What is Sundowner’s Syndrome?

Sundowner’s syndrome is the term to describe the combination of symptoms, like agitation, anxiety, confusion, irritability, mood changes, etc. that many seniors with dementia or cognitive impairment experience. The term “sundowner” appropriately hints towards the time of day these unfavorable symptoms tend to surface. While Sundowner’s can strike at any time of day, for most seniors it appears in the late afternoon and early evening.

Medical research suggests that it is the shifting of the biological clock in seniors with dementia that makes them more susceptible to Sundowner’s. Since human’s natural circadian rhythms respond to the loss of sunlight during this time of day, it’s only natural to feel more depressed in the evening. These theories as they relate to Sundowner’s symptoms do make sense. However, it’s just a small glimpse to shed some light on this mysterious, and oftentimes misunderstood, condition.

Caregivers to the elderly with dementia or Alzheimer’s would largely agree that the most difficult time of day for their duties is as sundown approaches. In addition to the body’s natural clock and rhythms, it’s thought that during this time of day seniors are tired and over-stimulated. It’s also possible that a drop in blood pressure, spike in hunger and changes in glucose levels play a role. While there is no cut and dry diagnostic process or treatment, there are some things a caregiver can do to lessen the degree to which seniors experience Sundowner’s symptoms.

Regulate sleep. Having a normal wake, nap, sleep routine makes all the difference. Limit daytime naps to a brief 20 minutes, only once or twice a day. This allows the senior to feel refreshed going into sundown, but not overly rested, as to avoid insomnia at bedtime.

Plan an appropriate daytime activity. Getting out of the house, and doing an activity like taking a walk, gardening or visiting a museum can have rejuvenating effects. Even just staying in, reading a book or playing a game provides the senior with a stronger sense of purpose which boosts their mental well being.

Keep the setting calm and bright. Take advantage of natural light during the day, and as sundown approaches maintain a well lit environment. This will detract away from the darkness outside and keep the mood light and relaxing.

If attempts are made with little to no success at keeping Sundowner’s symptoms at bay, it might be time to consult with a doctor. Medication to alleviate symptoms may help. A doctor can recommend an appropriate dosage of medication specifically suited for controlling even the most challenging sundowner’s symptoms.

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