Mood swings, restlessness, and confusion are all potential signs that your loved one has sundown syndrome, a group of symptoms seen in over 20% of patients with Alzheimer’s disease.
Coping with Sundowners Syndrome symptoms can be a challenge, but there are some non-medical ways to alleviate the symptoms and give your loved one the support they need.
What is Sundowners Syndrome?
Sundowners Syndrome commonly affects people with Alzheimer’s disease, dementia, or other cognitive impairments. If your loved one has Sundowner’s Syndrome, they may exhibit behavioral symptoms from late afternoon and into the early evening and night, including signs of confusion and agitation, or erratic behavior.
Because sundowners symptoms may point to a progression from early stages of Alzheimer’s disease to more serious deterioration of cognitive function, it’s important to let your loved one’s doctor know about it sooner rather than later.
According to the Mayo Clinic, doctors and researchers still don’t know what causes sundown syndrome, however, you can easily identify the signs and symptoms of a person who has sundowning symptoms and take proactive steps to ease their symptoms
Signs and symptoms of Sundowners Syndrome:
- Agitation
- Confusion
- Anxiety
- Aggression
- Disorientation
- Pacing or wandering
- Mood swings
- Sadness
Managing and treating symptoms of sundowning as a result of alzheimer’s disease can be a challenging situation that puts immense pressure on loved ones who are trying to care for a sundowner sufferer.
While there is no cure for Sundowner’s Syndrome, here’s how you can manage sundowners syndrome symptoms.
Tips for reducing Sundowning Symptoms
1. Encourage activities before late afternoon/early evening
Although the exact cause is still unknown, the National Institute on Aging brings up the possibility that changes in brain function due to Alzheimer’s disease, contributes to sundown syndrome. Sundowning syndrome can also impact our biological clocks—causing confusion and agitation, and interfering with sleep-wake cycles.
Because Sundowner’s Syndrome happens in the late afternoon, it’s important your loved one maintains a routine during daylight hours.
Having a routine:
Having a routine around daily activities can help reduce stress. In fact, a 2019 study suggests that a lack of routine can cause depressive symptoms among the senior population.
Get sunlight early in the day:
Encouraging your loved one to stay active and get outside in the morning can help reset their body clock and discourage late-evening restlessness.
Arrange appointments early:
Schedule doctor appointments, or community activities earlier in the day when your loved one is feeling awake and at their best.
Say no to stimulants later in the day:
Stimulants can worsen symptoms in dementia patients. Avoiding food and drinks that are high in caffeine close to the afternoon also helps regulate your loved ones sleep and waking patterns throughout the day and avoid sleep problems.
2. Set good sleep habits
Getting enough rest at night is another way to alleviate the symptoms of Sundowner’s Syndrome. Experiencing Sundowner’s Syndrome can make it harder to get to sleep at night and having less sleep can make it harder to function during the day.
It’s an endless loop that affects the quality of life for your loved one (and their caregivers).
Support sleep hygiene:
Having a predictable daytime and bedtime routine supports your loved one’s circadian rhythm and can help them develop better sleeping patterns preventing sleep issues.
Keep a night light close:
People who suffer from Sundowners Syndrome can get agitated in dark or unfamiliar surroundings (more on this in the next section).
Use melatonin at night:
If incorporating good sleep habits has not made a difference, some doctors recommend taking a low dose of melatonin to treat sundowners symptoms.
3. Provide a calm environment in the evening
As daylight starts fading, people experiencing Sundowners Syndrome can start acting differently. They may become anxious or confused, they could get upset, or start acting more demanding.
There are some theories around this. According to the AARP, as light becomes dimmer, people with Sundowner’s Syndrome may have an urge to ‘get up and go’ or a restless feeling they need to be somewhere else. This could be due to hormonal changes as the sun sets, or safety fears of being in a dark place. Their symptoms can worsen throughout the night, but usually get better by morning.
Turn on the lights:
Pull curtains at the first signs of fading daylight and replace the natural light with lights and lamps to ensure a well-lit environment. Light therapy is known to help with sundowners symptoms
Reduce sensory stimulation:
Keep in mind that loud TV shows, changing light, and extra activity in the early evening as people come home from work can all negatively affect sundowners.
Minimize clutter:
Make sure your loved one’s bedroom is a calm space—free from clutter and mess.
Create a comfortable temperature:
Experts suggest keeping the temperature at 68–70 degrees fahrenheit (20–21 degrees celsius).
4. Reassure and reduce anxiety
Sundowners Syndrome can cause a lot of anxiety and confusion. Krista Frazee, manager of regional services for the Alzheimer’s Association of B.C. recommends the ‘validate, reassure, distract’ formula when supporting a loved one with sundowning symptoms.
Validate:
Start by validating the person’s feelings (even if they don’t make sense to you). Say something like, “it sounds like you’re feeling really afraid or anxious right now, and that’s okay.”
Reassure:
Let them know that everything will be alright, and do what you can to make them feel calm and comfortable.
Distract:
Divert their attention toward something they enjoy and find soothing, like their favourite music or a good book.
Seek professional caregiving services
Caring for a loved one with sundown syndrome can take an emotional toll so it’s important to make sure you are looking after yourself while you support your loved one. Depending on your situation and the responsibilities you already undertake, the burden of Sun Downs Syndrome caregiving can outweigh the benefits.
In these instances, it’s a good idea to call in the experts. Handing over the reins to a qualified home care specialist will ensure your loved one is getting the highest quality care while they deal with sundown syndrome—and give you peace of mind that your loved one is in good hands.
Caregivers can help your loved one maintain their dignity by letting them continue their regular routines despite cognitive decline. As well as personal care needs, grocery shopping, and household chores, caregivers can manage your loved one’s sundowning symptoms, prevent wandering, and monitor for other sundowning risks.
