Sundown syndrome: Dementia symptoms can worsen at night; here's what you can do to manage them

Studies suggest that anywhere between two to over 60 percent dementia patients, whether in nursing homes or their own houses, have sundown syndrome

Myupchar November 25, 2020 15:09:18 IST
content powered by
Sundown syndrome: Dementia symptoms can worsen at night; here's what you can do to manage them

Representational image. Unsplash

The worsening of dementia symptoms with decreasing sunlight, also called sundowning, is a known problem faced by dementia patients all over the world. Studies suggest that anywhere between two to over 60 percent dementia patients, whether in nursing homes or their own houses, have sundown syndrome. The condition often worsens during fall and winter months.

Though the exact cause of the condition is unknown, several possible pathophysiologies are attributed to the condition, ranging from changes in the sleep-wake cycle to the effect of medications.

A study conducted at the University of Toronto, Canada, has indicated that expressions of certain genes and increase in the levels of Alzheimer’s related proteins (in case of Alzheimer’s related dementia) in the spinal fluid may be responsible for the worsening of sundowning during fall and winter months.

Here are some more possible causes attributed to sundowning in dementia along with a set of care tips that can help manage dementia symptoms better.

Possible causes of sundowning in dementia patients

Experts suggest several possible causes of sundowning in patients with dementia but it mainly involves degeneration of suprachiasmatic nucleus (SCN), a part in the brain that is involved in maintaining the circadian rhythm (sleep-wake cycle) in the body. This area has been found to be affected by increasing age (especially after the age of 80) and neurodegenerative diseases. Alzheimer’s patients are shown to have several neurofibrillary tangles (twisted proteins) in this area of the brain, though amyloid proteins are not that common.

Damage to the SCN is also responsible for the reduction of melatonin levels, a hormone involved in maintaining the sleep-wake cycle. Reduction in melatonin levels has also been seen both with increasing age and in neurodegenerative diseases like Alzheimer’s.

Other factors that may lead to sundowning include:

  • Dysregulation of the hypothalamic-pituitary axis, a system in the brain that is involved in maintaining homeostasis in the body
  • Reduced light exposure
  • Less availability of nursing staff in the evening hours
  • General fatigue
  • No daily routine
  • Use of certain medications like antidepressants and antipsychotics and health conditions like mood disorders and hearing or visual impairment

Ways to manage sundowning 

The National Institute of Health (NIH) suggests that following tips to deal with sundowning:

  • Be aware of and look for symptoms of sundowning in patients. These include increased agitation, anxiety and confusion. The patient may shout or yell more and keep pacing.
  • Make sure they spend a lot of time in daylight. But close the curtains before dusk and turn on the lights.
  • Stick to a routine. If you want to change nap time or anything else in the person’s routine, do it slowly and gradually. This will help them cope better.
  • Distract them by talking to them, switching on their favourite TV show or another activity.
  • Play some soothing music in the early evening and ensure that there is no noise or crowd in their room.
  • Avoid giving tea, coffee or alcohol to them later in the day.
  • Make them do some physical activity during the day and ensure that they get proper rest during the night.
  • Consult a doctor at the earliest if the problem worsens.

For more information, read our article on Dementia

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Updated Date:

also read

Gut microbes are connected to brain diseases; probiotic foods, high fibre, low sugar diet key in keeping your stomach healthy
India

Gut microbes are connected to brain diseases; probiotic foods, high fibre, low sugar diet key in keeping your stomach healthy

Many studies in the past have suggested that the microorganisms in the gut can affect the brain.

COVID-19 treatment: Melatonin hormone that regulates sleep-wake cycle may prove effective in managing infection
Health

COVID-19 treatment: Melatonin hormone that regulates sleep-wake cycle may prove effective in managing infection

Clinical registries from Cleveland Clinic also showed that regular use of melatonin was associated with a 30 percent lesser chance of testing positive for COVID-19 even after adjusting for age, smoking history, race, and the presence of comorbidities

Modified Mediterranean-keto diet and estrogen replacement may help reduce risk of Alzheimer's, reveal studies
Health

Modified Mediterranean-keto diet and estrogen replacement may help reduce risk of Alzheimer's, reveal studies

The modified Mediterranean-ketogenic diet can regulate the gut microbiome in a way that improves cognitive function instead of letting it decline enough for Alzheimer’s to strike