MYG Podcast 082716 Mary Yamin-Garone, DeMystifying Alzheimer’s: SunDowning
Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “Sundowning.”
If your loved one has Alzheimer’s, you may have noticed changes in how they act in the late afternoon or early evening. Doctors call this change in behavior sundowning or sundown syndrome.
Sundowning isn’t a disease. It’s a group of symptoms that occur at a specific time of day that may affect those with Alzheimer’s.
Doctors aren’t sure what causes sundowning. Some scientists believe changes in the brain of an Alzheimer’s sufferer might affect their inner “body clock.” The area of the brain that signals when you’re awake or asleep breaks down, which could be the cause.
Some studies indicate as many as 20 percent of those with Alzheimer’s will experience increased confusion, anxiety and agitation that starts late in the day. Others may experience changes in their sleep schedule and restlessness during the night. This disruption in the body’s sleep-wake cycle can lead to more behavioral problems.
Factors that may contribute to sundowning and sleep disturbances include:
- Feeling physically and emotionally exhausted at the end of the day
- An upset in the “internal body clock” that causes confusion between day and night
- Reduced lighting and increased shadows that cause Alzheimer’s sufferers to misinterpret what they see
- Reactions to visual signs of frustration from their caregiver, who is exhausted from their day
- Being disoriented because they can’t separate dreams from reality when they’re sleeping
- Less need for sleep, which is common among older adults
- Being hungry, thirsty, depressed, in pain or bored
- Yelling, pacing, hearing or seeing things that aren’t there and having mood swings
While you might not be able to stop sundowning completely, you can take steps to help manage this challenging time of day so you and your loved one will sleep better and be less tired during the day.
- Establish a routine, such as regular times for waking up, meals and going to sleep. Try to schedule their appointments, outings, visits and bath time earlier in the day, when they’re likely to feel their best.
- Don’t let your loved one smoke or drink alcohol.
- Limit sweets and caffeine to the morning.
- Serve a big lunch and keep their evening meal small and simple.
- Keep things quiet in the evening.
- Keep your loved one from napping or exercising later than four hours before bedtime. If necessary, let them take a short nap early in the day.
- Close curtains and blinds and turn on lights. Darkness and shadows can make them more upset.
- Play relaxing music, read, play cards or go for a walk to unwind.
As a caregiver, you should:
- Approach them in a calm manner.
- Ask your loved one if they need anything.
- Remind them what time it is.
- Don’t argue.
- Tell them everything is OK.
- Let them get up and move around or pace. Stay close by to keep an eye on them.
- Make a comfortable and safe sleep environment. Your loved one’s sleeping area should be set at a comfortable temperature. Provide nightlights and door and window locks to enhance their safety.
- Keep the home well-lit at night. Sufficient lighting may lessen the agitation that occurs when surroundings are dark or unfamiliar.
- Consider getting a baby monitor, motion detectors or door sensors to let you know if your loved one is wandering.
- If your loved one is in a strange or unfamiliar setting, bring familiar items—like photographs—to create a more relaxed, recognizable atmosphere.
- Play soothing music or relaxing sounds of nature, like the sound of waves, at night.
- Talk with your loved one’s doctor if you suspect an underlying condition, like a urinary tract infection or sleep apnea, might be exacerbating sundowning behavior.
- Try to identify triggers.
- Limit distractions, particularly during the evening hours, such as TV, having visitors, doing chores or playing loud music.
- Know when you’re mentally and physically exhausted. If you’re feeling stressed by the late afternoon, your loved one may pick up on it and become upset or confused. Try to get plenty of rest at night so you have more energy during the day.
If these tips don’t work, consult with your doctor. He can make sure your loved one’s medications to help them relax and sleep don’t cause more confusion the next day.
Sundowning can make it difficult for you to get restful sleep. As a caregiver, you need to take care of yourself so you can take care of your loved one.
- Ask a friend or relative to fill in for you at night
- If possible, take a nap during the day
- Take breaks whenever you can
- Hire a home health care service for relief
- Exercise and eat healthy
- Spend time with friends
- Find time for your own interests
- Share your experience with others. Join ALZConnected, an online support community and message boards, and share which of your response strategies are effective and get more ideas from other caregivers.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me next time for more Demystifying Alzheimer’s.