We all know that getting a good night’s sleep is essential for our health, but for many living with Alzheimer’s or other forms of dementia, changes in sleep behavior are part of the new normal. Frequent daytime napping and restlessness in the evening are all results of the sleep/wake cycle getting out of sync. Of particular concern is a phenomenon called sundowning. Sundowning refers to a set of behaviors, usually characterized by agitation or anxiety, that appear around the time the sun is setting.
There are many theories as to why sundowning occurs. Some experts believe that the increase in darkness and shadows around the late afternoon and early evening can be upsetting and confusing, while others think it could be due to general exhaustion from being awake for several hours. Another likely culprit could be the increase in home activity that begins around this time, with dinner preparations or family members returning from work or school. Consider that your loved one might have participated in a similar repetitive task or behavior at this time of day in their past, such as picking up the kids from soccer practice, which may result in restlessness or agitation in the absence of the activity. We may never completely uncover the specific causes of sundowning, but we can take a few simple steps to try and minimize the behaviors that come with it.
Have a schedule and stick to it
Try to have your loved one wake, eat, participate in activities, bathe, and sleep at the same times each day to reinforce a normal sleep cycle.
Curb the caffeine
Limit caffeine intake to the earlier part of the day to avoid stimulation later in the afternoon and evening; better yet, eliminate it altogether.
Engage in physical and/or meaningful activities as well as cognitive stimulation throughout the day
Autumn Leaves residents enjoy a variety of activities and programming each day as part of our So Much More™… To Do pillar. From daily walks with the Trailblazers club to Chair Chi, a gentle, chair-based form of tai chi, residents are moving throughout the day. Try a similar light physical activity that best suits your loved one’s abilities. Equally important is cognitive stimulation; working on puzzles or other “brain games” are great ways to keep the mind active. If your loved one is especially prone to sundowning, try incorporating these activities or take a short walk around 30 minutes before the typical sundowning period to help alleviate the feelings of anxiety or agitation.
Explore the outdoors
Getting lots of bright, natural light throughout the day can be very beneficial. Go for walks or consider taking your indoor activity out to the patio or park. Take advantage of any time you can be in a safe outdoor environment with your loved one.
Discourage napping
Cutting naps will help your loved one go to sleep more easily at bedtime, but if a nap is unavoidable, try to keep it under 20 minutes.
Illuminate your surroundings
Remember to turn on inside lights around dusk to keep the evening shade at bay. By the same token, the room should be dark when it’s time for bed to keep circadian rhythms in check. Use a nightlight if you’re concerned about wandering to help prevent falls.
And finally, if your loved one appears to be sundowning, try the following:
Redirect their behavior and find a quiet place where you can do something to soothe them, such as listening to music, flipping through a photo album, or another similar calming activity. Once the agitation or restlessness has passed, resume normal activities to stay on schedule.
For more information on this topic, visit Sleep.org
