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As the day progresses, people with dementia diseases like Alzheimer's can experience a condition known as sundowning. Sundowning occurs late in the day and can last through the night. A state of confusion referred to as sundowning occurs as the sunlight fades away. Symptoms get worse over the remainder of the day and improve the next morning. An Overview Sundowning is a disorder highlighted by a disconnection from reality. Sufferers will show aggression, anxiety, restlessness, irritability, and disorientation. They may refuse to follow directions or perform their regular tasks. Sufferers might pace or wander and could have trouble sleeping. The patient's stress is, of course, transferred to the caregiver. Caregivers can find themselves not getting good rest and having difficulty functioning during the day. It's believed one out of five Alzheimer's patients has sundown syndrome . This is also a condition that appears in mature persons who have no form of dementia. Possible Causes of Sundowning Scientists still debate the actual cause of sundowning. One hypothesis is a disruption in the "biological clock." The biological clock is a regulating cycle of circadian rhythms. Composed of molecules and cells interacting throughout the body, the process manages our 24-hour cycle of mental, physical, and behavioral activity. Circadian rhythms influence hormone release, eating, digestion, and even body temperature. They greatly impact sleep patterns. Our rhythms scan information about light. That info is delivered to the brain and transformed into preparation for sleep. In essence, when we "see" night coming, our brain makes melatonin that makes us drowsy. If there's a glitch in that delivery—such as the transmission to a brain not completely operational—the brain will receive messages but not send out signals. The body will never be told it's tired and should get ready to sleep. That, in turn, leads to the agitation and confusion associated with sundowning. Sundowning is often aggravated by: ● Fatigue ● Hunger and thirst ● Pain ● Depression ● Boredom ● Low lighting and increased shadows ● Inability to separate dreams and reality ● Infection such as a urinary tract infection Dealing with Sundown Syndrome Keep an eye out for symptoms of sundowning which tend to show up in the late hours of the afternoon and the early evening. Sufferers may be confused or irritated. They might yell, pace, or wander. If you come across this behavior, reassure them they have nothing to worry about and everything is fine. Listen calmly to their frustrations and concerns. Here are some other tips you can try: ● Minimize the number of people around the sufferer. ● Reduce clutter and noise. ● Relieve the stress by distracting the person with a favored snack, object, or activity. Give them a drink. Try talking about something they enjoy, like their grandkids or a cherished memory. Suggest a simple chore like folding clothes. Turn on a familiar and calming television show or movie. Avoid the news as it can be upsetting. ● Prepare so that the period where sundowning starts is quiet. Have soothing music playing in the patient's room or use a wave machine. Take them for a walk. Have a friend or family member call. Help the sufferer focus on a book. ● Shadows can agitate sundowning. Close blinds and curtains. Turn on lights at dusk to minimize shadows. Avoid Sundowning The restlessness associated with sundowning gets worse when everyone's tired. You can use the following tips to avoid restlessness among patients. Use them to give everyone a chance to reduce stress and possibly get a good night's sleep. ● Make sure the patient gets outside or sits by a window. Getting exposed to bright light can assist in keeping the body clock on point. ● Make sure the sufferer gets exercise or physical activity at least once a day. ● Have the patient take a short nap early in the day. There are also a few things you can do to keep sundowning from getting worse. ● Do not let sufferers drink cola, coffee, or other caffeinated drinks late in the day. ● Do not serve any alcoholic beverages. The psychotropic effect can aggravate the anxiety and confusion associated with sundowning. ● While we advise some exercise, do not think keeping sufferers busy with activities will help. Full schedules can be too tiring and may leave patients with unwanted energy. Get Professional Help Sundowning can be difficult for everyone. Even when following all the above guidelines, problems could still occur. Should you see any signs of sundowning in a loved one, talk to their doctor. They will conduct an exam to identify potential causes. The doctor will determine if it's a sleep disorder, a pain-related condition, or even a medication side effect. If the doctor prescribes a medication to aid with relaxation and sleep, make sure you know about side effects. Medication can increase the chances of falls, dizziness, and confusion. Medications are typically only used for short periods. It may be necessary to contact professional help to provide care at home that can help guide you and your loved one through difficult scenarios. First Choice Senior Care is the premier home care provider in Central Arkansas. Please contact us to learn more or visit our website for more information.