Sunset syndrome is a neurological phenomenon associated with increased confusion and restlessness in individuals suffering from delirium or some form of dementia. It is usually associated with Alzheimer's disease, but can also occur in other forms of dementia. Individuals with sundowning syndrome have numerous behavioral problems, which can have long-term negative consequences.
Apart from dementia, this syndrome can also be seen as a short-term mental confusion with decreasing daylight. Individuals who experience this process may experience hallucinations, blurred consciousness, difficulty in distinguishing, seeing the shape and position of objects in the environment change. A distinctive feature can be that the disorder manifests itself at times when daylight begins to fade and that chronic conditions such as dementia and depression are present.
A person withAlzheimer's disease may experience major changes in behavior in the afternoon or early evening. This is called sunset syndrome. Symptoms may worsen as the night progresses and usually improve by morning. Even if the syndrome does not disappear completely, steps can be taken to help manage the challenging time of day.
What are the symptoms of sundowning syndrome?
The behavioral symptoms of sundowning vary between sufferers. Recognizing the signs of this syndrome without wasting time will contribute to reducing the responsibility of both the person with dementia and the caregiver. Therefore, it is necessary to proceed with a multidisciplinary team approach. The symptoms of sunset syndrome are as follows;
- Sadness
- Anxiety
- Asabiyet
- Confusion
- Bewilderment
- Demanding
- Suspect
- Shouting
- Hearing and seeing things that are not there
- Mood changes
About 1 in 5 people with Alzheimer's disease experience sunset syndrome. But it can also be seen in elderly people who do not have dementia.
What Causes Sunset Syndrome?
It is not clear what causes this syndrome. According to research, differences in the brain of a person with dementia are thought to affect the internal "body clock". The part of the brain that signals when we are awake or asleep is disrupted in people with Alzheimer's disease and can lead to sunset syndrome;
- Feeling too tired
- Hunger and thirst
- Depressed mood
- Sleep problems
Events in a person's environment can also affect sunset symptoms. Low light in the home can lead to confusion and fear.
The caregiver may feel tired at the end of the day, and the patient with this syndrome may recognize this and become upset. It is normal for caregivers to feel this way, but it is important to be aware of how these feelings are managed.
How to Help Someone with Sunset Syndrome?
The situations that trigger this syndrome need to be recognized. The caregiver should establish a daily routine and set regular times to wake up, eat and sleep. The person with sundowning syndrome should not be allowed to smoke or drink alcohol. They should have a specific diet. The room temperature should be at a certain temperature. There should be light because darkness and shadows can make them even more upset. They should be in a calm environment. Their sleeping space should be comfortable and safe.
If your loved one becomes increasingly confused, anxious or agitated in the evenings, the causes should be tried to understand and resolved. For example, if you think loud TV shows or too much activity may be causing this, try to reduce these activities at night. People with this syndrome are very sensitive and so the reactions of the caregiver and those around them should be as follows;
- Try to remain calm.
- Do not argue with them.
- Reassure them and tell them that everything is OK.
- If they need to get up and move or speed up, do not try to stop them. Stay close by to keep an eye on them.
- Keep them safe with night lights and locks on doors or windows. Use a gate to close off stairs and put away anything dangerous, such as kitchen appliances.
Differences Between Delirium and Sunset Syndrome
The main difference between this syndrome and delirium is that delirium comes on suddenly and comes and goes throughout the day. It is normal for people with Alzheimer's disease to feel more confused as time goes by. Sometimes, however, this confusion worsens very quickly, within hours or days.
Experts do not know exactly why sundowning syndrome occurs, but it could be triggered by fatigue, less light or a problem with the "internal body clock".
Treatment usually involves things like turning on more light, planning more daily activities and helping your loved one get plenty of rest. However, if these do not work, it is necessary to seek help from a specialist.
Advice for Relatives
Caring for a loved one suffering from sundowning syndrome can make a peaceful sleep difficult. But you need to take good care of yourself to be there for your loved one.
It is normal to feel scared or overwhelmed when caring for someone with this syndrome. Even the things you do to help can upset them. It can also make them do things that are not safe for you and them.
It can be hard to know if or when someone with this syndrome will become aggressive. To prevent your loved one from hurting themselves or others, tools that can cause harm should be removed from the home. If you are feeling overwhelmed, you can do the following;
- Ask a friend or relative to stand in for you at night.
- Try to take a nap during the day.
- Take breaks during the day whenever you can.
- Exercise.
- Eat a healthy diet.
- Spend time with friends.
- Try to find time for your own hobbies and interests, but not too much.