The average life expectancy of an American is about 79 years. For the most part, we are able to lead healthy lives, both physically and mentally. It is in the later years (the twilight of our lives) that the danger of Alzheimer’s looms larger as the days go by, and which has been the subject of much discussion these days.
It’s a known fact that a substantial percentage of those afflicted with Alzheimer’s are senior citizens since aging is considered to be a big reason for the resulting breakdown that occurs with this condition.
To make matters worse, patients suffering with dementia also have to deal with Sundown (or Sundowner’s) Syndrome and that percentage is about 12 to 25 percent of patients, pertaining specifically to Alzheimer’s disease.
Much like Alzheimer’s, not much is known as to why Sundown (or Sundowner’s) Syndrome occurs, especially in the case of patients suffering with dementia – Alzheimer’s disease, in this case.
However, what is known is that Sundown (or Sundowner’s) Syndrome, simply put, is classified as a sleep or mood disorder, and is usually experienced by patients suffering from Alzheimer’s in the mild stage where they experience confusion or are irritable with their caregivers from the late afternoon all the way to the early evening hours or even until bedtime.
Experts attribute this confusion or irrational behavior to be due to disrupted ‘circadian rhythms’ and in some cases, patients might even demonstrate paranoia and demanding behavior. One reason why patients demonstrate such behavior is because their brain cannot cope with stimuli (like it used to in a healthy condition) causing confusion and frustration during the evening hours.
This is why it is recommended that all sounds and lights, among other external stimuli, that might affect our biological clocks should be turned down all the way, if only to cause the patient less discomfort.
Thanks to their deteriorating mental condition, in effect due to Alzheimer’s disease, it is for this very reason why they are not able to cope with so much incoming information (in the form of external stimuli) and thus express themselves in an aggressive manner by lashing out at their caregivers.
Other reasons for Sundown (or Sundowner’s) Syndrome is the fact that they might not like the caregiver for their lack of skills or even the patient might also feel tired and overwhelmed due to the brain being “awake” for more than eight hours and quite obviously – a lack of exposure to sunshine.
So, it’s only fair that the caregiver or the relative understand these reasons and should ensure that the causes for this irritation are prevented as much as possible. It’s in the best interests of both of the caregiver and the patient suffering from Alzheimer’s.
Some patients with Sundown Syndrome respond well to several treatments like light therapy, supplementation with melatonin, anti-psychotics and certain other drugs. However, other medical professionals believe that sundown syndrome might be exacerbated by medications.
Elderly patients with sundown syndrome who are on selective serotonin reuptake inhibitors like Prozac or antipsychotics or other medications that lower the level of dopamine in their bodies sometimes have periodic leg movement syndrome and restless leg syndrome.
This is where their legs move involuntarily in their sleep, sometimes to the point where it wakes the patient up. Some drugs taken for Parkinson’s disease might also cause involuntary movement and the side effects of ant cholinergic drugs that block the actions of a neurotransmitter might cause mental changes.
Indeed, all manner of drugs might cause changes in the behaviors and thinking of people who suffer from dementia.
Some ways that have been shown to ease sundown syndrome include the above mentioned light therapy, aromatherapy, music therapy, exercise and having the patient follow a regular and predictable schedule during the day.
Educating caregivers in how to cope with and soothe patients with sundown syndrome is also helpful. Medications might work for some patients, but in others it will make Sundown Syndrome paradoxically worse.

