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Shedding Light on Sundowner’s Syndrome

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For those with Alzheimer’s disease, dusk can be a distressing time. It’s called sundowning, and here’s what you need to know.

Have you noticed changes in your parent’s behavior as nighttime approaches? Does their mood darken as the sun goes down? If a loved one starts acting differently when day turns to evening, it could be a sign of sundowner’s syndrome. Keep reading to learn about the signs of sundowner’s, plus strategies to help alleviate or lessen symptoms.

What is Sundowner’s syndrome?

Sundowner’s syndrome is a behavioral condition represented by a collection of symptoms. The exact cause is unclear, but some specialists believe it happens when a person’s biological clock is off kilter. This is often due to disturbances in their circadian rhythms or sleep cycles.

Many doctors and neuropsychiatrists believe there’s a direct connection between brain deterioration and an increased prevalence of sundowner’s symptoms. This is one reason the behaviors are more common among people with dementia. Some statistics show one out of every five Alzheimer’s disease patients have multiple symptoms associated with the syndrome.

Techniques For Reducing Sundowning Symptoms

The good news is that Sundowner’s syndrome is not a new condition. Why is that good news, you’re wondering? Rather than throw their hands up in frustration over this mysterious condition, caregivers have experimented, tested and come up with techniques to help loved ones experience more peaceful evenings. Here are some expert tips:

Keep it routine. Establishing (and sticking to) a regular daily schedule is the number one recommendation from caregivers. It’s also important to talk to your parent throughout the day, before symptoms appear, and remind them of their set bedtime routine.

Know what to avoid. It’s easier to minimize symptoms when you understand what may trigger them in the first place. Things to avoid include:

  • Large meals in the evenings; serve a big lunch, then keep dinner simple and small
  • Caffeine and alcohol before bedtime
  • Overactivity, especially before bed; although it’s good to stay active during the day, a fatigued parent is more likely to become irritable
  • Overstimulation from loud noises (TV, music, children) during the evening is a common trigger for people with a prevalence toward sundowning
  • Darkened rooms during daylight hours; exposure to sunlight helps keep those circadian rhythms in check

What triggers sundowning symptoms in one person may not affect another. Make sure you know what they are for your parent. Watch for behavior patterns to determine the activities or environmental factors that contribute to worsening symptoms. Becoming aware of what causes their behavior will help you use these techniques more effectively. And remember: The best way to reduce stress and anxiety for both you and your loved one is to take care of yourself first.

The Signs And Symptoms

The overall symptoms associated with sundowner’s syndrome involve dramatic changes in behavior as early evening or nighttime approaches. Specific signs of possible sundowner’s syndrome include:

  • Increased agitation as evening draws near (typically occurs between 5 p.m. to 11 p.m.)
  • Drastic mood swings or changes in personality with no external trigger, other than sunset
  • Shows signs of mental confusion often accompanied by difficulty thinking or speaking clearly
  • Experiences sleep disturbances like restlessness, waking in the middle of the night or insomnia
  • Develops aggressive or violent behavior including yelling
  • Becomes overly paranoid and may begin to hallucinate

If your parent or loved one develops more than two or three of these behaviors let their doctor know. Set up a meeting to discuss the symptoms you’ve observed. Although there is no definitive test to diagnose sundowning, the doctor may be able to rule out other causes.