Oh Frannie, I know how you feel! I have a geriatric (20 yr old) cat with a few health issues of his own, and he frequently howls at night for various reasons. I wonder if a
D.A.P diffuser might help Alfred? He's likely suffering some degree of dementia and it's possible the calming pheromones will help comfort him.
I wish you the best. It's hard to know what to do sometimes in these circumstances, but I figure as long as my guy is eating well, loves getting his regular cuddle sessions, and overall has more good days than bad, then we'll just keep trucking along. I've learned to live on less sleep than I'd prefer, but if the alternative is not having my old guy around, then I can suck it up for now. We all have to decide what's best for our own situation though.