The Sundowning , also known as Sundown Syndrome is a feature of some cases of dementia and Alzheimer’s disease in which symptoms and behavioral changes occur simultaneously with the sunset. To learn what it is, why it happens and how to catch it early in elderly, whether or not these have been diagnosed with neurological or dementia disorders.
What it is and why it happens?
The sundowning is a fairly common phenomenon among patients with Alzheimer’s, dementia and other diseases of geriatric medicine, characterized by the presence of behavioral changes and cognitive in the last hours of the afternoon and into the evening. Patients may become irritable, aggressive, depressive, or also present problems of memory and cognition that, usually are generally absent in the daytime.
It is not a mere coincidence. Many studies indicate that Sundown Syndrome originates, in a bad function of the biological rhythm of sleep and wakefulness. This, in normal operation, dictates when it is time to rest and when to be alert (using our “biological clock”), which is why the best rest is in the evening hours, when the hormonal functions and regeneration occur optimally. When our mind loses control of this rhythm, the body begins to ignore the natural mode of behavior, and can cause confusion, irritability, and affecting both mood and cognitive and biological functions of our body.
Sundown Syndrome Symptoms
Even when the person has a perfectly normal behavior during the day, the phenomenon of sundowning (whose symptoms occurs after sunset) evidence:
- Changes in motor activity: Agitation, violence and other compulsive behaviors;
- Changes in mood: Irritability, depression, confusion, disorientation, anxiety, irrational fears (panic), anger, apathy or others;
- Changes in the expression: Isolated monologues, shouting, emotional discussions and more;
- Changes in behavior: Nocturnal activity similar to sleepwalking, wandering, insomnia and others;
- Changes in cognition: Memory problems, ignorance of relatives, disorientation in time and more.
How to help a patient with Sundowning?
If you notice these changes during the last hours of the day, it is best to consult a specialist in geriatric medicine if the person has not been previously diagnosed with cognitive or neurological disorders: it is always better to be prevented rather than underestimate these behaviors as simple fatigue by age. In already diagnosed patients, consult with the attending physician to evaluate changes in patient treatments and medications.
If the person lives alone, it is best to have the assistance of a family member or a health care professional for the hours of the night. First of all check patient safety: grilles and suitable closures in the doors and windows, locking systems and devices that use fire or electricity, and installation of communication systems that are easy to use, as intercoms or phones with large numbers and even with automatic dialing.
The specialists recommend regulating the hours of sleep, ensuring exposure to the sun in the morning, physical activities throughout the day, and promoting relaxation few hours before bedtime. It is necessary to maintain the well-lit home as possible during the day and reduce artificial lighting at night, to help the biological rhythm in performance. If possible, insulate the house noise and reduces sources of loud sounds in the rest hours.
Avoid drinks and stimulating foods (caffeine, sugar and other) from the first half of the afternoon, and verifies that food is as healthy as possible, with enough fruits, vegetables and others that are easy to consume by patients. Remove the drinks and meals with stimulants from the refrigerator, so that these are not available, including alcohol.