Sundowning Disease

How to Manage "Sundowning"

When you are with someone who has Alzheimer's disease, you may notice big changes in how they act in the late afternoon or early evening. Doctors call it sundowning, or sundown syndrome.

Fading light seems to be the trigger. The symptoms can get worse as the night goes on and usually get better by morning.

Although you may not be able to stop it completely, you can take steps to help manage this challenging time of day so you both sleep better and are less tired during the day. Let your loved one’s doctor know what changes you have seen, too.

Symptoms

When someone is sundowning, they may be:

• Agitated (upset or anxious)
• Restless
• Irritable
• Confused
• Disoriented
• Demanding
• Suspicious

They also may:

• Yell
• Pace
• Hear or see things that aren’t there
• Have mood swings

 Up to 1 out of 5 people with Alzheimer’s get sundown syndrome. But it can also happen to older people who don’t have dementia.

Causes

Doctors aren’t sure why sundowning happens.

Some scientists think that changes in the brain of someone with dementia might affect their inner “body clock.” The area of the brain that signals when you’re awake or asleep breaks down in people with Alzheimer’s. That could cause sundowning.

It may be more likely if your loved one is:

• Too tired
• Hungry or thirsty
• Depressed
• In pain
• Bored
• Having sleep problems.

What happens around someone can also set off sundowning symptoms. Some triggers are:

• Less light and more shadows in the house. This can cause confusion and fear.
• Trouble separating dreams from reality. This can be disorienting.

If you feel tired or frustrated at the end of a day of caregiving, your loved one may notice, even without you saying anything. This can upset them, too. It’s normal for you, as a caregiver, to have feelings like that. Try to be aware of how you manage those emotions if you think that might make a difference.

CO