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Sundowner’s syndrome, or ‘sundowning,’ is a condition that can co-occur with dementia. However, while those who suffer from sundowning have dementia, not all who have dementia suffer from sundowning. Sundowning causes agitation, confusion, and hyperactivity during the nighttime. Along with all the difficult changes that manifest with a dementia diagnosis, sundowner’s syndrome can provide an additional set of challenges for both the caregiver(s) and the patient.
Symptoms
Medical News Today was able to compose a list, based on older research, of sundowning symptoms. They tend to occur later in the afternoon, in the evening, and at night and can include:
- Confusion
- Reduced attention levels
- Agitation and restlessness
- Anxiety
- Pacing
- Shouting
- Sleep disturbance
- Paranoia
- Hallucinations
- Mood changes
Treatment
Since sundowner’s syndrome affects the patient in the late hours of the night, it can be more difficult to monitor accurately. If the patient is up while all others are asleep, chances of their injury and distress are increased— which can be incredibly worrisome for the caregiver. That is why treatment for sundowners is primarily focused on keeping the patient as calm as possible during the evening and night.
Home Treatment
For patients that are dealing with sundowner’s syndrome, the first course of action is to employ a few lifestyle changes. Regular light therapy is one type of non-invasive treatment that can be put into action. Light therapy is the use of artificial light to stimulate the body the same way natural sunlight does, stabilizing moods and the circadian rhythm. This form of therapy is especially effective for patients that are also suffering from depression. They start their day on a positive note and can carry that feeling into a calm night.
The second home treatment that may be considered is aromatherapy. Some specific scents have calming properties, including lavender, rose, ylang-ylang, and chamomile. On the other hand, scents such as orange, grapefruit, lemon, and mint provide energy and wakefulness earlier in the day. Cycling between energizing and relaxing scents over the course of the day can help the patient sleep and wake at more regular hours.
Medication
Most medications cause unwelcome side effects. Therefore, they may not be considered as the first option for treatment. However, if there is a case where lifestyle changes cannot help manage the patient’s symptoms, there are a few medications that can be used to help treat sundowners.
The first type of medicine that may be prescribed is an antipsychotic. Antipsychotics are meant to quell the agitation and behavioral symptoms that accompany the condition. They also have sedative effects which can stabilize the sleep pattern of the patient.
Furthermore, evidence surrounding the benefits of melatonin supplementation has not been conclusive, but it may improve general sleep patterns. It is an effective medication for patients struggling with sundowner’s syndrome because it helps them avoid the hyperactivity and restlessness that they may experience as a result of their condition.
Conclusion
The agitation, confusion, and restlessness of sundowner’s syndrome can be quite difficult on the family or caregiver of the patient. Implementing some lifestyle changes may help the patient feel more relaxed. If that should fail, there are a few different medications that can help manage the symptoms.
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