All About Sundown Syndrome – Symptoms, Causes & Treatments

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Caregivers and family members of people living with dementia may notice that their loved one acts differently later in the day. When the sun goes down and someone you love experiences intense mood swings, disorientation, and unusual aggression, it may be a sign of sundown syndrome.

If you or another family caregiver believes that your loved one could be experiencing this phenomenon, know that you have plenty of options available to your family to manage this condition, so you can choose the solution that works best for your loved one's unique needs.. that the following may contribute to sundowning behaviors: about how our dedicated team tailors care for each resident.

What is Sundowning?

Sundown syndrome refers to a group of symptoms that older adults present in the late afternoon or early evening. Other common names for this condition include late-day confusion, sundowner's syndrome, and sundowning.

What are the Symptoms of Sundown Syndrome?

Common signs of this condition include new or worsening:Agitation and anxiety

  • Disorientation
  • Sleep disturbances
  • Behavioral changes
  • Memory loss
  • Unusual aggression
  • Wandering and pacing

Who Develops Sundowning?

People living with some form of severe memory loss, including various types of dementia, are more likely to show sundowning behaviors. Individuals living with Alzheimer's are especially prone to sundowning, most often displaying symptoms of late-day confusion in the middle stages to late stages of Alzheimer's disease, according to the Alzheimer's Association

What Causes Late-Day Confusion?

Unfortunately, medical experts are still not 100% sure why some older adults develop this condition. That said, many experts believe

  • Memory loss - One of the most common sundowner's risk factors is having a memory loss-related condition like dementia.
  • Disruptions to daily routines - Routine is the friend of people living with conditions like dementia. Disruptions to daily routines, especially later in the day, may cause agitation, disorientation, and aggression.
  • Age - This condition almost exclusively affects older adults.
  • Low-light environments - As natural light wanes throughout the day, older adults may have difficulties navigating their home. Not being able to see well could cause confusion and anxiety-related symptoms.
  • Drug side effects - Side effects from medications, medications wearing off, or interactions with other medications may cause sundowning symptoms to present at the particular time of day it does.
  • Circadian rhythm disorders/sleep disturbances - The circadian rhythm guides our internal body clock, or sleep-wake cycle. Disruptions to the circadian rhythm can cause a whole host of issues, including sleep problems. Difficulties sleeping can, in turn, cause or worsen agitation, frustration, confusion, and other symptoms attributed to sundown syndrome.
  • Other unmet needs - Feeling frustrated in other aspects of life may worsen sundowning behaviors like agitation, which is why it's important to check in with your loved one to discover any potential unmet needs, such as hunger.

How is Sundowning Treated?

If you believe that your loved one is displaying worrying signs of sundowner's syndrome, you can talk to their healthcare team to develop a strategy that works for your family's unique situation.

How Does My Loved One Get a Sundowner's Diagnosis?

While sundown syndrome is common enough among older adults experiencing some form of memory loss, this condition is not a medically recognized illness. In other words, your loved one's doctors cannot officially diagnose sundown syndrome the same way they could diagnose Parkinson's disease or Lewy body dementia.

While doctors may not be able to give an official sundowning diagnosis, medical practitioners and senior caregivers can work with you to develop an effective strategy for helping your loved one manage sundowning symptoms and triggers.

What are My Family's Sundowning Treatment Options?

There is no cookie-cutter solution to sundown syndrome because its causes will vary by person. The best way to manage this condition? To talk with your loved one and their healthcare team to determine potential causes for their sundowning behavior. Once you identify potential triggers, you can start working on a management strategy.

Your loved one's treatment could include the following:

  • Aromatherapy - Aromatherapy is the practice of using essential oils for health benefits. While more research is needed to confirm the effectiveness of aromatherapy, many family caregivers report that they notice an improvement in their relative's mood when using this method.
  • Light therapy - Bright light therapy is a type of therapy that simply involves exposure to bright lights. The idea is to use light to help treat certain conditions like circadian rhythm disorders, as light therapy could help reset the body's internal clock. This reset may help improve sleep quality, which in turn may improve mood and reduce other negative side effects of sundown syndrome.
  • Improve lighting - Having a night light or improving the lighting in your loved one's space can help them see better at night, which may reduce confusion and restlessness.
  • Medication management - Many older adults take medications that can contribute to sundowning. That means that reigning in the side effects of current prescriptions could improve sundowning behaviors. For example, maybe your mother's unusual late-day behaviors are due to her morning medications wearing off. The solution could be for her to take her medications at a different time of day.
  • Taking new medications - Some doctors prescribe certain medications , like antipsychotics and AChE inhibitors, to manage symptoms that many people experiencing sundowner's display, such as hallucinations.
  • Address sleep problems - There is no understating the importance of a good night's rest. Improving not just the quantity, but quality, of your loved one's sleep could be one of the single-most effective ways to manage sundowning symptoms. Fixing sleep issues could involve taking melatonin at night, eliminating late-day naps, or not drinking caffeine past noon.
  • Attend support groups - Attending support groups for someone with a progressive condition like dementia can be incredibly therapeutic. Your loved one may find that talking to others experiencing similar situations may help lessen their anxieties and frustrations.

Managing Sundown Syndrome at Monarch Communities®

Every individual has a story, and we believe in hearing those stories. That's why we work with families and residents to identify potential triggers and manage symptoms of sundown syndrome and other conditions. By working together, we believe that we can make each day more enjoyable and worth celebrating.

Contact us to learn more