Sundowners Syndrome: Causes and Symptoms

Sundown syndrome sounds as mysterious as it is. The medical industry does not have definitive proof as to what causes sundown syndrome, however, there is evidence of specific triggers that causes behavioral changes. This behaviour shift predominately affects elderly people with forms of dementia such as Alzheimer’s disease during the time of sunset and can manifest in increased confusion, agitation, mood swings, and memory loss.

Sundown Syndrome

Sundowners or Sundown Syndrome is a term used to describe a behaviour shift in people with dementia during the transition from daylight to darkness. These atypical behaviours include confusion, mood swings, and agitation, and it is commonly seen during the early evening but can also happen during the early morning sunrise. This syndrome predominately affects people with dementia and people recovering from surgery or in an unfamiliar environment. Each person will experience sundown syndrome in a way that is unique to the individual and the severity of their symptoms will be circumstantial to the person. Sundowning is temporary as it generally only occurs during a specific period of time – usually at sundown. Ensure you are keeping proper records so you would be able to notice a consistent pattern. Another aspect of sundowning is that prescription and medication may be the unintended side effect causing behaviour changes in people with dementia. It is important to touch base with your doctor if you are noticing symptoms to appropriately address medication side effects.

Early Signs of Sundown Syndrome

The early signs of sundowning may begin subtly so it can be easy to miss a pattern. The behaviours are varied and often inconsistent so you may overlook minor confusion and irritability.

Typical beginning signs of Sundown Syndrome:

  • Confusion
  • Mood swings
  • Anxiety
  • Sadness
  • Anger
  • Communication issues

Severe Symptoms of Sundown Syndrome

  • Paranoia
  • Hallucination
  • Violent mood swings
  • Wandering

Sundown Syndrome Triggers

 Research indicates there are common possible triggers of Sundown Syndrome:

  • Fatigue – The exhaustion of the day can catch up to an elderly person.
  • End of day activity – End-of-day routine can cause anxiety due to the busyness of care tasks.
  • Low light – Low light will make perception difficult and confuse.
  • Winter – The shorter days of winter can amplify seasonal affective disorder and exacerbate sundown syndrome.
  • Infection – Infections can exacerbate sundown syndromes.
  • Internal imbalance – Medicinal or hormonal imbalances can disrupt their internal biological clock which will lead to dysregulation between waking and sleeping hours. This can also disrupt cognition and affect sundown syndrome.

Sundown syndrome can be difficult to diagnose due to its inconsistent behaviour changes, however by keeping active records and being in tune with the routine of your elderly loved one’s day, you may be able to help them navigate their symptoms with the assistance of their primary physician.

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