Sundown Syndrome  Sundown Syndrome is a term that describes the onset of confusion and agitation that generally affects people with dementia or cognitive impairment and usually strikes around sunset. Many people use the term to describe increased agitation and confusion that can occur anytime but may be more noticeable in the late afternoon, early evening or night.Although the cause is not well understood, there is an association between sundown syndrome and changes in the internal biological clock among people with dementia. The internal clock controls sleeping and waking. It is connected to how active we are at different times of the day and influences changes in the body that regulate behavior. Studies suggest that the biological clock shifts in people with dementia and this may make people with dementia prone to sundown syndrome.Sundown syndrome may prevent people with dementia from sleeping well and may also make them more likely to wander. This syndrome is seen in about 20% of people who have Alzheimer’s disease or other kinds of dementia. Sun downing typically peaks during the middle stages of Alzheimer’s and diminishes as the disease progresses.Signs and Symptoms of Sundown Syndrome:

  1. Forgetfulness
  2. Confusion
  3. Delirium
  4. Agitation
  5. Anxiety
  6. Restlessness

     Clients Unable to Sleep May:

  1. Pace the floor
  2. Wander
  3. Yell
  4. Become combative

 Triggers That May Increase the Risk for Sun downing:

  1. Pain
  2. Fecal impaction (severe constipation)
  3. Poor nourishment
  4. Drug interactions or side effects of medications
  5. Infection (ex: urinary tract infection)
  6. Noisy and disruptive sleeping environment

Ways to Reduce the Severity of Sundown Syndrome Include:

  1. Increase daily activity;

* discourage daytime naps* encourage daily exercise routine (ex: walking)* encourage hobbies that get client up and moving

  1. Monitor diet

* limit caffeine and sugar to morning hours*  Plan an early dinner* Keep snacks and fluids light before bedtime

  1. At sunset avoid stressful situations

* limit activities* limit appointments* limit trips and visits

  1. Play soft music
  2. Set a bedtime routine and keep it
  3. Give a soothing backrub
  4. Distract the client with a simple, calm activity (ex: looking at a magazine)
  5. Provide calm reassurance by reorienting the patient to person, place & time
Don’t forget to Care for yourself too

Sundowning syndrome can be exhausting, not just for your loved one but for you too. As a caregiver, it’s essential to take good care of yourself. You’ll be in a better position to give your loved one the patience and support they need when you’re rested and healthy.  Try to eat a well-balanced diet, exercise regularly, and get enough sleep at night.

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Brenna Major

Brenna is a marketing guru who enjoys running, coffee, and a good game of Mario Kart! She works mainly in digital marketing, and dabbles in some design work and project management on the side. When she's not working, she can be found exploring new restaurants and coffee shops in Scranton, PA with her husband, Kyle.

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