Sundown syndrome refers to a consistent increase in confusion, anxiety, restlessness or aggressive behavior in the late afternoons and evenings, as the sun goes down, and it affects a great number of people with Alzheimer’s disease or other dementias.
Pacing and wandering are also common symptoms of sundowning. Sundowning can occur at any stage of the disease but is most commonly experienced during the middle stage and tends to decrease as the disease progresses. While there is no conclusive proof as to what causes sundowning, there are many factors which may trigger it.
Factors influencing sundown syndrome
- Disruption of the circadian cycle: It is thought that as a person’s dementia progresses, the part of the brain that regulates sleeping patterns can no longer distinguish day from night.
- Pain or discomfort: Toothaches, joint pain or even being excessively tired at the end of the day can cause an increase in irritability and an inability to sleep.
- Disorientation: The fading light and increased shadows can cause people with Alzeimer’s to hallucinate and become increasingly confused and anxious.
Having many years experience providing eldercare in Montreal, we know that sundown syndrome can be incredibly difficult to cope with. Because each person affected by sundowning may react differently, ways to address their behaviors may also vary from person to person. Here are some tips to help manage the symptoms of sundown syndrome.
Dealing with sundown syndrome
- Visit the doctor/ dentist: It is important to determine whether there is a physical ailment, such as a bladder infection, constipation or dental pain, causing or contributing to the sundowning behaviors.
- Activities: Appointments should be made for early in the day. A walk or other physical exercise in the morning may prevent restlessness later on.
- Lighting: Proper lighting will decrease shadows and reduce confusion.
- Stimulation: Minimize stimulation in the evening. Restrict caffeine and sugar to the mornings and replace T.V. in the evening with soft music.
- Routine: Create routines, such as closing the curtains, warm milk and a consistent sleep schedule to increase familiarity and security.
- Medications: Some evidence suggests the use of melatonin can be helpful.
In many cases the behaviors associated with sundown syndrome can occur throughout the night, putting an enormous strain on family members who are caring for their loved ones at home and depriving them of sleep. Often, family members who visit during the day may not understand how dramatically sundowning can affect behavior. An adult son visiting his parents may believe that the symptoms of his father’s dementia are not as severe as his mother describes. Without assistance and support, sundowning can lead to family caregiver burnout.
Caring for an elderly family member can be a daunting and exhausting job. Please do not hesitate to contact us if you have any questions or require assistance with home care in Montreal for a senior member of your family.