Inevitably, even the most consistent daily routine can be interrupted by things out of your control, like doctor’s appointments or home repairs. Since sundowning symptoms tend to get worse as the day goes on, try to schedule new things in the morning or whenever your loved one feels their best.
Prioritize natural light
A lack of exposure to natural light may increase sundowning symptoms, which is why Dr. Bock recommends aiming for at least 20 minutes of natural light in the morning. During the day, open curtains and blinds to let in as much light as possible. If appropriate, help the person spend time outside for additional sunshine.
Keep rooms well-lit in the evening
“As the term sundowning implies, when it gets dark, that’s when the patient starts misinterpreting their surroundings, and they start getting agitated,” says Dr. Small. Shadows in the room can increase confusion and fear, so turn on as many indoor lights as possible as the sun starts to set. Use plenty of lamps to light dim corners and cover reflective surfaces like windows and mirrors.
Minimize noise and clutter
Dr. Small says environmental triggers like loud sounds and jumbles of papers and clothing can increase sundowning symptoms. Calm, tidy surroundings are more soothing.
Be sure the rooms they spend most of their time in are extra clean and organized, and consider getting headphones for other household members so they listen to music or watch movies quietly.
Redirect to a calming activity
When your loved one starts to show signs of anxiety, turn their attention to a favorite activity. “Get to know who they are,” recommends Dr. Small. “Know the type of music they like. Maybe there’s a certain TV series they like that would calm them down.” Listening to soothing music, reading to them, or having a lighthearted conversation may also help ease their concern.
Help them practice good sleep hygiene
Dr. Edgerly, who is currently the Senior Director of Community Programs and Services at Alzheimer’s Association, says sleep hygiene is crucial for promoting a restful night’s sleep and regulating circadian rhythms. To put this into practice, make sure your loved one sleeps in a dark, quiet room that’s neither too warm nor too cold, and start their bedtime routine at the same time each night.
Other sleep-promoting tips include exercising during the day, avoiding caffeine after noon, and limiting blue light exposure from TV, computer, or phone screens in the evening. A comfortable mattress is another must-have for deep sleep.
Related: I’m a Sleep Specialist. Here’s the Bedtime Habit I Swear By for Better Rest
Be patient
It’s important to remember that people with sundown syndrome don’t act out on purpose. “In my experience, these patients have very little insight into what’s going on,” says Dr. Small. “It’s a manifestation of the brain damage that’s occurred.”
He recommends taking a deep breath to stay calm and patient. A relaxed attitude can transfer to your loved one and help reduce their anxiety.
Remember, there’s no shame in asking for help. Here’s when to seek it out.
You’re not alone if you feel entirely overwhelmed, burnt out, or depressed while caring for someone with sundown syndrome. Studies show that one in three dementia caregivers experiences major depression symptoms. It’s okay to reach out for help, to schedule temporary caregivers so you can rest, or to figure out a new living situation for your loved one.
“It can be an emotional rollercoaster,” says Dr. Edgerly. “[Sundown syndrome] also increases the likelihood of conflict between the care partner and the person living with it because they’re confused, maybe more agitated, and sometimes even angry. It can be very difficult to deal with it.”
The Alzheimer’s Association offers free resources that may help, including:
- The Empowered Caregiver: A training program full of tips for managing dementia symptoms
- A 24/7 Alzheimer’s Helpline: Call 800-272-3900 for real-time help
- Community Resource Finder: Search for local housing options, respite care services, and more.
Despite the challenges, it’s possible for someone with sundown syndrome to have a good day—and a good evening. “You don’t have to be an expert,” Dr. Edgerly concludes. “You just have to figure out different ways to do things.”
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