SUNDOWN SYNDROME

SUNDOWN SYNDROME
 a psychological phenomenon associated with increased
confusion and restlessness in patients with some form of
dementia.
 Most commonly associated with Alzheimer's disease,
but also found in those with mixed dementia
 Occurs among cognitively impaired, demented, or
institutionalized elderly patients.
 A set of neuropsychiatric symptoms occurring in elderly
patients with or without dementia at the time of sunset at
evening or at night
 Gets
confused & agitated as the sun go down &
sometimes throughout the night.

 Sundown syndrome is a term that describes the

onset of confusion and agitation that generally
affects people with dementia or cognitive
impairment and usually strikes around sunset. 
CAUSE
 The internal clock -- governed by the circadian
rhythms -- controls sleeping and waking, is
connected to how active we are at different times
of the day, and influences changes in the body
that regulate behavior. Studies suggest that the
biological clock shifts in people with dementia,
and that shift may make some people with
dementia more prone to sundown syndrome.
SIGN &SYMPTOMS
 Anxiety
 Anger

 Agitation

 Restlessness

 Hallucinations
TREATMENT
 Practical Advice for Dealing with Sundowner’s
Syndrome(given by The Alzheimer’s Foundation of America)
suggests:
 Allow for light exposure in the early morning to help set
internal clock.(placing a full-spectrum fluorescent lamp
(between 2,500 and 5,000 lux) about 1 meter from the person
suffering from sundown syndrome and within his visual field
for a couple of hours in the morning can work wonders at
getting his biological clock back on track and making him less
agitated at sundown.)
 Discourage day-time napping to regulate sleep cycle.
 Encourage exercise throughout the day to
expend excess energy.
 Limit caffeine intake, particularly in the evening
to avoid potential Sundowner’s symptoms.
 Plan activities for the daytime so there is
sufficient time to adjust to night
 Have a quiet nighttime activity ready and a
private space for relaxing.
 Consider purchasing a bedside commode. Leaving
his or her bed to use the restroom can start the cycle
all over again, making it hard to get back to sleep.
 Schedule regular medical appointments to ensure he
or she is not in any physical pain and to check for
worsening Sundowner’s symptoms.
 Take precautions to provide a safe space for him or
her at night so that we can get a solid night’s rest,
even if he or she needs to stay awake and wander.
 Have healthy diet: serving food earlier or offer a
snack or something to drink until dinner is ready
as if he/she gets hungry gets agitatied more.
Caffeine is a (fast-working) brain stimulant, but
should be limited at night if a night's sleep is
needed.
 Provide relaxation therapy using music,
watching television or by using massaging.
 Reassurance : avoid unnecessary arguing for any
unnecessary demands & provide calm
environment & reassure.
REFERENCE
 https://www.caring.com/articles/sundown-syndrome
 https://www.caring.com/articles/sundowners-syndrome-c
auses-symptoms-suggestions
 https://en.wikipedia.org/wiki/Sundowning