor. The caregiver may need to have extra help or a night or two off to help keep her healthy. It often pays off in the end. Respite care may need to be considered if the situation continues for a long time.   Hope this helps   Christine