Sundowner’s Syndrome: Some Helpful Tips on Diagnosing and Coping

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With a handful of exceptions (i.e., shift workers, college students and arguably rock stars), most of us would agree that we’re often sharper during the waking hours, rather than when evening comes to call. But imagine the unfortunate situation when towards the end of the afternoon, you realize your cognitive abilities and mood are diminishing proportionate to the setting sun.

There is a very real diagnosis that surrounds this fateful condition. Occurring in people who almost exclusively suffer from Alzheimer’s and other types of dementia, “Sundowner’s Syndrome” is clinically defined as “a cognitive ailment that causes symptoms of confusion after sundown occurs.”

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An authority in the field of Alzheimer’s and dementia, Nikki Jong says that from a symptomatic standpoint, Sundowner’s Syndrome can vary wildly by individual in regards to mannerisms and is also based on the stage of the disease process. Behaviors can range from standard agitation and confusion to paranoia and even hallucinations.

Theories surrounding the causes and origins of Sundowner’s Syndrome are as varied as its symptoms. Some experts suggest that darkness actually plays a role in the condition, while others hypothesize that “sundowning” is a natural reaction to the accumulation of sensory overload throughout the course of a full day. Other experts in the field point to simple fatigue. What is known about sundowning is, that like Alzheimer’s and dementia themselves, there is no cure. There are, however, many strategies for coping with the condition.

Some suggestions: Engage in activities at bedtime that encourage nighttime sleepiness, like reading or crossword puzzles; establish a familiar and consistent routine; limit caffeine and sugar to morning hours; engage in safe and appropriate exercise during the day; eat dinner early and snack lightly (if at all) before bedtime. Another recommendation is to keep a night light on to reduce agitation in a dark or an ostensibly unfamiliar environment.

As a caregiver for someone with Sundowner’s Syndrome, always listen carefully to try and understand a loved one’s particular anxiety or agitation: For instance, if loud noises seem to cause significant stress, help create a calm and quiet environment, especially at night.

Physicians and caregivers for seniors are familiar with Sundowner’s Syndrome, so be sure to consult a professional to determine the best road to diagnosing – and coping – with a loved one’s condition. It also helps to remember that those suffering from sundowning do so through no fault of their own, so maintaining a thoughtful and tolerant outlook when caring for them is always the best and kindest approach.

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