Caregiver Tips: Reducing the Effects of Sundowning

People living with Alzheimer’s or other dementia sometimes have problems sleeping, or behavioral issues that start at dusk and sometimes last through the night. This is known as sundowning, and there are steps you can take to minimize its effects. The changes in their sleep schedule can lead to more behavioral issues, so it’s important to minimize the difficulties as much as possible. Oftentimes sundowning peaks during the middle stages of Alzheimer’s, though it can surface at any stage.

There are some factors to look out for that can exacerbate sundowning:

  • Mental and physical exhaustion 
  • Upset in the “internal body clock”, causing a biological mix up between day and night
  • Shadows due to reduced lighting can cause confusion about what people living with Alzheimer’s are seeing 
  • Inability to separate dreams from reality can cause disorientation

Ways to help reduce effects of sundowning:

Keep a precise schedule. In order to maintain a restful night’s sleep, set times for every meal, bedtime, and waking up. Even working in a timed daily walk or exercise routine can help uphold the day’s structure.

Avoid stimulants. Nicotine, caffeine and alcohol can all affect one’s ability to sleep. Television can also be activating, so turn it off at least an hour before bed and avoid using television during periods of wakefulness during the night.

Be active during the day. Resting most of the day can cause restlessness at night. Discourage late afternoon napping and instead replace afternoons with activities. Puzzles, card games, cooking/baking, looking at family photo albums, reading out loud, or listening to music are all stimulating options to help fill the day. 

Stay mindful of your own exhaustion. Sometimes loved ones living with Alzheimer’s can pick up on your stress and become agitated. Caregivers need to get enough rest at night as well to ensure they can stay energized during the day. 

Keep the home lit in the evening. Shadows and the dark make for unfamiliar and sometimes disorienting settings. Keep the home well lit until it’s time to sleep.

Create a safe and comfortable sleeping environment. Make sure to keep the room at a comfortable temperature. Install the appropriate door and window locks to avoid wandering- door sensors and motion detectors can be used to alert family members if a person is awake and roaming. 

Share your experience and connect. Join ALZConnected, our online support community and message boards. Here you can share your experiences, what did and didn’t work, and hear from others about coping mechanisms or just general support. Join ALZConnected
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