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Sundowning: How Seasons Changing Affects People With Dementia

Late afternoon arrives. The sun sets. Night falls. For most of us, this is the time when our bodies naturally start to relax. For those with sundowner’s syndrome, it’s just the opposite. Sundowner’s syndrome is also called sundowning syndrome or sundowners. It’s not a disease itself, but it affects up to 20% of older adults with Alzheimer’s or other forms of dementia.  

While the rest of us are winding down, people with sundowning symptoms feel increasingly tired, confused and anxious as day passes into night. They may shout, become more aggressive or pace. Because of their agitation and confusion, the risk of injury to themselves or others increases. Since these behaviors are often dramatically different from how they normally behave, it’s upsetting for both the affected person and their caregiver. 

What Is Sundowning?  

Disruptive behaviors associated with sundowning typically occur in the late afternoon or evening and sometimes last well into the night. Symptoms include: 

  • Exhaustion that intensifies as the sun goes down 
  • Confusion that doesn’t respond to reasoning 
  • Drastic mood swings 
  • Inability to identify where they are or who someone is 
  • Fear or violence as a result of hallucination or paranoia 
  • Insomnia at night and excessive sleeping during the day 
  • Trouble speaking or thinking clearly 
  • Restlessness, pacing and wandering 
  • Yelling and other aggressive behavior 

 Tips for Managing Sundowners 

Not everyone with Alzheimer’s or other forms of dementia will experience sundowner’s syndrome, and no one really knows what causes it. That’s part of why sundowner’s syndrome treatment is more about managing symptoms versus a “cure.”  

Some researchers believe it happens when dementia disrupts a person’s circadian rhythm, our body’s natural sleep-wake cycle. Or that it’s caused by a lack of melatonin, the hormone that helps our brain recognize darkness and fall asleep. Conditions such as a urinary tract infection or sleep apnea can make sundowning worse. A person’s surroundings can also set off symptoms. Low lighting, shadowy rooms or excessive and prolonged noise are all culprits that lead to sundowning symptoms. 

The Mayo Clinic recommends the following tips to reduce sundowning symptoms and help a person feel more comfortable: 

  • Maintain a predictable evening routine 
  • Plan activities and exposure to light during the day 
  • Limit daytime naps and keep them short 
  • Limit caffeine and sugar to mornings   
  • Limit exercise before bedtime 
  • Keep the evening meal small and simple 
  • Keep a night light on to reduce anxiety upon waking 
  • Reduce noise and overstimulation, especially TV viewing 
  • Play gentle music or nature sounds to create a relaxing mood 
  • Check for an underlying condition such as a urinary tract infection 

The Effects of Changing Seasons 

As summer changes to fall, and fall to winter, the days grow shorter. Even fit and healthy adults feel tired as a result of daylight saving time changes or suffer seasonal affective disorder due to the lack of sunlight. For seniors with dementia who do better with a regular routine, the effect of fluctuating seasons is more marked. Winter months when the sun sets earlier and the night lasts longer can cause sundowning syndrome to worsen. In addition to the tips listed above, these steps may be of help during the winter months: 

  • Switch on as many lights as possible before the sun begins to set 
  • Spend as much time in the sunshine as possible 
  • Try a mild sleep aid like melatonin (consult your doctor first) 
  • Offer a foot or a hand massage with soothing oils for relaxation 

Taking Care of the Caregiver 

Caring for an older adult with sundowner’s syndrome can make it hard for you to get restful sleep. And you need to take care of yourself to be there for your loved one. If possible, ask another family member or a trusted friend to fill in for you at night, and try to fit in a daytime nap when you can. Take breaks during the day, eat healthy meals and find time for exercise and your own hobbies and interests. 

The Benefits of Memory Care 

Memory care communities offer specialized help for people with dementia. They’re staffed and equipped to provide 24/7 support and supervision, lifting the burden of caregiving from families while giving loved ones the attention they need.  

At Cypress Village, we offer Heartfelt CONNECTIONS – A Memory Care Program®, a nationally recognized option for older adults living with dementia. This approach focuses on the abilities that remain rather than those that are lost. As specialists, our staff members are trained to recognize and manage sundowning symptoms and keep residents safe, calm and reassured. Our memory care neighborhoods are designed to be safe and secure places for seniors to move around without becoming confused or lost. At Cypress Village, our specially trained staff works to enrich the lives of our residents with dementia, including those with sundowner’s syndrome. Contact us today to learn more about our memory care services and schedule a visit.