Sundowners syndrome affects the elderly and those in the early or advanced stages of dementia. It is a state of confusion and disorientation that typically occurs in the late afternoon and early evening, hence the name, and is considered to be a form of mood or sleep disorder.
What causes Sundowners syndrome?
The exact cause of Sundowners syndrome is unknown. Doctors originally thought the symptoms were caused by a malfunction in the person’s internal body clock and that the condition arose as a result of the change from day to night, but experts now believe that a variety of other factors are responsible for Sundowners syndrome, including the cognitive decline caused by dementia, reactions to medications, and the noisy and stressful environments often found in hospitals and nursing homes.
How common is Sundowners syndrome?
Sundowners is very common and it is thought to affect around 45% of all elderly dementia patients. It is characterised by a period of disruptive and volatile behaviour that often occurs in nursing homes and hospital dementia wards following the final meal of the day, usually lasting until bedtime.
What are the symptoms of Sundowners syndrome in the elderly?
A patient exhibiting the symptoms of Sundowners syndrome will become agitated and upset towards the end of the day. They will appear confused and disorientated, be irritable and abusive towards caregivers, and suffer from negative thoughts. They may also be prone to aggressive outbursts and make bizarre demands on carers.
What is the treatment for Sundowners syndrome?
There is no cure for Sundowners syndrome, although medications such as antidepressants may be able to control some of the symptoms and lessen the severity of any underlying depressive mood. Sedatives can also help reduce the symptoms, especially if the patient is suffering sleep deprivation as a result of a related sleep disorder—daytime naps can help, although these sometimes need to be eliminated in order for the patient to sleep properly at night.
However, whilst medications are useful in the treatment of Sundowners syndrome, there are other methods carers can use to try and reduce the level of irritability in their loved one or patient. It can be helpful to reduce noise and activity as much as possible as evening approaches and sticking to mainly quiet and soothing activities may help the patient sleep better at bedtime. Some patients suffering from Sundowners syndrome might also benefit from having a quiet, private place where they can retreat when they feel overwhelmed by noise and the over stimulation afforded by visitors. It can also be helpful to keep lots of lights on as day turns into evening.
Caring for patients suffering the effects of Sundowners syndrome can be very challenging, but it is important to remember that the person is not being deliberately combative and obnoxious. They genuinely cannot help their behaviour and their confusion and irritability is all part of their declining mental function rather than a case of bad temper.
Are there any complications of Sundowners syndrome?
Patients with Sundowners syndrome are also prone to wandering around aimlessly, which can cause major problems if they are able to leave the secure environment of their care home or hospital.