What is Sundowning?

Are you caring for a loved one with dementia or Alzheimer’s disease?  Do you notice significant changes in the way they act in the late afternoon or early evening?  Doctors call this behavior sundowning, or sundown syndrome, as it appears to be triggered by fading light.  Symptoms may get worse as the night progresses.

As many as 1 out of 5 people with Alzheimer’s get sundown syndrome. But it can also happen to older people without dementia.

Symptoms of Sundowning

The most common symptom is confusion as natural light fades and shadows increase.  The individual may get agitated easily and have severe mood swings.  These may lead to increased yelling and frustration toward the caregiver.

As the sun fades, individuals becoming increasingly fatigued both mentally and physically.  He or she may have uncontrollable tremors.

As the individual tries to go to sleep, restlessness can increase and can lead to pacing and roaming if individual is in confused condition.

Causes of Sundowning

Doctors are not really sure what causes sundowning. Some scientists think that changes in the brain of someone with dementia might mess up their internal body clock. The area of the brain that signals when you’re awake or asleep breaks down in people with Alzheimer’s, which might cause sundowning.

Other things can trigger sundowning such as:

• Extreme tiredness
• Hunger or thirst
• Feeling depressed, in pain, or bored

Another big culprit may be sleeping troubles. About one-third of people over age 65 have problems falling and staying asleep. (Read our blog post for tips on getting better sleep.)

Tips To Reduce Sundowning

It is really important to try to maintain a consistent schedule and routine for sleeping, eating and other daily routine activities.  Limit daytime napping if possible.  If your loved one’s condition allows, increase daily activity to encourage an earlier bedtime and try to incorporate light exposure in these activities

In the evening, try to reduce stimulating activities and background noise, including watching television.  Play some calming music or relaxing nature noises, such as the sound of rainfall or waves. Also, avoid large dinners, caffeine, alcohol and sweets. Let your loved one choose sleeping arrangements if possible and use a dim light to ease confusion.  If you are worried about wandering or pacing, install monitors or sensors to track movements. Talk to your loved one’s doctor about melatonin, which may help promote sleep.

Coping With Sundowning When It Happens

What should you do if your loved one is awake and upset? The Alzheimer’s Association offers the following tips:

• Remain calm at all times.
• Check if there is something the person needs.
• Remind the individual of the time.
• Do not argue.
• Reassure them that everything is okay.
• Do not try to physically restrain the person.  Allow them to pace while you supervise.

Take Care of Yourself

Taking care of a loved one with sundowning is extremely hard on caregivers and can affect your sleep.  Be sure to take breaks when possible and do things to promote sleep for you such as exercise and healthy eating.  Join a support group if you need to talk or spend time with your friends.

SeniorAdvisor.com Staff

Senior Advisor's knowledgeable writers blog about senior care services, trends and more.