Sundowning is a common problem in dementia patients, characterized by lack of sleep and high levels of anxiety and delirium. It impacts the  safety and well-being of both the patient and caregiver.

The big question is “How long does it last?”  According to Dr. Barry Baumel, Division of Cognitive Disorders at the University of Miami School of Medicine“sundowning usually occurs in the intermediate phase of the disease and will often pass as the disease progresses. Just like there are many theories as to why sundowning occurs, there are many different approaches to effectively treat it.”

Here are some of his suggestions:
  • Make sure that the lighting during the day is bright and full. At night time, leave a little night light on so there is just enough light to see should the patient awaken.
  • As much as possible, keep the individual as active as possible during the day since Alzheimer’s patients naturally tend to have less motor activity during daytime hours.
  • Make sure all Alzheimer’s medications, (such as Aricept, Exelon or Razadyne) is given in the evening. This may help improve the disturbed sleep-wake cycle.
  • Adding a little Melatonin may also help induce sleep at night. Dosage range should be determined by the individual’s doctor. He should avoid napping during the daytime, if possible.

For additional reading, Dr Baumel recommends“The Alzheimer’s Action Plan” by Dr. Murali Doraiswamy. It includes a chapter on the treatment of anxiety and sleeplessness.