By: Shawn Jackson
The
nights are the hardest. I've heard this phrase from many people I've
known family members who have lost loved ones, friends recovering from
addictions. Somehow in nighttime, with its relative quiet and vivid
darkness, it's nearly impossible to hide from one's own mind.
For people
in the early stages of Sundowner's Syndrome, Alzheimer's, and forms of
dementia, nighttime can be so much more than a bit too dark and quiet.
In fact, sundown may be a trigger for extreme agitation and confusion
that lasts throughout the night, preventing sleep, exacerbating
Sundowner's symptoms (in this case) and rendering it impossible to be
alert the following day.
Symptoms
of sundowning, also known as Sundowner's Syndrome, occur in the late
afternoon or early evening and, according to the Sundowner's Facts
website, can include increased confusion, disorientation, agitation,
anger, depression, restlessness, paranoia and rapid mood changes. Some
resultant behaviors to look out for are rocking, crying, pacing, hiding
things, acting out violently and wandering. The individual may even
experience hallucinations. A person who is sundowning will likely spend a
great deal of time wandering, trying to come to terms with her
surroundings and mental state, and therefore is highly unlikely to be
able to sleep.
The
Sundowner's Facts website lists some possible causes of sundowning.
Decreased energy could be a trigger for Sundowner's symptoms. After of a
full day of activities and stimulation, feeling drained can make a
person anxious and aggravated by her inability to perform chores, such
as cooking dinner and tidying around the house—chores once done
effortlessly. Nightfall can be disorienting, not only because it gets
darker, but also because most people change their environment from day
to night. Some experts theorize that Sundowner's symptoms are related to
darkness; studies have shown that symptoms decrease within an hour of
daylight. While there is no known cure, there are a few measures that
can be taken to help alleviate Sundowner's symptoms.
Practical Advice for Dealing with Sundowner's Syndrome
The Alzheimer's Foundation of America suggests:
Allow for light exposure in the early morning to help set internal clock.
Discourage day-time napping to regulate sleep cycle.
Encourage exercise throughout the day to expend excess energy.
Limit caffeine intake, particularly in the evening to avoid potential Sundowner's symptoms.
Plan activities for the daytime so there is sufficient time to adjust to night.
Have a quiet nighttime activity ready and a private space for relaxing.
Consider purchasing a bedside commode. Leaving his or her bed to use
the restroom can start the cycle all over again, making it hard to get
back to sleep.
Schedule
regular medical appointments to ensure he or she is not in any physical
pain and to check for worsening Sundowner's symptoms.
Take precautions to provide a safe space for him or her at night so
that you can get a solid night's rest, even if he or she needs to stay
awake and wander.
Even
the coziest, quietest home can be suffocating and treacherous for
someone in a further confused, unfamiliar state. Whether or not you
fully understand psychiatric illnesses, there's no denying the look of
terror that accompanies dissociation, and no ignoring it when it comes
from someone you love.
Here's to preserving the midnight oil.
Read more about Improving the Quality of Life of an Elder with Dementia or about Validation Therapy and Redirection Techniques.
Find what you need to create an Alzheimer's friendly home.
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