Alzheimer's "sundowning" is a top concern for family caregivers

Family caregiver tip of the month

Are you dealing with sundowning? One of the most common problems I hear from family caregivers regards their loved one with Alzheimer’s disease or related dementia becoming restless or agitated in the evening.

While no one really understands why sleep disturbances occur with Alzheimer’s disease or related dementias, it’s believed that the changes somehow result from the impact of the disease on the brain.

According to “Sleep Issues and Sundowning,” from, factors that may contribute to sundowning and sleep disturbances include:

• end-of-day exhaustion (both mental and physical)

• an upset in the “internal body clock,” causing a biological mix-up between day and night

• reduced lighting and increased shadows causing people with Alzheimer’s to misinterpret what they see and become confused and afraid

• reactions to nonverbal cues of frustration from caregivers who are exhausted from their day

• disorientation due to the inability to separate dreams from reality when sleeping.

Here are some strategies to help you cope with sleep issues and sundowning:

• Keep the home well lit in the evening (turn on as many lights as you can)

• make the environment as comfortable and safe as possible for sleeping

• maintain a schedule for going to bed

• avoid stimulants and large dinners

• plan more active days instead of letting your loved one rest during the day

• be mindful of your own mental and physical exhaustion.

Sleep disturbances and sundowning can be a difficult issue to deal with, but researching the issue and trying some of the coping strategies have the potential of making all the difference.

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