Sundowner’s Syndrome, also called Sundowning, is a clinical phenomena that occurs in approximately 20% of senior citizens with Alzheimer’s or dementia. It is a state of agitation or confusion that begins as the sun sets. For many patients, this upsetting state of mind will last through the night. While it is obviously disturbing for the person experiencing Sundowning, it can be equally or more disturbing for caregivers who have to watch a person they love in distress, and who become exhausted from lack of sleep and constant worry.
Unfortunately medical science does not know exactly what causes it. It is thought that the cognitive physiological changes that cause Alzheimer’s and dementia may also damage the area of the brain that controls our circadian rhythm – the internal clock each of us has that maintains a certain rhythm to our waking and sleeping cycles.
What are the symptoms of Sundowner’s Syndrome?
As the sun begins to set adults affected by Sundowning may become:
As a result, they will have difficulty sleeping, which can further exacerbate their Alzheimer’s or dementia symptoms during daytime hours. It can also cause them to wander, yell, become delirious, angry or combative.
There are also factors that seem to increase Sundowner’s symptoms. If a person is already tired or fatigued they can experience more dramatic Sundowning. Low-lighting, a disruptive or noisy sleeping environment, and poor nourishment are also factors. It has also been linked to certain medications, severe constipation, or a disruption in daily sleeping and waking patterns.
Is there a way to avoid or mitigate Sundowning Symptoms?
Because the exact cause of Sundowning has yet to be known, there isn’t a specific fix. However, there are things that can help to prevent it and/or ease the symptoms.
Adequate Lighting. Nighttime lighting is already important in senior housing as it improves sight for seniors with poor vision, and prevents trip and fall accidents. However, lighting is even more important for those with Alzheimer’s and dementia. Shadows and dark places can intensify their agitation and anxiety. The more you can prevent shadowing, the more it will help the senior feel secure.
A Healthy Diet. As mentioned above, malnutrition and constipation seem to trigger more Sundowner’s Symptoms. Make sure your senior loved one is eating a well-balanced diet to remain nourished. A high-fiber diet and adequate hydration will help as well. Have dinner early and then offer a light snack before bedtime. Limit caffeine and other stimulant intake during the afternoon and evening hours.
Be Active. Keep your senior busy and active during daylight hours so they begin to feel tired at night. A sedentary lifestyle causes sleep troubles at any age, but seniors and those with Alzheimer’s or dementia are especially prone. Daytime exercise, hobbies and mental stimulation will help to trigger a healthy sleep response.
Familiarity. Use night lights in the bathroom and bedroom at night so they can orient themselves when they wake up. If they are in the hospital or away from home, bring pictures as well as favorite and familiar objects that will lend a sense of security to a new location.
Melatonin. Ask the senior’s healthcare provider about melatonin supplements. Recent studies have shown low doses of melatonin can inhibit the development of Sundowner’s Syndrome, decrease its symptoms, and help patients sleep. In turn, this has seemed to slow down their general cognitive decline.
If your loved one is experiencing Sundowner’s Syndrome, speak to a healthcare professional immediately so you can begin to find what works for your client or loved one.