Sundowning, a term that refers to the agitation, restlessness, confusion or irritability that can affect a person with Alzheimer's disease when tired or when the day is almost over, can be an upsetting and disruptive issue. Unfortunately, the winter months tend to make sundowning worse, which is disturbing to caregivers and those with Alzheimer's disease alike.
There are reasons for sundown syndrome getting worse in the winter months. Here are a few things to keep in mind about the condition, as well as what might help make it easier to cope.
Sundown syndrome is often most pronounced during the hours of sunset and twilight, which is why winter can tend to be worse for people living with it. The days are shorter, and it gets darker much sooner during the main winter months. Unfortunately, short days and a lack of sun can both be triggers.
Sundowning isn't well understood, but it's possible that the confusion of the body's sleep-wake cycles could be part of the problem. The good news is that even though the winter puts stress on the sleep-wake cycle people are used to, you can make it easier on someone with sundown syndrome.
There are several methods you can use to reduce the impact of the winter months on those with Alzheimer's disease and related sundown syndrome.
The first thing to remember is that the change from day to night is the primary trigger for many people, since the circadian rhythm is disrupted. To prevent the earlier nights from bothering someone with sundown syndrome, you can try to turn on lights and minimize the impact of shadows and darkness within their room or home.
Another good option is to allow as much natural light in during the day as possible, so the person still receives adequate vitamin D from the sun. As night approaches, start switching over to soft lighting inside.
Along with trying to minimize a dramatic change from light to dark, consider building a routine around making the evening a quiet, restful time of the day.
Since sundown syndrome is sometimes associated with being tired or in pain, having a time of day when rest and pain management is a focus can help minimize the symptoms associated with the condition.
If you know the syndrome tends to show signs in the early evening, consider setting a mealtime before that time. Then, think about establishing a period of time when napping or rest is allowed. By turning on the TV for a few hours or setting up a standard time for reading and resting in bed, you may be able to prevent some symptoms by managing your loved one's energy levels.
Winter is dark, and that darkness can lead to seasonal affective disorder (SAD) in some people. SAD causes depression and is commonly associated with winter and a lack of vitamin D.
Those with sundown syndrome sometimes get more significant symptoms in response to developing depression or SAD in the winter. You can help minimize the likelihood of SAD by encouraging your loved one to interact with others, stay on a routine and get enough sunlight during the day. You may also want to consider signing up your loved one for talk therapy or looking into antidepressants with the approval of their medical provider.
Finally, remember that a core cause of sundown syndrome symptoms is a person's unmet needs that they aren't able to communicate clearly to others. Your senior parent or friend needs to take their medications on time, get enough rest, be comfortable and eat regularly.
If the person you love is acting frustrated or anxious, talk to them. Ask them what they need and try to adapt the situation to their benefit. Do your best to reassure them that everything will be fine and that you'll be taking steps to resolve the issue that's bothering them.
Some things you can do each day to minimize unmet needs from influencing symptoms in the winter include regularly checking the temperature, bringing extra layers of clothing when your loved one is too chilly and making sure to establish regular meal times.
If agitation occurs, try to be as soothing as you can. Turn on a familiar television show or song. Ask a family friend or loved one to call to talk to your loved one. Reduce noise in the room, or clean up clutter to make it less overwhelming for the person with Alzheimer's disease.
Your loved one may need extra support during the winter months. Still, with good preparation and support, you may be able to help minimize sundown syndrome symptoms and make them feel more comfortable throughout the season.