Dealing with dementia or Alzheimer’s disease is incredibly difficult: you might be both going through many changes as the disease progresses, and also feeling afraid of losing your memory. The behavioral changes that come with these conditions might be accompanied by feeling sad, irritated, scared, delusional, or even hallucinations, feelings that get worse at night. These are actually quite common symptoms of sundowner’s syndrome, which can be a distressing part of dementia and Alzheimer’s disease, and while you cannot reverse dementia or Alzheimer’s, there are some lifestyle changes and medications that can help alleviate the symptoms of sundowner’s syndrome.
What Is Sundowning or Sundowner’s Syndrome?
Sundowner’s syndrome is not a disease, rather it is a group of symptoms exhibited by people diagnosed with dementia and Alzheimer’s. This syndrome is so named because the symptoms occur as the sun sets, and get worse at night. Sundowner’s syndrome usually begins later in the afternoon, and can last into the night, and so is also called late-day confusion.
Doctors and researchers are not sure what causes sundowner’s syndrome, but they believe there are various factors that contribute to it. Mainly, they believe that the syndrome occurs because of all the sensory stimulation built up over the course of the day, which can become very overwhelming, causing patients to become irritated, confused, and act out. Other factors might include:
- Hormonal imbalances that occur at night, affecting your natural circadian rhythm
- Anxiety caused by the inability to see well in the dark
- Changes in melatonin levels affecting your internal body clock
- Reduced lighting affecting you see shadows and objects around you
- Too much or too little light
- Sleep problems, such as too little sleep or disturbed sleep
- Difficulty distinguishing dreams from reality when sleeping
- A loss of routine
- Reduced sight and hearing
- Prescription medication wearing off toward the end of the day
Sundowner’s Syndrome Symptoms
If you have an episode of sundowner’s syndrome, you will exhibit certain behaviors and express certain emotions, including:
- Anger
- Agitation
- Anxiety
- Confusion
- Emotional outbursts
- Delusions and hallucinations
- Reduced attention levels
- Fear
- Depression
- Stubbornness and being demanding
- Restlessness
- Rocking
- Visual and auditory hallucinations
- Pacing and wandering
- Paranoia and suspiciousness
- Violence
- Mood changes
- Crying
- Insomnia
- Yelling or screaming
- Shadowing
Managing Sundowner’s Syndrome
Experiencing the aforementioned symptoms and changes can be difficult for both the person going through it and their caregivers. But there are some things that can be done to help manage the syndrome, including making lifestyle changes like:
- Developing a daily routine– Routines are important for older patients, not only to help keep you on track throughout the day, but also to help alleviate the anxiety that can occur as the sun begins to set.
- Taking walks– Going for an evening walk can help reduce restlessness.
- Changing your diet– Sweets and caffeine during the middle of the day or evening can interrupt sleep. Snack light and try to limit sugar, caffeine, and heavy meals to earlier in the day.
- Avoiding daytime naps– Unless they seem to help, try to avoid midday naps, which can cause sleep issues at night.
- Increasing light– To prevent shadows that can cause anxiety, fear, or delusions, try to keep rooms well-lit.
Medications & Natural Remedies To Consider
There are a number of medications that can help manage sundowner’s syndrome, although they are not guaranteed to work. You can try:
- Cholinesterase inhibitors, such as donepezil, which reduce cognitive decline in people with Alzheimer’s disease
- NMDA receptor agonists, such as memantine hydrochloride, which aim to slow the brain damage responsible for Alzheimer’s symptoms
- Melatonin supplements or light therapy to help balance your sleep-wake cycle
- Antipsychotic medications to manage delusions and hallucinations
If you are seeking more natural remedies, consider:
- Light therapy- Talk to your doctor about a high-quality lightbox that might help you
- Music therapy– Listening to music, playing instruments, and dancing can be soothing
- Aromatherapy- Scents like lemon balm, lavender, and cedar can help relax and calm you
- Multisensory stimulation- This includes painting and other forms of art therapy
- Simulated presence therapy– Playing a video or recording of a loved one can help bring comfort and calmness
If you are experiencing any of the above symptoms and it is becoming too much, reach out and ask for help. Contact your doctor and see if there is anything you can do to lessen the severity of the symptoms, and help calm you down towards the evening; you can also seek out some natural remedies to help manage the symptoms. And if you do decide to see the doctor or opt for medications, it is important to make sure Medicare will cover the costs, since worrying about medical bills, or not seeking help because of the cost of treatment, will not help you get better.
If you are interested in reviewing Medicare options in your area to see if you can find better coverage and save more money, we can help you. EZ can compare all available plans in your area for free- no hassle and no obligation. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.
