9 Ways to Help Manage Sundown Syndrome

Sundown syndrome, also known as sundowning, is a condition often seen in people with Alzheimer’s disease or dementia. It refers to a pattern of increased confusion, agitation, anxiety, aggression, or restlessness that typically happens in the late afternoon or evening as the sun goes down. Sundown syndrome can result in difficult behaviors such as pacing, rocking, yelling, crying, confusion, resistance, anger, or even violence. Many individuals with sundown syndrome feel an urgent need to go somewhere or do something, yet they may struggle to explain why.

According to the Alzheimer’s Association, about 20% of those who have Alzheimer’s report experiencing sundown syndrome. It’s a challenging condition, but with the right strategies, symptoms can often be minimized to improve quality of life.

What triggers sundown syndrome?

• Disruptions of internal clock
• Fatigue
• Low light and increased shadows
• Medication Side Effects
• Hunger and Thirst

Ways to Help Manage Sundown Syndrome

1. Minimize Triggers
Changes in the day can cause sundown syndrome. For instance, does the household become noisy and hectic when family members return from work? Minimizing noise can help reduce the anxiety and agitation that can trigger sundown syndrome.

2. Maintain Routines
Keeping routine is a good sense of security — something that older people need. Try and keep any activities for early in the day when they may seem more alert, and encourage them to not nap during the day so their days don’t get flipped between night and day.

3. Simplify Surroundings
A chaotic environment can be overwhelming for someone with dementia. Excessive sensory stimulation, combined with changing light, can heighten anxiety and confusion. Since dementia damages the brain, processing visual information becomes increasingly difficult. A cluttered or visually busy space may feel disorienting to them. This sensory overload can contribute to sundowning behaviors as they struggle to interpret and organize what they see.

4. Modify Sleep Environment
Modifying where your loved one sleeps can be very beneficial with managing sundowning. A few tips for this are: keep a comfortable temperature throughout the night, light-blocking curtains to keep the bedroom dark and cozy, and providing dim lighting to assist with moving around in the event they need to get up in the middle of the night.

5. Validate Feelings
As frustrating as it can be when taking care of someone with sundown syndrome, try validating their feelings instead of trying to reason (even if it doesn’t make sense to you). By doing this you’re showing that you understand them and you’re listening to them, which can manage agitation and aggression.

If they still seem to be agitated, distract them with an activity they find comfort in. This could be their favorite tv show, music, or a visit from a family pet.

6. Adjust Light Exposure
Ever hear that if you’re feeling sad you should go outside and soak up the sun? The same principal applies to sundowning. Experts theorize that our hormones and body clocks are regulated by exposure to light, and too little exposure can throw us off. Hence, why we feel may feel more sad during the winter and darker months.

When it starts to get dark outside earlier, keep lights on to have the appearance of day time, which can help keep a regulated sleep schedule.

7. Play Music or Calming Sounds
If you notice anxiety setting in later in the day, playing your older loved ones their favorite music can distract their brain. Using calming noises at night such as rain or white noise can help them fall asleep.

8. Provide Physical Touch
Don’t underestimate the power of physical touch. A good tip for when someone is dealing with sundowning is to distract them with a massage. This can help calm them and transition them to the night time, making the sudden change easier to deal with. It also gives them a sense of self-care and something to look forward to.

9. Try Different Medications and Herbs
It may be a good idea to ask the doctor for medications that help with any symptoms of sundown syndrome. But, make sure to monitor side effects once starting a new medication.

Also, ask about herbs and supplements like lemon balm, chamomile, kava, and holy basil. These supplements are marketed for their calming and stress-relieving effects, including melatonin, magnesium, and vitamins B, C, and E.

Sources:
Article Source: https://www.aarp.org/caregiving/health/info-2017/ways-to-manage-sundown-syndrome.html?intcmp=AE-CAR-CRC-LL

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