Dementia is an umbrella term that refers to a group of symptoms related to memory and cognitive problems. The most common form of dementia is Alzheimer’s disease. According to to the National Institutes of Health, Alzheimer’s affects more than 5.5 million Americans.
Symptoms for Alzheimer’s generally appear for people in their mid-60s. Alzheimer’s currently ranks as the sixth leading cause of death in the United States for older people, and some estimates say it may be as high as third, behind only heart disease and cancer.
There are a number of problematic side effects associated with Alzheimer’s and other forms of dementia. For example, people diagnosed with Alzheimer’s will generally experience changes in the brain that can cause symptoms like memory loss, poor judgement, repeating questions, problems with daily tasks, wandering, anxiety, personality changes, and more. One difficult side effect that many experience is called sun downing.
What Is Sun downing?
Sun downing, or sundown syndrome, is defined as a period of restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to turn to night. Sun downing can continue into the night and can make it hard for people with Alzheimer’s to fall asleep or stay in bed. The side effects mentioned above can cause problems for caregivers who normally get their break during the nighttime.
Some of the other clinical features of sun downing include mood swings, suspiciousness, and visual or auditory hallucinations in the late afternoon and evening.
The causes of sun downing are still not well understood, however, one possibility is that the Alzheimer’s-related brain changes that can influence a person’s biological clock that can lead to problems with someone’s sleep-wake cycles. There is some evidence that shows that institutionalization of older patients with dementia is one thing that can lead to sun downing.
Other causes of sun downing can include:
- Being too tired
Preventing Sun downing
There are a number of methods to reduce chances of sun downing in older individuals. To start, one thing to be aware of is to look for signs of possible sundown syndrome in the late afternoon and early evening. Some of these signs include confusion, anxiety, pacing, wandering, or yelling. Trying to find the cause of this behavior and eliminating it at the source may be your best bet for dealing with sun downing.
Dealing with sun downing in a person with Alzheimer’s may prove to be difficult, as some people have a hard time explaining their problem and can even become frustrated and agitated. If this is the case, reminding the person that everything is okay and distracting them from stressful events may be enough to get rid of the sun downing issue.
There are a number of things that you can do to try and minimize instances of confusion before bed that could help to prevent sun downing. For example, reducing noise and clutter is one way to help seniors clear their mind and prepare for sleep. Making early evening a quiet time and doing soothing things like listening to music, reading, or going for a walk can help someone relax before bedtime.
Some other things that you can do to avoid sundown syndrome include:
- Going outside to getting exposed by bright light, which can help reset the person’s body clock
- Participating physical activity and exercise every day
- Getting daytime rest, short naps not too late in the day
Some things that can make sun downing worse include drinking high caffeine drinks like coffee and soda late in the day. Similarly, drinking alcoholic drinks can increase confusion and anxiety and may increase sun downing.
Some of these preventative methods may not work for some people who are dealing with sundown syndrome. However, there are a few options that you can include in your daily routine that could help to treat sun downing in some individuals.
One method to reducing sun downing is light therapy. Studies show that placing a full-spectrum fluorescent lamp close to a sun downing patient, within his or her visual field, for a few hours in the morning may help to change the patient’s circadian rhythm and can help to reduce agitation. Other studies showed that patients with Alzheimer’s and sun downing who were treated with some type of light therapy experienced improved sleep quality and less sun downing.
Many studies have shown that disruptions in the circadian rhythm have been linked, and may be a result of decreased melatonin levels and may be the cause of the development of sun downing behavior. While melatonin supplements may work in some cases, there is no concrete evidence that shows that melatonin treatment is effective sun downing in patients with dementia.
One research study says that anti-psychotic medications are probably the most widely used to manage the symptoms of sun downing. There is some evidence that shows that patients with anti-psychotic medications may experience sedation that can help with sleep. However, there are some side effects to using these types of medications, such as pneumonia and stroke, that should be weighed against the potential benefits of the drug.
There are other options that could help treating sun downing, including:
- Music Therapy
- Creating a stable, daily routine
- Multi sensory stimulation
While there may not be one easy way to get rid of sun downing, trying out a few methods may be the best way to see results. If the problem persists, it may be beneficial to reach out to a doctor or medical professional on finding a proper path forward.
Sun downing is a serious side effect that is associated with dementia, and may even just occur organically in non-dementia patients. Sundown syndrome happens before bed and generally is characterized by confusion, poor judgement, wandering, anxiety, and visual or auditory hallucinations. While the causes for the problem are still not fully understood, there are a few thing that you can do to address the issue. Exercise, light therapy, medication, and daytime rests are all options that you can use to try to reduce sun downing. If your loved one is dealing with sun downing, it may be beneficial to get professional help. At Landmark Senior Living, our care staff has the knowledge and tools that can help. If you want to learn more about our programs and want a tour of one of our assisted living facilities, please reach out to our admission staff today.