About one in five people with Alzheimer’s disease or other forms of dementia are affected by “sundowning” ““ they become confused and agitated as the sun goes down, and may stay that way throughout the night.
The behavior can make it difficult for people with dementia (and their caregivers) to sleep at night. It may make people with Alzheimer’s more likely to wander, and having to keep up with people prone to sundowning is a major contributor to caregiver burnout, according to the Alzheimer’s Association.
What is “sundowning?”
It’s unclear what causes sundowning. Some researchers theorize as the brain changes during the dementia process, its built-in clock may be affected, leading to the behavioral changes.
Sundowning can include pacing, wandering, yelling and fighting or confrontational behaviors.
Because people with dementia have trouble communicating, some factors may make sundowning behaviors worse, including pain that’s going untreated, hunger or poor nutrition, an undiagnosed infection, a sleep environment that’s too loud or disruptive or drug interactions.
Help your loved one avoid sundowning
To help ease sundowning behaviors, the Alzheimer’s Association offers these tips:
- Activity
Being more active during the day may help people with dementia sleep better at night. Try discouraging daytime napping, increasing physical activity and adopting hobbies that get the patient up and moving around.
- Healthy diet
Plan an early dinner, keep bedtime snacks light and cut back on the patient’s caffeine and sugar intake after breakfast to help encourage better sleep. - Medical advice
Ask the patient’s physician to look for infections, sores or other factors that might be causing pain your loved one can’t communicate. Undiagnosed urinary tract infections are a big problem in vulnerable older adults. They can be very painful and can add to dementia symptoms. Also ask the doctor to review all of the medications your loved one is taking to make sure they’re not interacting in a harmful way and that they’re all still necessary. - Sleep environment
Letting the patient sleep in a different bedroom or in a favorite chair ““ if that’s what he or she wants ““ may help improve sleep. Keeping the room partially lit could also cut down on confusion and anxiety if the patient wakes frequently during the night. - Light therapy
Exposure to bright light during the day may help “reset” the body’s internal clock, and may help the patient sleep better at night, especially when combined with light exercise, such as walking. - Calm reassurance
Gently remind your loved one where he or she is and what time it is. Remain calm; if you become agitated or upset, so will your loved one. Remind them calmly that they’re safe.
