Causes of Sundown Syndrome in Senior People and Phoenix Assisted Living

Sundown syndrome affects people in the mid to late stages of Alzheimer’s disease and related forms of dementia. When you are with someone with Alzheimer’s disease, you may notice changes in ways they act in the late afternoon or early evening. This is called by doctors sundowning or sundown syndrome. Fading light seems to be the trigger with the symptoms getting worse as the night goes on and usually gets better by morning. Sundown syndrome is not actually a syndrome or a disease in and of itself, it can be defined as a “group of symptoms that occur at a specific time of the day that may affect people with dementia.” Simply put, it refers to a state of confusion that comes on in the late afternoon and lasts into the night.

The syndrome has different effects in different people but mainly includes feelings of sadness, fear, delusions, hallucinations, and agitation which invariably leads to inadequate rest for both the people who have it and their caregivers and can exacerbate existing symptoms.

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Causes of Sundown Syndrome:

The exact causes of sundowning are unknown which often appears in mid to late stages of dementia. There are a few steps that caregivers can take to mitigate its effects though. According to some scientists, 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 which could cause sundowning. It is more likely if your loved one is too tired, hungry or thirsty, depressed, bored, in pain and having sleeping problems. According to some medical professionals, the entire day’s sensory stimulation accumulates and becomes overwhelming once the day settles, causing people with dementia to become stressed and exhibit signs of that stress. For some, the hormonal changes that occur at night may cause a hormonal imbalance, affecting one’s natural circadian rhythm.

Regardless of the cause of Sundowner’s Syndrome, most medical professionals agree that the following factors can trigger an episode of sundowning or make an existing episode worse:

1. Low Lighting
2. Exhaustion
3. Urinary tract infections or other infections
4. Increased shadows
5. Sleep schedule disruption

Download an app to track your loved one’s behaviors and schedule in the app which can help you identify any triggers that may be unique to your beloved.

Signs and Symptoms:

Sundown syndrome affects each person differently so a person experiencing sundowning can exhibit a wide range of behaviors. One may lose their ability to communicate in a coherent way, while others may wander aimlessly looking for an escape route. Other behaviors exhibited by someone experiencing a sundowning episode include insomnia, anger, agitation, depression, fear, restlessness, emotional outbursts, delusions/hallucinations, restlessness, rocking, paranoia. A person, in extreme casesmay become physically violent as the confusion and disorientation sets in.

Tips to Help Someone who’s Sundowning:

1. Note down things that seem to trigger it, look for patterns, and then do your best to avoid or limit those triggers.
2. Limit or avoid things that affect sleep like smoking, excess alcohol consumption, sweets, caffeine, etc. Keep their evening meal smaller and simple.
3. Make sure you keep things calm in the evening which you can do by fixing the room temperature so they are comfortable, close curtains and blinds and turn on lights as darkness and shadows can be more upsetting, and wind down putting on relaxing music, reading, playing cards, or going for a walk.
4. Consult with your loved one’s doctor if the above tips don’t work who can check to make sure that your loved one’s medicines that help him relax and sleep don’t cause more confusion the next day.

It is extremely important that as a caregiver you take care of yourself as sundowning can make it hard for you to get restful sleep. You need to take care of yourself in order to be there for your beloved.