Do you have a family member or other loved one who becomes agitated and confused late in the day? This is the main symptom of an issue called “sundowning.” Sundowning can develop after a stroke or other neurologic event, especially in older individuals. Learn more about sundowning and how to reduce its severity.
What Is Sundowning?
Sundowning is a behavior that can develop in individuals with cognitive concerns, including dementia and Alzheimer’s disease. It can also occur in people who have recently had a stroke. Sundowning is categorized by erratic and confused behavior that occurs later in the day.
Someone who struggles with sundowning may become increasingly irritated or aggressive in the later afternoon and remain that way well into the night.
Factors that Increase Sundowning
The exact cause is not known, but there are a variety of factors that have been shown to contribute to instances of sundowning. These include:
- Change of location or living environment
- Tiredness or fatigue
- Low lighting
- Increased shadows
- Severe nightmares
- Being hungry or thirsty
- Feelings of boredom
- Chronic pain
- Disruption or change in the normal schedule.
While these factors will not always lead to an episode of sundowning, they can exacerbate the behavior when it does occur. In order to reduce the severity of each sundowning episode, you should try to avoid things that make your loved one uncomfortable or changes in their routine and setting.
How to Navigate It
While sundowning isn’t an official medical condition, it can still impact someone’s quality of life in a significant way. To minimize sundowning behavior, there are various things to avoid and accommodations you can make. The following are just a few simple ways to cope with sundowning after a stroke:
- Follow a routine or predictable schedule.
- Increase exposure to light.
- Provide more activities that will encourage sleepiness later in the day.
- Limit caffeine and sugar intake after noon
- Reduce background noise in the evening, such as television and music
- Avoid exposure to unfamiliar settings or circumstances.
- Keep familiar, comforting items around
- Limit daytime naps that could alter the sleep schedule.
Research has suggested that melatonin supplements can help reduce episodes of sundowning.
The natural lethargy and tiredness brought on by melatonin can cause your loved one to sleep through the night and not struggle with feelings of confusion or agitation. There is still ongoing research in terms of these results, so this is not a foolproof approach to sundowning.
Treatment for Sundowning
Since the cause of sundowning is unknown, there is no definitive treatment for this symptom or behavior. With that said, there are treatment options that can resolve certain issues after having a stroke. These include regenerative options like stem cell therapy.
If you or a loved one is struggling with the after-effects of a stroke, speak with a physician about potential treatment options.