by Tim DitmanOSF Healthcare
Courtney McFarlin, PA
Key takeaways:
Sundowning describes nighttime behavior in older adults, especially those with dementia, due to a disruption in the circadian rhythm. The person may be agitated, moody, not want to go to sleep or physically aggressive.
Ways to help include medicine like melatonin, eliminating long naps and practicing general good sleep hygiene. Homes should also be arranged so the elder does not fall or wander outside.
A caregiver may ultimately have to decide whether to move the person to an assisted living facility.
Many things can disrupt your circadian rhythm, like illness, stress, artificial light and genetic factors. But McFarlin says sundowning is most often seen in older adults with dementia and similar disorders like Parkinson’s disease and Huntington’s disease. Chronic alcohol use can also bring about sundowning.
What does sundowning look like? McFarlin says the person may be agitated, have mood changes and pace around. They may not want to go to sleep. And the person may even physically lash out at others.
“Reports and research have shown that it’s most common when people are in mild or moderate stages [of dementia],” McFarlin says. “You would think as one progresses with dementia, it would get worse. But it actually improves a little bit.”
How to help
McFarlin says caregivers of older adults often come to her with a plea: help us do something about my loved one’s nighttime behavior. The caregivers are sometimes awake through the night keeping an eye on things, leading to sluggishness, crankiness and other issues during their workday.
First, McFarlin reminds you that support groups exist – if not in-person in your community, then online – for caregivers of older adults. But for medicinal aids, McFarlin says melatonin is a good first option.
“It’s a natural hormone that our body produces that helps aid in sleep,” she says.
McFarlin adds that studies have found decreased levels of melatonin in older adults with or without dementia.
Serotonin-based medications, hypnotics and anti-anxiety medications can also help. Paxil, Prozac, Seroquel, Risperdal and Haldol are common brand names. Talk to your health care provider or a sleep specialist if you have questions about these medicines.
Something to strike from your loved one’s routine: long naps.
“It’s suggested that a less than three-hour naptime schedule is advised,” McFarlin says. “If I find my patients are napping quite a bit, I’ll encourage them to take less naps.”
Other sleep hygiene tips:
Any family in need residing in the Unit 7 school district is encouraged to visit The Giving Place Wednesdays from 4:00 – 6:00. TGP is located at 113 N Bourne in Tolono.
This week, the organization served seven families, which included 18 adults and seven children, with eight boxes of food totalling $400.
Williams said the ministry will continue for as long as they are able to do so and thanked those who donated items throughout the year.
Donated items and food may be dropped off every Wednesday between 4:00 - 6:00 p.m. or every first Saturday between 9:00 a.m. - Noon. TGP asks that donation not be left outside the building during closed hours.