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
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 (natural sleep/wake cycle.) The longer they’ve had dementia, the deeper is their confusion. It seems to occur as they begin to sleep more and stay awake less.
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.