Managing Sundown Syndrome

Sundown Syndrome is a phenomenon that causes a person with dementia to become anxious, agitated, restless, and moody in the late afternoon or early evening when the sun starts to go down.  It can also cause hallucinations and delusions that are frightening and disturbing for the person.

The affects of sundowning can lead to

• pacing
• crying
• angry outbursts
• aggressive behavior
• increased confusion
• wandering
• repetitive questions

These behaviors could last for a brief amount of time or may go on for hours.

As many as 20 percent of those with Alzheimer’s or related dementias experience Sundown Syndrome.  Doctors aren’t sure why sundowning occurs, but some think that changes in the brain of someone with dementia may affect their inner body clock.  This is the area of the brain that signals when you’re awake or asleep.

Some scientists speculate that the syndrome occurs due to an accumulation of all the sensory stimulation the person received over the course of the day that by the end of the day builds up and becomes overwhelming and stressful.   Other causes could include fatigue, hunger, thirst, physical pain, or boredom.

Tips for Managing Sundown Syndrome

• Keep the lighting bright and the window shades drawn
• Play your loved one’s favorite music
• Before sundowning begins, engage your loved one in an activity such as folding laundry or helping to prepare dinner
• Approach your loved one in a calm manner. Keep your voice soft and avoid touching them in an unexpected way
• Try “light therapy”, an intervention that uses a light box to reduce toxic proteins that build up in the brain in Alzheimer’s disease
• Keep your loved safe by locking the doors and keeping the car keys hidden
• Validate your loved one’s fears and try to redirect their attention to another activity such as, looking through a photo album or holding onto a comfort object such as a stuffed animal
• Talk to your doctor about medications that help with sundowning

If you provide care or live with a loved one with dementia who experiences sundowning, remember to care for yourself too.  Family caregivers dedicate so much of their energy and attention to their loved ones and tend to put their own health and well-being last.  Keep in mind that in order to be there for your loved one, you must be strong and well yourself.  Consider hiring an in-home care service to provide you with some relief or other community programs such as, adult day care.