After a busy day providing care for someone you love with dementia, a good night’s sleep is essential to recharge and prepare for the next day. This is easier said than done in many cases, however. Sundowning and changes to sleeping patterns are common in Alzheimer’s, and often the overnight hours are the most wakeful – and can be fraught with challenging emotions and behaviors, too.
What Is Sundowning?
Simply put, sundowning is a state of enhanced agitation, confusion, and anxiety that sets in as the sun goes down and can last throughout the night. Sundowning is one of the most difficult challenges for family caregivers, who are exhausted at the end of the day. Rather than being able to relax and unwind, there’s an increased and immediate need for patience, creativity, and calming techniques.
Even if sundowning isn’t a factor, the circadian clock in those with dementia is often upset, causing the person to feel wide awake overnight and wanting to sleep throughout the day.
Although the cause for sundowning and other sleep changes isn’t fully understood, there are some contributing factors that can make the situation worse:
- Problems distinguishing dreams from reality, which enhances disorientation
- Shadows that can distort the senior’s visual perception and cause fear and agitation
- Physical and/or mental exhaustion
- A family caregiver’s own stress and agitation, which can exacerbate the senior’s own feelings and reactions
How to Prevent Sleep Difficulties
It’s often more effective to take proactive measures to try to prevent sleep challenges from occurring than to manage them in the middle of the night. Try:
- Helping the senior stay active throughout the day
- Limiting naps, especially later in the day
- Sticking as closely as possible to a predictable routine of meals, activities, and bedtime
- Spending time outside with the senior for fresh air and sunshine when weather permits
- Preparing a larger meal at lunchtime and a lighter meal for dinner, avoiding caffeine and alcohol
- Minimizing distractions and stimulation during the early evening, such as by turning off the TV and providing quiet, calming activities
- Closing the curtains before sunset and keeping the home brightly lit
It’s also a good idea to talk to the senior’s doctor for recommendations.
What to Do When Sundowning Occurs
In the midst of sundowning, it’s very important to remain calm yourself. Use a quiet, soothing voice and try to see if there’s an underlying issue that you can help resolve, such as hunger, thirst, or the need to use the bathroom. If all of the senior’s physical needs are met, reassure him or her that everything is ok, and that it’s time for bed – but never argue with the person or use physical restraints. Pacing is common in sundowning, and perfectly acceptable within a safe area.
At Nightingale Homecare, an Alzheimers care company in Phoenix and the surrounding areas, we’re always on hand to “take the night shift” and help a senior with sundowning issues to stay engaged and safe throughout the night, so you can get the rest you need. Contact us to learn more about our Connections dementia care program and to schedule a free in-home consultation to see how we can help with the particular challenges your loved one is facing.