Sundowning, Sleeplessness & Alzheimer's: How to Cope in the Evenings
Channel: Alzheimer's & Dementia Resources
Date: 2016-09-01

http://www.alz.org/illinois

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As many as 20% of people with Alzheimer’s disease struggle with sleep disturbances and other issues known as Sundowning. People who struggle with Sundowning are often awake at night, asleep during the day, and regularly battle reduced energy and increased irritability in the afternoon and evening. This is the challenge of Sundowning.
The physical and emotional strain associated with Sundowning can make the challenges of caring for someone with Alzheimer’s or another dementia even more difficult, so below are some simple strategies that you can use to try to help address the Sundowning issues you’re experiencing.
Try to Manage Your Day Considering Sundowning: Getting through the day is difficult enough for a person with Alzheimer’s or dementia, without it being unintentionally exacerbated by a schedule that is just not a good fit, so it is extremely important that caregivers be very intentional about establishing a daily routine and schedule, in order to avoid creating additional Sundowning challenges. The time and energy spent on structuring the day will pay huge dividends in avoiding unnecessary frustrations and increasing the quality of life for everyone, whether it is the person with Alzheimer’s disease or another dementia, or their caregiver, family or friend.
People with Alzheimer’s and other forms of dementia generally have less energy in the afternoon due to Sundowning, so you’ll want to plan activities that are more physically or mentally challenging in the morning. Encourage naps in the afternoon and do everything you can to get a little sun and fresh air. Please remember to use sunscreen and drink plenty of water, but understand that exposure to sunlight helps our bodies’ natural rhythms recognize night and day, so even a little light can go a long way toward addressing Sundowning issues. And because you play a big part in setting the tone for how each day goes, Alzheimer’s and dementia caregivers should be extra attentive to getting plenty of rest and monitoring your own energy levels.
Be Very Intentional about Establishing a Clear Bedtime Routine Aimed at Addressing Sundowning: The term “sleep hygiene” is one you’ll want to become very familiar with to help with Sundowning. This refers to habits that promote healthy and restorative sleep, and these can be critical to addressing problems with Sundowning in people with Alzheimer’s or another form of dementia.
Addressing Sundowning by doing simple things like eating smaller dinners; limiting consumption of caffeine, alcohol, nicotine and sweets in the afternoon and evening; turning off the TV and other electronics at least an hour before bedtime; turning on soft, soothing music; and using essential oils to help get ready for bed, can help you reduce Sundowning issues significantly for those with Alzheimer’s or other forms of dementia.
Even aside from Sundowning, these are great tips for everyone: people living with Alzheimer’s disease or dementia, caregivers or really anyone who just wants a better night’s sleep.
Consider any Prescribed Medications That May Be Interfering With Sleep: Sometimes as caregivers, we have a tendency to lump all of the challenges we face with under the Alzheimer’s umbrella, without realizing that other underlying issues, like prescription side effects, can really be driving the problem we’re trying to address. Don’t assume that a problem you face is simply because of the nature of Alzheimer’s or dementia. Medications often have multiple side effects and sleep disruptions are common. If you care for someone who is experiencing Sundowning issues and they take one or more prescription medications, talk to their doctor - there may be other medication options to provide a better night’s sleep and reducing Sundowning.
Medications have various side effects and sometimes they can be turned into an advantage for people with Alzheimer’s or another form of dementia. For instance, if a side effect is drowsiness, often that medication can be used to help prevent problems with Sundowning by being taken before bed. Most medications will take some fine tuning by your doctor, so if you are able to make observations and take good notes, you and your doctor will become a team that can work to address Sundowning issues and provide much better Alzheimer’s and dementia care overall.
There is a lot to know about Alzheimer’s disease, dementia, Sundowning and sleep issues, and you can get more information by following the links here in the description box. 
Call for Help: The Alzheimer’s Association, Greater Illinois Chapter, has a free, 24/7 Helpline at  800.272.3900 or emailing illinoishelpline@alz.org.
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