Sundowner’s Syndrome

For many people suffering from Alzheimer’s disease or dementia, sunset can be a confusing and tumultuous time. While the cause of this transition isn’t well understood, many individuals suffering from dementia or Alzheimer’s disease begin to display changes in behavior and mood when the sun sets. This is referred to as sundowner’s syndrome.

Sundowner’s Mood Symptoms

Many caregivers have reported a rapid change in mood from a patient’s normal or previous mood as being a common sundowner’s symptom. Patients that are generally calm and easy to get along with may become agitated, difficult, and even violent. Patients may also experience depression, restlessness, confusion, paranoia and a host of other strong emotions as the sun goes down – often these emotions conflict with their usual moods.

Sundowner’s Changes in Behavior

When experiencing sundowner’s syndrome, patients frequently exhibit extreme behavioral changes. Patients often wander, but they may also cry, scream, rock back and forth, or attempt to hurt caregivers. It’s important for caregivers to identify these symptoms as being sundowner’s syndrome as quickly as possible so they can take precautions to protect patients and themselves.

Sundowner’s Cognitive Symptoms

It’s not uncommon for patients to experience hallucinations as a symptom of sundowners. In many cases, hallucinations are related to events and people from the sufferer’s past. Even patients that usually only suffer from mild Alzheimer’s symptoms may experience more extreme cognitive symptoms after sunset.

Sundowner’s Symptoms Effects

Sundowner’s syndrome often causes the patient suffering to lose sleep, but may also deprive other residents or caregivers of rest. This can exacerbate dementia symptoms at other times of day and make sundown even worse. Patients may also injure themselves or others while lashing out.

Possible Triggers and Causes

There are several changes that commonly occur with sunset that are often cited as possible triggers for sundowner’s. The lack of energy caused by a combination of the decreased sunlight and the exertion from the day may have an impact on patients, causing feelings of overwhelm. When patients live in a nursing home, staff shift changes may cause agitation and confusion.

Even when patients live in a private home or apartment, changes in noise volume coming from neighbors, caregivers closing blinds, and other alterations to the atmosphere may serve to stir up emotions and trigger sundowner’s symptoms.

Mitigating and Coping with Sundowner’s Symptoms

Understanding how to recognize sundowner’s symptoms and having some idea of potential triggers for sundowner’s may be helpful in formulating mitigation plans and coping methods. If shift changes or changes in an apartment or home that occur at nightfall seem to trigger sundowner’s, it may be helpful to start these changes earlier or shield the patient from experiencing them.

Making sure that the patient receives adequate exercise and stimulation throughout the day may also help to use up excess energy and keep patients calmer after sunset. If symptoms persist, making sure that patients have a safe space to wander and that others will still be able to rest can be helpful coping methods.