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Sundowning: What is it?

What is sundowning?

Sundowning, also known as Sundowner’s Syndrome, refers to a state of confusion, anxiety, and agitation commonly experienced by people with dementia, starting during late afternoon and spamming later into the night. This is during the later parts of the day, when the sun is setting, hence the name. 

Is it dangerous?

Sundowning isn’t necessarily a disease, but instead a group of symptoms that occur at a specific time of day. Fading light seems to be the trigger, getting worse as the sun continues to set, before getting better during sunrise the next morning. 

That isn’t to say that it isn’t dangerous, of course. Sundowning is serious, and can affect the quality of life of both the patient and their caretaker, and can even cause a change in personality of those affected, along with their memory and mood. 

What causes sundowning?

At the moment, it’s currently unknown what actually causes sundowning. Some scientists think that it has to do with how dementia affects a patient’s body clock. It appears to be more likely when a patient is:

  • Tired
  • Hungry or thirsty
  • Depressed
  • In pain
  • Bored
  • Having sleep problems
  • On medication

It can also be caused by a patient being moved to an unfamiliar place such as a hospital or new home, hormonal balances, or low lighting or presence of shadows. It’s also possible that it is when the patient has trouble differentiating dreams from reality, which causes confusion. 

What are some symptoms of sundowning?

Patients are most likely to experience sundowning between the hours of 4:30 PM to 11 PM. When someone is experiencing sundowning, they may be:

  • Agitated 
  • Restless
  • Irritable
  • Confused
  • Disoriented
  • Paranoid
  • Demanding
  • Suspicious

They may also yell, pace, see or hear things that aren’t there (hallucinations), have trouble speaking, and have mood swings. 

How to manage sundowning?

People who experience sundowning may be difficult to deal with. However, if you’re familiar with their symptoms and coping mechanisms, it may be easier to deal with. Here are some ways you can manage sundowning:

Keep a daily routine: Have a set time for going to bed and waking up, along with meal times. 

Limit or avoid things that affect sleep: Don’t let the patient drink alcohol or smoke, and limit or avoid caffeine and sugar.

Keep the sleeping environment comfortable: Patients can rest better if their environment is comfortable. This means making the temperature well-regulated, with the bed being just right. Provide night lights if necessary.

Consult with a doctor: Doctors and other medical professionals help pinpoint whether there’s an underlying condition that could be causing or aggravating symptoms, and can recommend solutions. 

Vision check: Poor vision often causes hallucinations due to the patient’s inability to make out shapes properly. Check their vision with a specialist. 

Play soothing music or sounds: Gentle music such as classical or familiar sounds such as nature or waves can help the patient to relax and feel at ease

How can you react?

If you’re a caregiver to a patient or loved one with sundowning, it may be difficult for you to deal with them. Here are some ways you can react properly.

  • Remain calm
  • Ask if they need anything
  • Remind them what time it is
  • Don’t argue with them
  • Put away anything potentially dangerous 

Also remember to take care of yourself as well so that you can be there for your patient.

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