Sundowners Syndrome and Sleep
When my Mom had Alzheimer’s, Sundowners Syndrome could make bedtime a nightmare.
Late evening was a dreaded time for my Mom. Some evenings she would fall asleep as soon as her head hit the pillow. But, more often than not she would begin to cry only hours before bed time.
A gentle weeping at first would turn into a very sad, groan then escalate to a loud sobbing wail that filled the house.
It didn’t happen every night, but it happened often enough to ask the doctor if there was something wrong and what on earth could I do.
Some antidepressants cause anxiety and irritation and keep them awake rather than help them to sleep. Mom seldom took more than a mild antidepressant at night as we hoped for a sound and restful sleep.
Despite all our efforts, several nights a week Sundowners Syndrome haunted Mom. Her wailing cry was unnerving. It almost sounded like someone in horrific emotional pain. If you’ve ever heard a mother weep from the death of a child, that is exactly how my Mom sounded on many nights. She wouldn’t walk or flail, but sit on the side of the bed and weep into the darkness.
Mom took a light medication to help her sleep, but remained alert during the day. Most often, she had really good days, it was only the evening hours that brought nightmares while she was wide awake.
A few things I did find to help during those Sundowners Syndrome Nights:
- Keep the last meal of the day fairly early, usually before 5 pm
- Take an afternoon walk, so Mom would be ready to settle down
- No naps during the day, as that prevented sleep at night
- For an hour or so before bed time, Mom would wind down from her daily activity
- She’d be drowsy and perfectly happy to go to bed with a little warm milk
Sometimes these small activities would do the trick and she’d sleep soundly
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Though no one really knows for sure what causes it, Sundowners is common among those with dementia
Some behaviors during Sundowners include: shouting, wandering, expressing fear, sadness, crying and anxiety.
Since the cause of Sundowners is unknown, many think it might have something to do with the body’s natural cycle or Circadian Rhythms
A few other recommendations I’ve learned since my Mom passed away 7 years ago are:
- Shadows seem to bring them a lot of fear, so try for a well lit atmosphere as much as possible
- Make sure they get lots of exercise during the day, so sleep-time comes more naturally
- Keep caffeinated beverages or foods to a minimum as they too can keep them awake
- Playing soft music also helps them to stay asleep and if they need to get up for bathroom time in the middle of the night, be certain the bathroom is well-lit
- Touch-base with their doctor. Let them know about the issue and ask for suggestions, perhaps a light sedative– or check on the medications they are already taking, could one of them be keeping them awake?
All the best to those caring for someone with Sundowners Syndrome. If you find something that helps or would like to share something you’ve learned, comment below. We’d love to hear from you.
Anon says
01/01 at 9:06 amOur family’s experience is that once we cut out alcohol for our mom (switched her wine for fake), the sundowning ceased completely.
She would wander, fight with us, cry, get completely lost in the past on the evenings of high-stress days. She was never a big drinker but she had a habit with my father, prior to his passing, of having a drink each night with him. Once he passed she got confused on when to drink (or missing him) and would have a drink during the day. Again, not a ton of alcohol by any means, but more often than normal. Once we cut out the alcohol the sundowning stopped.
Sandysgingham says
01/01 at 7:55 pmOh my goodness. Now that is interesting. The alcohol probably had much more effect than if she was without Alzheimer’s. Very interesting and I’m sure helpful to some other readers.
Thank you for sharing,
Sandy
Lori Burdoo says
05/04 at 5:04 amMy Mom had Sundowner’s but nowhere near the depth that you describe; she’d just wander at night and keep me up at all hours.
One thing we did that helped a bit was to draw the blinds prior to sunset. We’d then turn on every light in the room. Somehow, it seemed to set her internal clock to a more decent time. It wouldn’t work every night – what does? – but, at least I’d get 4-5 hours of sleep before she’d pad softly into my room with a ‘Honey, is it time for coffee?’
She always got her coffee.
Sandysgingham says
05/04 at 9:35 amI know, Lori. You have that so right. Every single person I know who had/has Alzheimer’s are just a little different. You were very fortunate that worked for your mom. She sounds like she was a very sweet lady. Some are really distraught with Sundowners.
It was terrible for my Mom. Yet she would awake in the morning and never remember a thing about it.
I’m with your Mom. Gotta have the coffee!
Sandy
Karen Walls says
03/05 at 6:05 pmGreat article! I had the white noise machine. Lavender scented oil for the pillow case and in my mom’s room which I also asked this would be implemented to help others sleep and relax. Aromatherapy candles out of reach of course would be helpful. Music therapy is number one I found. Sunlight bulbs work great, why they aren’t used more often and check for Vitamin D deficiency.
I used to get my mom a shot of vitamin B-12 once a month. Fresh air, a drive a walk, was good to get sleep. Melatonin is a natural way to help Alz or Dementia patient sleep. Sometime, you just have to let them walk it out unfortunately until they tire themselves out.
If TV is comforting turn to something that isn’t shrieking at them or the news, sometimes that can be disturbing. I would find the channels that were ambient. Even comedy for example would work, believe it or not get them in a good mood hearing laughter. Night lights. I love this article.
What would saddens me, if your loved one is in a home and you want these measures implemented. It bothers me that some homes, I might go back later to visit to find that they were “saving electricity” by turning all everything mentioned above. I advocate that caregivers while so many are good, training and compassion is needed to understand this disease.
While the pay is low in many instances have a heart by not doing something you don’t have the heart to do. It’s a very hard task. For those who are just innately wonderful with this disease, I hold you to the highest level of regard!
Sandysgingham says
03/06 at 7:56 amKaren, Those are some wonderful ideas! My Mom laughed the funny shows. We had many taped for her, including Bob Barker (the only person she never forgot.)
So pleased that you gave us a glance at some wonderful ideas!
Thank you,
Sandy
Mike Mountain @mgmoun7 says
01/05 at 6:52 amEileen has been sundowning now for some months. I thought about the caffeinated drinks, and her last one is around 5pm at latest. Our evening meal is over by 7pm at latest. Though amounts of food being eaten and variation of diet has altered an awfull lot ( this really worries me at times ) we seem to be eating the same meal, a few times a week. But at least Ei is eating, and that is a blessing in its self.
Within an hour of going to bed Ei is up and about for about 15 mins and if I’m lucky I can then get her back to bed and get her settled ( until the next episode ). The main thing that keeps me going through it all is the memories of how she used to be, ands it’s this cruel disease that’s causing it.
On speaking to our GP about these problems, she prescribed a small dose of diazepam before bed. The calming effect works well, but I can’t help thinking that this may be causing other issues regarding the night in bed overall. I hope all this makes some sort of sense as I have done this in between seeing to Eu, and may have missed the plot along the way.
To all those caring for a loved one during this, please remember, that without you, life would be more miserable for your loved one.
Sandysgingham says
01/05 at 7:34 amHello Mike,
I do understand your predicament. It is so similar to my Mom’s situation. And yes, I know how you feel it is a blessing that she is eating.
But it’s sheer misery for us when they don’t sleep. My mom wouldn’t allow me in the room, but I could hear her crying and wailing. I hope your Eileen isn’t having such issues.
The main thing I noticed is that I tried to make Mom’s day end earlier. Perhaps you could try de-caffeinated drinks instead of those with caffeine. My Mom didn’t mind, but I think she may have been further along in her disease process.
I spoke with a lady I know who runs a nursing home and her advice at that time was to start winding Mom’s day down about 4-5 pm. Start with a walk. If Eileen is able. It could be a short walk just around the yard or block where you live. Then dinner. Then give her evening med, and perhaps watch a movie or read to her. The idea is, lots of quiet time before they go to bed. Sometimes it’s a better sleep if they go to bed really relaxed.
I hope that might help. But I know how you feel. It’s a sad thing to watch them during Sundowners and have no way to help. You might try music also. Soft music sometimes helps.
Take care and bless you for being such a loving caregiver for Eileen.
You are so right, Mike. Without the caregiver, life would be miserable for them.
Sandy