Sundowners Syndrome

Posted by McKenna Burr on Apr 4, 2016

In Alzheimer's & Dementia, Main




The sunset is usually a calming time for people where they wind down from their hectic day. But for the elderly with dementia or Alzheimer's, Sundowners Syndrome may occur. This is where those elderly, reach a time during the day where it increases memory loss, confusion, agitation and even anger. Sundowning affects up to 20% of the more than 5 million Americans with Alzheimer's. 

This can add a lot of stress onto a caregiver when they are not confident in being able to handle their loved one with sundowners syndrome. An example of sundowner syndrome is of a resident who has the early- stages of Alzheimer's and lives in an assisted living facility. During breakfast and lunch time she experiences the normal symptoms of her alzheimer's but it is very manageable by the staff. She is enjoyable to be around and likes to socialize with other residents. 

When the sun begins to set, her mood drastically changes. She becomes extremely moody and acts out toward the staff and other residents. She gets so worked up that it then becomes hard to calm her down while trying to go to bed at night so she is not able to get a good nights sleep. 

Common triggers for Sundowning syndrome- 

- Too much activity too late. Some researchers believe that if there is too much activity too late in the day that it can cause confusion and anxiety with some elderly. 

- Low Light. Make sure to make it as bright as you can when the sun is starting to set. This will allow the elderly to not let the nighttime affect their vision. 

- Fatigue. Exhaustion at the end of the day from activities, meals and visitors can build up and may be a contributer. 

- Winter. Since the days are shorter in the winter, seasonal affective disorder may occur with some residents so be sure to try to lighten the rooms up and bright light around them. 

- Internal Imbalances. Some researchers even think that hormone imbalances or possible disruptions in the internal biological clock that regulates cognition between waking and sleeping hours may also be a principle cause.

Treatment for sundowning is not well established. Some approaches that have been successful to managing the sundowning syndrome behavior include:

- Establishing a routine. Routines are very helpful with making the sundowner feel safe and avoids confusion. By sticking to a routine, you are going to be able to not allow surprises to upset your loved one and trying to schedule bigger activities in the morning will help with their mood. 

- Medicating. In some cases of sundowning, especially when associated with depression or sleep disorders, medication may be helpful. Talk with a physician carefully, for some medications may actually disrupt sleep patterns and energy levels in a way that makes sundowning worse, not better. 

- Controlling Noise. It may be beneficial to quiet the TV, radio or phone from noises so they can relax. Avoiding visitors in the evening so they can just relax and start preparing for bedtime. Just try to keep the noise down as much as possible so they do not form any anxiety with all the movement happening around them. 

-Letting Light In.  As the evening approaches, keep rooms well-lit so that your loved one can see while moving around and so that the surroundings do not seem to shift because of shadows and loss of color. Night lights often help reduce stress if he or she needs to get up in the night for any reason.

There are many different sources out there that are helpful when you have questions about sundowning. We received this information above from A Place for Mom. It is always good to be well informed about your loved ones health, especially if they start acting differently. Never hesitate to ask for help or advice from others.  

To read more about dementia, visit our other articles here.