Posted on 09/28/2021 7:54:44 AM PDT by Red Badger
Sundowner’s syndrome can affect a person with dementia. The person may experience increasing episodes of confusion, agitation, and activity as night approaches.
The agitation and personality changes that occur with sundowner’s syndrome can cause anxiety and pose other challenges for the individual and their caregiver. Sundowner’s syndrome has links to dementia, which is a condition that affects memory, personality, and the ability to reason. It is also known as sundown syndrome or sundowning.
Some lifestyle strategies and medications can help manage the symptoms and enhance the person’s ability to sleep. Treatment aims to ensure the person does not experience fear or accidentally injure themselves.
In this article, find out what sundowning involves and get some tips on managing it.
Symptoms
Older research from 2011 suggests symptoms of sundowner’s syndrome typically occurTrusted Source late in the afternoon, in the evening, and at night.
They include changes in behavior and thinking, such as:
confusion, including about where they are and who other people are reduced attention levels agitation and restlessness anxiety pacing and wandering disorientation shouting sleep disturbances paranoia and suspiciousness auditory and visual hallucinations mood changes being unusually demanding Sundowner’s syndrome will usually occur alongside some form of dementia, such as Alzheimer’s disease. But not everyone with Alzheimer’s disease or dementia will have sundowner’s syndrome.
Some 2011 researchTrusted Source suggests sundowner’s syndrome may speed up the mental decline of a person with Alzheimer’s disease.
Is it sundowner’s or delirium? It can sometimes be difficult to distinguish between sundowner’s syndrome and delirium that results from another condition.
Possible causes of delirium include:
a urinary tract infection (UTI) a stroke low blood sugar some drugs a head injury carbon monoxide poisoning lung or heart problems The symptoms can be similar to those of sundowner’s syndrome, but delirium usually starts suddenly, is temporary, and does not occur at specific hours. Sundowner’s syndrome is ongoing and becomes more pronounced in the afternoon and evening.
Some expertsTrusted Source argue that people who develop sundowner’s syndrome may already have some degree of delirium.
When to see a doctor Regardless of the cause, if a person starts to show new signs of confusion or agitation, someone should seek medical advice. They may have a condition that needs urgent medical attention. If they are experiencing sundowner’s syndrome, a doctor and other professionals can provide medication and support.
To discover more evidence-based information and resources for healthy aging, visit our dedicated hub.
Causes Various factors may contribute to sundowning and sleep problems, according to the United States’ Alzheimer’s Association and the United Kingdom’s Alzheimer’s Society.
They include:
mental and physical exhaustion due to the pressures of trying to navigate an environment that feels unfamiliar and confusing changes in melatonin levelsTrusted Source affecting the internal body clock and the boundaries between day and night reduced lighting affecting how a person sees things too much or too little light other people’s verbal or nonverbal communication, which may be hard to interpret a reduced need for sleep, which is common as people get older sleep disturbances, such as too little sleep or disturbed sleep difficulty distinguishing dreams from reality when sleeping a loss of routine reduced sight and hearing background noise prescription medication wearing off toward the end of the day One small study of 36 people found that 53%Trusted Source experienced irritability, 47.4% had unusual nighttime behavior, and 42.1% showed aggressiveness.
Participants in the study also showed:
hallucinations (40%) unusual movements (37%) apathy (37%) a loss of inhibition (26.3%) anxiety (24%) delusions (18%) euphoria (16%) changes in eating patterns (16%) Risk factors Factors that may increase the risk of having sundowner’s syndrome include:
having dementia, for example, Alzheimer’s disease older age, as the risk of dementia increases and melatonin levels tend to fall with age having specific genetic features, notably the APOEɛ4 allele having rapid eye movement sleep behavior disorder (RBD) and A 2019 study of 104 people with Alzheimer’s found that almost 28%Trusted Source had sundowner’s syndrome, and it was more common among those with the APOEɛ4 allele and RBD.
Lifestyle tips Sundowner’s syndrome can be challenging for both the individual and their caregivers, but some strategies can help manage the situation.
Here are some suggestionsTrusted Source that may help:
Help the person do something they find relaxing and enjoyable at this time of day. Take an evening walk to reduce restlessness. Schedule less enjoyable activities earlier in the day when the person finds it easier to cope with them. Consider whether hunger, fatigue, pain, or other factors may be contributing to symptoms. Encourage a regular routine of eating, sleeping, and other daily tasks. Consider discouraging daytime naps, unless they appear to help. Ensure the lighting is not too bright or too dark. Try to minimize noise and other environmental triggers that could increase agitation and confusion. Keep a note of behavior changes and possible triggers. Avoid restraining the person, as this can increase agitation. Allow the person to pace if they need to. Consider limiting the person’s use of alcohol, caffeine, and tobacco. Avoid arguing, but speak calmly and reassure the person that everything is OK. Gently remind the person of the time, if necessary. Monitor screen viewing, as violent or aggressive scenes may be disturbing. Create a relaxing environment by playing music they enjoy, sitting quietly, and possibly holding hands. Discuss any concerns with a doctor and ask for advice on medications. Caregivers may benefit from the support of a local or online community.
Get some more tips on how to care for someone with Alzheimer’s disease here.
Links at Site............
Natural remedies Some non-drug remedies that may help are:
light therapy that involves controlled exposure to daylight or artificial light music therapy, such asTrusted Source listening to music, playing instruments, and dancing aromatherapy, or exposure to fragrant oils, such as lemon balm, lavender, and cedar multisensory stimulation, in which the person engages in activities such as painting and music therapy simulated presence therapy, which involves playing a video or recording of a loved one to help calm the person In most cases, more research is needed to confirm that these can help.
Medications If lifestyle measures do not help, a doctor may suggest medications. It is worth noting that these are not guaranteed to help manage sundowner’s syndrome, and some may have adverse effects.
Options includeTrusted Source:
cholinesterase inhibitors, such as donepezil (Aricept), which aim to reduceTrusted Source cognitive decline in people with Alzheimer’s disease NMDA receptor agonists, such as memantine hydrochloride (Namenda), which aim to slow the brain damage responsible for Alzheimer’s symptoms melatonin supplements or light therapy to help balance the sleep-wake cycle antipsychotic medications to manage delusions and hallucinations A caregiver should work with a doctor to decide on a suitable treatment plan. If symptoms change or worsen, it may be necessary to adjust the plan or discontinue a medication. A person should not use any medication or supplement without first checking with a doctor.
Get some tips on caring for someone with dementia during the COVID-19 pandemic here.
Takeaway Sundowner’s syndrome can affect people with dementia, such as Alzheimer’s disease. It can lead to mood and behavior changes in the late afternoon and evening. The person may become anxious, restless, and possibly aggressive, and they may have difficulty sleeping.
Environmental and lifestyle tips are the first choice for managing sundowner’s syndrome, but a doctor may suggest medication. People with dementia should not use any medication or supplement unless their doctor advises them to do so.
What are the early signs of dementia?
Dementia is a term that describes a variety of symptoms affecting a person’s cognitive functioning, including their ability to think, remember, and reason. It tends to get worse over time, so there are a few key early warning signs.
Dementia occurs when nerve cells in a person’s brain stop working. Although it typically happens in older people, it is not an inevitable part of aging. The brain’s natural deterioration happens to everyone as they grow older, but it occurs more quickly in people with dementia.
There are many different types of dementia. According to the National Institute on Aging, the most common is Alzheimer’s disease. Other types include:
Lewy body dementia frontotemporal dementia vascular disorders mixed dementia, or a combination of types There are 10 typical early signs of dementia. For a person to receive a diagnosis, they would usually experience two or more of these symptoms, and the symptoms would be severe enough to interfere with their daily life.
These early signs of dementia are:
1. Memory loss A person developing dementia may have trouble remembering dates or events. Memory loss is a common symptom of dementia.
A person with dementia may find it difficult to recall information they have recently learned, such as dates or events, or new information.
They may find they rely on friends and family or other memory aids for keeping track of things.
Most people occasionally forget things more frequently as they age. They can usually can recall them later if their memory loss is age-related and not due to dementia.
2. Difficulty planning or solving problems A person with dementia may find it difficult to follow a plan, such as a recipe when cooking, or directions when driving.
Problem-solving may also get more challenging, such as when adding up numbers to paying bills.
3. Difficulty doing familiar tasks A person with dementia may find it difficult to complete tasks they regularly do, such as changing settings on a television, operating a computer, making a cup of tea, or getting to a familiar location. This difficulty with familiar tasks could happen at home or work.
4. Being confused about time or place Dementia can make it hard to judge the passing of time. People may also forget where they are at any time.
They may find it hard to understand events in the future or the past and may struggle with dates.
5. Challenges understanding visual information Visual information can be challenging for a person with dementia. It can be hard to read, to judge distances, or work out the differences between colors.
Someone who usually drives or cycles may start to find these activities challenging.
6. Problems speaking or writing Handwriting may become less legible as dementia progresses. A person with dementia may find it hard to engage in conversations.
They may forget what they are saying or what somebody else has said. It can be difficult to enter a conversation.
People may also find their spelling, punctuation, and grammar get worse.
Some people’s handwriting becomes more difficult to read.
7. Misplacing things A person with dementia may not be able to remember where they leave everyday objects, such as a remote control, important documents, cash, or their keys.
Misplacing possessions can be frustrating and may mean they accuse other people of stealing.
8. Poor judgment or decision-making It can be hard for someone with dementia to understand what is fair and reasonable. This may mean they pay too much for things, or become easily sure about buying things they do not need.
Some people with dementia also pay less attention to keeping themselves clean and presentable.
9. Withdrawal from socializing A person with dementia may become uninterested in socializing with other people, whether in their home life or at work.
They may become withdrawn and not talk to others, or not pay attention when others are speaking to them. They may stop doing hobbies or sports that involve other people.
10. Changes in personality or mood A person with dementia may experience mood swings or personality changes. For example, they may become irritable, depressed, fearful, or anxious.
They may also become more disinhibited or act inappropriately.
When to see a doctor A person who experiences any of these symptoms or notices them in a loved one should speak to a medical professional.
According to the Alzheimer’s Association, it is a myth that cognitive functioning always gets worse as a person gets older. Signs of cognitive decline may be dementia or another illness for which doctors can provide support.
Although there is no cure for dementia yet, a doctor can help slow the progression of the disease and ease the symptoms, and so improve a person’s quality of life.
Great post. Deal with it every afternoon/evening.
Sundown syndrome....aka Biden after dark.
A common symptom of dementia is when the old person starts screaming the same words over and over and over again....
Example:
“Mandatory.
Mandatory.
Mandatory.”
Lol!
So that’s what that is.
Raise taxes on the rich!
Raise taxes on the rich!
Raise taxes on the rich!
Raise taxes on the rich!........................
And you just thought it was a song by Gordon Lightfoot...............
I sure hope the crazies behind him can keep him stable for another three+ years.
My grandmother went through dementia and sundowners syndrome kicked in a few weeks before the end. It is a death I would not wish on my worst enemy.
Red Badger, absolute class. Very informative. Be blessed! Founded
Sundowner’s and possibly delirium often seem to get worse:
When we stop daylight savings time and it gets dark earlier and quicker.
So, we are approaching the worse time of the year for these poor people and their family.
My brother was afflicted with this during his final days. It was both heart-breaking and frustrating.
Other folks refer to this as “getting tired”.
My dog experienced sundowners as he descended into dementia
I have about five of those signs, especially #9.
I stopped socializing with people who are self-righteous virtue signaling jerks.
Once you are retired it is really easy to do that—and it feels so good!
Or tools when doing a DIY fix up on the house, spoons when cooking, ... Wait a minute - that's ME! ;-P
Pay your fair share
Your fair share
Your fair share
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