Research shows that some people with dementia experience restlessness, agitation, disorientation and other troubling behaviors towards the end of the day. While others may experience a disruption in their body’s sleep-wake cycle. They may become restless and sleepless during the night. Experts call this syndrome sundowning.
Sundowning is a symptom of dementia, usually occurring from the middle to the advanced stages of the disease. It is associated with the changes in the person’s internal biological clock. Other factors that are believed to contribute sundowning include:
A person with dementia is unable to separate dreams from reality. Non-verbal cues from the people around him. The person may be affected by the nonverbal cues of frustration from his care provider, who may be exhausted from work. Reduced lighting and increased shadows. He may misinterpret what he sees, making him afraid and confused.
As his caregiver or a family member dealing with a dementia sufferer, you can help reduce sundowning. First and foremost, try to identify what triggers the person’s confusion and agitation. For example, environmental distractions, like noise, TV, loud music, or children playing around him may upset him. To help you identify the triggers, keep a record of his daily activities, behavior, and the environment. Check the patterns of activities and environments that seem to worsen his symptoms. And then, apply these simple tips to make him calm down.
Help the person relax. If commotion around the house makes him upset, try taking him to a quieter area. If the cause of his agitation is hunger, serve his food earlier than usual, or give him a little snack or something to drink. If he makes unrealistic demands or keeps arguing with you, let him know that you are listening to him. Speak in a calm and reassuring voice.
Sometimes, too, a gentle hand massage, a stroke on his arm or a hug might be what he needs.
As much as possible, minimize the person’s stress in the evening hours. Let him engage in simple activities that are not frightening or challenging. You may play soft music to make him relax, or allow him to snuggle with his pet animal.
Create a comfortable and familiar environment.
For a dementia patient, the world is a scary place. So, it is important that you create for him a comfortable and familiar surrounding to help him cope with the difficult situation.
Whether the person stays at home, move into a hospital, or transferred to an assisted living facility, furnish his surrounding with some of his cherished items. A family photo by his bedside table or his favorite coat may ease the transition and control his sundowning syndrome. Make sure, also, that his sleeping area has a comfortable temperature.
Maintain a routine.
Dementia makes it hard for the person to remember new schedules. He might get confused when you introduce new things and places. It’s rather advisable that you adhere to the same schedule every day. Set a regular time for his waking up, going to bed, and his meals. This will make him calmer, and have a restful sleep at night.
Organize more daytime activities. Help the person stay active during the day to promote a good night’s sleep. Discourage afternoon naps. Allowing him to rest most of the day would only make him awake at night. You may go for a walk together in the park, a car ride, make him dance to his favorite music, or schedule a visit to the doctor. Encourage him to exercise daily.
Adjust his dinner portions and avoid stimulants. Refrain from giving your loved one large dinners. This will only worsen his agitation and make him awake at night. Instead, give him a light meal or healthy snack.
You may give him large meals only during lunch. Also, do not serve him alcohol and nicotine. Restrict his sugar, caffeine, and other stimulants consumption to the morning hours.
Keep the person’s room well-lit.
Persons with sundown syndrome need adequate lighting to minimize agitation. So, as a care provider of someone with the condition, you may put a full-spectrum fluorescent lamp about a meter away from him for a couple of hours every morning. Turn this lamp on while the person is doing some of his daily activity. This can help in getting his biological clock back on track.
Take good care of yourself, too. The sundowning syndrome can be exhausting for both the person with dementia and you. As his care provider, you must also take good care of yourself. Eat a well-balanced diet and make sure you get enough sleep at night. Take a good daily exercise, too. There is no better position to care for a loved one than a healthy and well-rested body.
You may also ask other family members to take turns with you in attending to your loved one. So, you can take regular breaks. Or, you may consult your doctor about respite care or other similar professional support services.
Seek the doctor’s advice. You may discuss with the person’s physician about his sleep disturbances. He may be suffering from another ailment.
Research shows that 1 out of 5 persons with dementia is susceptible to sundowning. But, this syndrome can also happen to older individuals who do not have the disease.