Understanding Sundowner’s Syndrome
By Melissa Andrews
You may not have heard of Sundowner’s Syndrome.
If you’re taking care of a loved one living with Alzheimer’s or some other form of dementia, you will probably notice a change in their behavior by the time the sun sets.
Those with dementia are already likely to experience episodes of confusion, memory loss, agitation, restlessness, and even aggression at any time of the day, whether they’re in assisted living care or home care.
However, these symptoms tend to be more pronounced and intense when the sun goes down, and managing these symptoms can prove challenging for the people who look after them.
To this day, doctors still aren’t sure what causes all these symptoms that occur at a specific time of the day. In any case, modern medicine already has a name for the condition, and an appropriate one at that: – Sundowner’s Syndrome.
Also referred to as sundown syndrome and sundowning, sundowner’s syndrome is less a disease and more of a collection of symptoms that apparently rears its head just before nightfall and could get worse as the night progresses.
While it occurs most often among those with a dementia diagnosis, sundowner’s syndrome can also affect seniors not living with dementia.
Symptoms of Sundowner’s Syndrome
Aside from increased confusion, memory loss, agitation, restlessness, and aggression, other symptoms of sundowner’s syndrome may include:
● Irritability
● Disorientation
● Sleeplessness
● Paranoia
● Anxiety
● Suspiciousness
● Depression
● Mood swings
People living with dementia may also be inclined to yell, pace the room, or hallucinate when sundowner’s syndrome sets in.
What Causes Sundowner’s Syndrome?
As mentioned above, sundowner’s syndrome remains a mystery, as no one really knows its exact cause. However, theories abound as to the triggers that set off the medical condition.
One theory has it that sundowner’s syndrome is some sort of a tipping point for people with dementia after all the built-up sensory stimulation they’ve had over the course of a day.
By the time a day ends and the sun sets, all the stimuli they’ve received for the past few hours could make them feel overwhelmed and stressed, leading to the manifestation of the symptoms listed above.
Another theory is that people living with dementia become more anxious by twilight since they’re unable to see well in the dark. Complicating things is the shadows changes in lighting can cause, which can contribute to the anxiety and disorientation of someone with dementia.
Alzheimer’s may also disrupt the body’s internal clock or cause hormonal imbalances, which are believed to trigger the symptoms of sundowning.
Some attribute sundowner’s syndrome to fatigue, while others say that boredom, loud noises, hunger, thirst, and pain all have something to do with it as well.
Coping With the Challenges of Sundowning
Caring for someone living with dementia is already challenging enough, but sundowner’s syndrome adds another level of difficulty that could prove to be draining not only for the patient but for the caregiver as well.
Still, even though it’s near impossible to stop sundowner’s syndrome altogether, caregivers can take measures that can help prevent or, at the very least, reduce its symptoms, including:
● Identifying triggers—The triggers that cause symptoms of sundowner’s syndrome may differ from person to person. For some, it could be loud noises. For others, it could just be fatigue. Observe your loved one and identify what you think are their triggers, and do what you can to help them avoid any situation where those triggers are present.
● Watching your tone—It’s normal for caregivers to feel tired and frustrated looking after a person with dementia, but you have to watch your tone when speaking to them because any indication of annoyance, irritation, or anger in your voice will likely trigger responses that will make the situation even worse. So always speak to the person living with dementia using the calmest, most peaceful tone of voice you can muster.
● Establishing a routine—People with dementia tend to feel less fearful and confused when they have daily routines to follow. With an established routine, you can keep surprises to a minimum. However, make sure you don’t overwhelm those living with dementia with one too many activities. Two major activities per day should be enough.
● Discouraging napping—Those who experience sundowning already tend to have problems sleeping at night. Letting them take a nap during the day can only make their already messed-up circadian rhythm worse.
● Keeping rooms well-lit—If the loss of sunlight at sunset is what triggers sundowner’s syndrome symptoms, what better way to make the transition easier for a person living with dementia by keeping the home well-lit as evening approaches? With more lights, your loved one with dementia will see better at night and minimize confusion-inducing shadows as well.
● Helping them get more sun—Whatever activities you may have lined up for your loved one, always include walks. That way, the person you’re caring for will get some fresh air and more sunlight, which, for its part, can help correct their body’s internal clock, too.
Sundowner’s syndrome can be a head-scratcher at times. Still, being patient, getting the proper support, and having a better understanding of this rather complex medical condition will better equip you to handle the challenges that come with it.
About the Author
Melissa Andrews is the Content Marketing Strategist for Paradise Living Centers, an assisted living center for seniors with locations in Paradise Valley and Phoenix, Arizona. In her spare time, she enjoys cooking and going on hiking trips with her siblings and cousins.
The views and opinions expressed in this post are those of the author and do not necessarily reflect all or some of our beliefs and policy. Any links on this page do not necessarily mean they have been endorsed by Defying Mental Illness.
About The Author