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Expert Tips and Advice on Dealing with Sundowning and Dementia

elderly men playing chess in the park

 We Written by:

Jeffrey Grossman


November 15th, 2021

If you have a loved one with dementia, you may notice that some symptoms of dementia seem worse in the afternoon/evening. This pattern is called sundowning, and many family caregivers often want to know, “How long does sundowning last in dementia?”

Caring for a loved one with dementia is challenging. It becomes even more difficult as dementia progresses and symptoms increase. In particular, sleeplessness and sundowning in dementia patients can become more common.

So, how do you help loved ones overcome dementia sleep issues, like sundowning?

In this article, we’re looking at sundowning and dementia. We’ll share how to help sundowners sleep and answer questions, like:

Continue reading for care approaches for sundowning.


What Is Sundown Syndrome?

Before we look at how to help sundowners sleep or care approaches for sundowning, let’s answer the question, “what is sundowning in dementia?”

Sundowning in dementia patients is a term used to describe a sudden state of confusion or behavior change. It often occurs in the late afternoon/evening, making dementia in the evening seem worse than at other times. 

Unfortunately, experts aren’t exactly sure what causes sundowning. Some factors that may increase someone’s risk of sundowning include:

  • A disrupted internal clock
  • Low lighting
  • Fatigue
  • Being too tired or having too much energy
  • Unmet needs (e.g., hunger, thirst, etc.)
  • Depression
  • Pain

You can tell that your loved one experiences sundowning if they exhibit a quick increase in any of the following symptoms during the evening:

  • Anxiety or worry
  • Pacing or wandering
  • Aggression or anger

In addition, because sundowning happens in the evening near bedtime, sundowning can affect the individual’s ability to sleep at night. And in turn, affect a caregiver’s nighttime sleep.

Dementia sleep issues, like sundowning, often leave caregivers tired, frustrated, and wondering how to help sundowners sleep.

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Tips for Dealing with Sundowning and Dementia Sleep Issues

If you’re a family member caring for a loved one with dementia, you may be looking for some dementia and sundowning strategies.

Here are three ways to help curb sundowning and other dementia sleep issues.


1. Maintain a Nighttime Routine

Individuals with dementia can greatly benefit from a routine in general. But a consistent nighttime routine is especially valuable when it comes to sundowning or a dementia patient waking up at night.

Your loved one’s routine should involve low stress, low energy activities to help them relax and calm down before going to bed. 

You’ll want to avoid activities like watching TV or exercising. It’s also best to stay away from caffeinated or alcoholic beverages in the evening. 

Instead, some activities that can help sundowning in dementia patients include:

  • Playing a simple card game
  • Listening to their favorite music
  • Talking about past memories

Ultimately, you want to suggest activities that will keep your loved one occupied and relaxed until they get into bed.


2. Monitor Daytime Naps

When it comes to the question of, “Why do dementia patients not sleep at night?” experts most highly suspect it has to do with a messed up internal clock. 

When someone’s internal clock is confused, they’re often awake during the night and sleep long hours during the day. 

To help someone reset their internal clock, you can monitor their naps to ensure:

  1. They don’t nap too often: Try to keep your loved one from napping more than 3 times during the day.
  2. Their naps aren’t too long: You’ll also want to keep track of how long they nap. Naps should last no longer than 30-60 minutes.
  3. Naps happen at the same time each day: Lastly, keep them on a consistent napping schedule so that naps occur roughly the same time each day. 

Taking daytime naps is okay, but frequent, long naps during the daytime can further confuse their internal clock.


3. Get Exercise and Sunlight 

Getting physical exercise and being in the sunlight each day can also help with sundowning and dementia sleep issues.

Physical activity doesn’t need to be anything intense. It can be as simple as taking a walk outside each morning and each day after lunch, which will also provide an opportunity for sunshine.

Participating in regular physical activity can help your loved one use energy which promotes nighttime drowsiness. Being in the sun can help reset their internal clock and get them back in normal sleep rhythms.

Dementia and sundowning strategies ultimately come down to increasing the likelihood of nighttime sleep and decreasing their risk of agitation.  

Now that you know more about sundowning and some ways to alleviate it, let’s look at a question many family caregivers have, “How long does sundowning last in dementia individuals?”


How Long Does Sundowning Last in Dementia Individuals?

Sundowning doesn’t usually start occurring until the mid to late stage of dementia. However, once it does start, it’s something that can potentially happen every afternoon/evening.

Additionally, while a sundowning episode is happening, it can last for many hours or through the night. If it lasts through the night, it can greatly affect sleep for both the caregiver and person with dementia.

Because the person with dementia may be awake at night, the family caregiver will also need to stay alert in case their loved one wanders or experiences an onset of confusion.

It may be okay for the person with dementia to forgo nighttime sleep. But for family caregivers who may have other personal responsibilities, watching a loved one 24/7 isn’t possible. And even though we provided some ways to help decrease the risk of sundowning, these practices won’t be 100% effective.

So, how can you ensure high-quality around-the-clock care for a dementia patient who won’t sleep or regularly suffers from sundowning? 


Professional In-home Care for Sundowning in Dementia Patients

Caring for a loved one with dementia can be a challenge. When you add sundowning on top of it, it can become even more difficult.

If you’re wondering, “What is sundowning in dementia?” it’s a condition of where someone with dementia experiences drastic mood or behavior changes in the late afternoon/early evening.

Because sundowning happens later in the day and can affect nighttime sleep, it’s often seen as a dementia sleep issue

Fortunately, you can help alleviate the symptoms of sundowning in dementia patients by:

  • Maintaining a consistent nighttime routine
  • Monitoring your loved one’s daytime naps
  • Ensuring your loved gets regular exercise and sun exposure

Unfortunately, these methods may not always work, and you’ll be left watching your loved one through the night. Providing 24-hour care for your loved one with dementia can lead to exhaustion and burnout.

One of the best long-term dementia and sundowning strategies is to get professional in-home care for your loved one. With full-time in-home care, your loved one will have a personal caregiver caring for them 24/7.

At Commonwise Home Care, we specialize in home-based elder care. We offer a comprehensive list of in-home care services, ranging from 4 hours of care once a week to 24-hour care every day of the week. So whether your loved one needs assistance with simple daily life tasks or is struggling with sundowning and dementia, we can provide the care they need.

Contact us today to hear more about how in-home care can relieve your caregiver burden and improve your loved one’s quality of life.

In-home elder care solutions in Charlottesville, Richmond, Williamsburg, VA and Charleston, SC.

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