So it seems to be the melatonin/antihistamine combo, then? That's useful to know, especially if you can cope without that particular combination. Absolutely, yes. Unless you are restricting your light exposure to lights which are between yellow-orange and red (some people think only red will do, though most are happy with yellow-orange), and that means absolutely ALL light, including bits coming in at the tops of windows and alarm clock displays and so on, you are getting exposed to blue light. And blue light suppresses melatonin release. Apparently it only takes a few seconds of white/blue light exposure to stop all melatonin production for the next few hours, so merely turning the light on to go to the toilet at night can be enough to wreck your night's sleep. I've managed to mess up a night's sleep by simply having warm white fairy lights on for half an hour around midnight, which at the time I didn't think would be enough to bother me (I was putting on my orange specs at about 9pm back then). It doesn't make much difference what the light source is, if it's white light then it will contain enough blue to disrupt circadian rhythms. Some lights contain more blue - fluorescent as you've noticed, also cool white LEDs, computer screens, TV screens - which mean that they may make you even more wakeful, but even a fairly dim incandescent white bulb will suppress melatonin. With the lists for the carers, are you getting them to tick stuff off as they do them? That makes a big difference, I find. How often are you getting carers in, and how many different carers do you have on the go at any one time?