Many have heard the term, “sundown syndrome” or “sundowning,” but fully understanding it is important for those providing care for a loved one with Alzheimer’s disease or other dementias. Essentially, sundown syndrome is not a disease at all, rather it is the behavior of increased confusion from late afternoon to early evening in those living with memory impairments. These behaviors are said to be related to changes in the brain, but there is more to grasp with these unique behaviors. It’s important to understand the symptoms to properly care, empathize, and seek senior living care for a loved one struggling with sundown syndrome.

Common Behaviors

You may recognize a few of these common behaviors right around sunset in seniors with Alzheimer’s disease or dementia. In fact, around 20% of people with Alzheimer’s disease experience sundown syndrome at one point or another, according to the Cleveland Clinic. A few behaviors in those experiencing sundowning are wandering, violence, crying, insomnia, yelling, and pacing, to name a few. While those are the outward behaviors, the feelings associated are anxiety, sadness, fear, restlessness, and irritability. 

Possible Triggers

There are a few factors that can agitate these symptoms. For instance, sundown syndrome tends to intensify if the person is sleep deprived. Aside from lack of sleep, insomnia, and other sleep disorders, and certain triggers can make it worse. These include dehydration, certain medications, pain, overstimulation, low lighting, infection, and more.

Cause and Treatment

The exact cause of sundown syndrome is not fully understood, but a common theory is that the changes in a person’s brain with Alzheimer’s disease also has the power to impact the person’s biological clock, which in turn confuses the sleep-wake cycles. There are several ways that caregivers help those experiencing sundowning cope. Encouraging plenty of rest is key. Also, it’s important to schedule any important appointments or activities in the morning hours or early afternoon when those with dementia are more alert. Encourage a regular routine, ensure plenty of sunlight intake, reduce stimulation during those early evening hours, keep ample lighting in the home in the evening, and encourage walks to manage restlessness and keep your loved one active.

Try these tips when caring for someone who experiences sundown syndrome:

- Allow natural light in throughout the day.
- Play calming music or practice relaxing activities in the early evening.
- Reduce noise and try to limit the amount of people in the room at the time of sundown.
- Avoid long naps late in the day.
- Try not to serve coffee or other caffeinated beverages late in the day.

It’s crucial to approach a person with sundown syndrome calmly while seeking to provide what they need. This is not the time to argue. Simply remain calm, give gentle reminders of the time, and let them know that everything is alright. Caring for a loved one with sundown syndrome may feel overwhelming at times, but by implementing a few of these helpful tips, you will have better success in helping your loved one remain calm and at peace.

For more information, download The Caregiver’s Complete Guide to Alzheimer’s and Dementia Care for free. Learn more about what dementia is, the early warning signs, and options and resources.

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