Do you find that your loved one who is living with dementia often deteriorates towards the end of the day?
They may be experiencing â€˜sundowningâ€™ - a term coined to describe the effects of a person living with dementia as the sun sets and evening draws in.
Here at Wellbeing Care, weâ€™re exploring the possible causes and symptoms as we ask the question, â€˜what is Sundowners Syndrome?â€™
What is Sundowners Syndrome?
The term sundowning describes how a person living with dementia often becomes increasingly more irritable as the day progresses. They may begin to find conversations or tasks more difficult, and their behaviours may begin to regress as their mood deteriorates.
This can be particularly worrisome for family members, particularly if there have been signs of improvement or cognitive stability earlier in the day. The concept of Sundowner Syndrome relates to the idea that tiredness can creep in and affect the person living with dementia drastically.
Many people find that as they near their bedtime, they may not function quite so well. Their body and brain are entering a shutdown state ready for slumber, and so their cognitive abilities become less sharp. This is a perfectly normal response to our bodies preparing for rest and is caused by a reduction in dopamine levels and an increase in melatonin production, but it can have a heavier and more negative effect on someone who is living with dementia.
This is because their bodies donâ€™t produce as much melatonin, leading to disrupted sleep patterns and restlessness. Also, because their cognitive capabilities are already in decline and theyâ€™re already a bit hazy, the period where their brains then start to shut down for bed can be far more noticeable and, often, distressing. Theyâ€™re already in a state of confusion, and so tiredness can amplify this and cause them to perhaps become more forgetful and misbehave or lash out.
How to Reduce the Effects of Sundowners Syndrome
Whilst this is an unpleasant situation for the person living with dementia and their loved ones, there are some helpful tools to help reduce the effects, and limit the period they go on for. We do recommend that you also speak to your loved oneâ€™s healthcare provider for further advice and treatment options to help ease the sundowning effects.
Try to reduce or omit their caffeine intake. Caffeine is a brain stimulant and can affect the bodyâ€™s internal body clock. Switching to decaffeinated drinks or herbal teas can help to regulate their sleep patterns and help them feel calm before bed.
A consistent sleep routine is essential; try to keep a set time for bed and waking up, so theyâ€™re not out of sync each day. The same applies to napping, but this can be a difficult balance to strike. The person living with dementia should nap if they feel tired, as overtiredness can lead to irritability. However, over napping can then interrupt their sleep at bedtime, and so finding a napping schedule that works for them is key.
A comfortable room can help them to feel relaxed. Try to use neutral tones in the bedroom to prevent them from feeling stimulated at nighttime.
Try to keep their daily routine as consistent and simple as possible to help with familiarity and comfort. However, they should also be encouraged to increase their daily exercise and activity levels, as this can promote a need for sleep.
If your loved one is living with dementia and youâ€™re experiencing sundowning, please feel free to contact a member of our team. Weâ€™ve had extensive dementia training and would be happy to help you in any way we can. We can also help you explore our care service options.
Alternatively, you may find our previous blog on dementia communication helpful.