Last Updated: December 3, 2013
At least 40 million Americans each year suffer from chronic,
long-term sleep disorders, and an additional 20 million experience
occasional sleeping problems. Sleeping problems occur in almost all
people with mental disorders, including those with depression and
Alzheimer's. Sleep affects our daily functioning and our physical
and mental health in many ways that we are just beginning to
understand. Many people who care for those with Sundowners believe
that difficulty sleeping is central to the problem.
The term Sundowners describes a pattern of increased behavior
problems with onset usually in the late afternoon and early
evening. It can be most frequent in those people that have
Alzheimer's or perhaps dementia. This syndrome is also sometimes
seen in older people who are in recovery from surgery in a hospital
setting. Persons may exhibit increased confusion, agitation,
wandering, hallucinations and general disorientation. For those
living with or caring for someone exhibiting "sundowning" symptoms
it can be quite startling and often intensely frustrating.
Although the following care tips may sound extreme, it has been
shared that once a routine is set, life becomes a lot easier when
caring for someone with Sundowners. Not all of these ideas will
work for everyone; through experimentation you may find the right
formula for your situation.
Care Tips for Sundowners Syndrome
- Allow for light exposure in the early morning to help set an
- Daytime napping should be discouraged to help regulate the
- Encourage exercise throughout the day to expend excess
- Limit caffeine intake, particularly in the afternoon.
- Plan activities during the day so there is sufficient time to
transition into the evening.
- Create a private space for relaxing.
- When you sense agitation coming on, try a five-minute hand
massage or just hand holding for a few minutes. It is good to get
in front of this and not wait until it progresses.
- Music or other sounds like ocean waves or singing birds can be
- Interaction with a pet has also been known to calm
- 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.
- 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 your loved
one needs to stay awake and wander.
- Maintain a comfortable temperature in the bedroom; extreme
temperatures may disrupt sleep or prevent one from falling
- Talk to your doctor about the many medications on the market
that support those with Sundowners.
Intense and visceral frustration for family members and
caregivers is not uncommon when dealing with loved ones
experiencing episodes of Sundowners. Outbursts and strange demands
are not unusual and not always under their control, requiring
extreme patience on the part of family members and caregivers in
order to make it through these episodes. Like pets and kids, you
will need to experiment in order to discern the right pattern and
methods for your family. Following these tips above may make your
life easier by bringing rhythm to your loved one's life, thus
positively impacting your life.