What is Sundowning?

For many people living with Alzheimer’s and other forms of dementia, late afternoon and early evening hours may prove to be the most difficult, Therefore, the term “sundowning”. When the sun begins to go down, confusion, agitation, and anxiety begin to set in.

There is no known cause for sundowning, nor is it considered a disease in its own right. It is simply a group of symptoms that occur at a specific time of the day and affect some people with dementia.

Sundowning can lead to pacing and wondering, problems sleeping, aggression, restlessness, irritability, and other emotional responses to a confusing environment. Sundowning can continue into the night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they don’t get enough sleep and have trouble functioning well during the day.

 

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Possible Causes of Sundowning

• Fatigue – Mental and physical exhaustion from a full day trying to keep up with an unfamiliar or confusing environment.
• A disruption in the body’s internal clock – causing a biological mix-up between day and night.
• Low lighting – can increase shadows and may cause the person to misinterpret what they see and become more agitated.
• Disorientation due to the inability to separate reality from dreams.
• Presence of an infection such as urinary tract infection.
• Unmet needs such as hunger or thirst.
• Depression and sadness.
• Physical or emotional pain.
• Boredom may also lead to agitation and anxiety.

 

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Tips To Help Manage Symptoms of Sundowning

• Make notes about what happens before sundowning events and try to identify triggers.
• Try to maintain a predictable routine for bedtime, waking, meals and activities.
• Plan more activities and exposure to light during the day, such as walks, errands, or exercise.
• Reduce stimulation in the evening, such as the TV, loud noises, clutter or too many people in the room. Make the early evening a quiet time of day.
• Try to identify activities that are soothing to the person, such as listening to calming music, looking at photographs, or watching a favorite movie.
• In a strange or unfamiliar environment, bring familiar items such as photographs to create a more familiar setting.
• Close the curtains or blinds to minimize shadows. Keep the room well lit in the evening and leave a night light on at night.
• Try to limit or avoid alcohol, caffeine, nicotine, or daytime naps to help with nighttime sleeping.

If a person experiencing sundowning becomes agitated, listen calmly to his or her concerns and frustrations. Try to distract and reassure them that everything is OK. Do not physically restrain.

For more information about Alzheimer’s and Dementia – The Alzheimer’s Association

Disclaimer: The information provided in this article does not, and is not intended to, constitute legal advice and is for general informational purposes only.

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