Miya Pearson
Sleep is an essential part of our lives, and our body clocks, located in our brains, use light and darkness as signals for day and night. Sundowning, also called sundowner's syndrome, is a set of symptoms that causes increased confusion and sleep issues for people with Alzheimer's or dementia from late afternoon through the night. For those without these conditions, sleeping at sundown can be a result of lifestyle factors, such as socializing and increased alcohol intake during the summer, or working shifts. Preparing for bed by keeping lights dim and reducing screen time can help your body prepare for sleep.
| Characteristics | Values |
|---|---|
| Definition | Sundowning is increased confusion that people living with Alzheimer's and dementia may experience from late afternoon or dusk through the night. |
| Other Names | Sundowner's syndrome |
| Symptoms | Difficulty sleeping, anxiety, agitation, hallucinations, pacing, disorientation, restlessness |
| Causes | Disease progression, changes in the brain, physical and mental exhaustion, navigating a new or confusing environment, mixed-up "internal body clock", low lighting causing confusion and hallucinations |
| Treatment | Reduce stimulation, offer a larger meal at lunch, keep the home well-lit in the evening, identify soothing activities, take walks, talk to a doctor about medication timing, limit daytime naps, reduce/avoid alcohol, caffeine, and nicotine, light therapy |
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What You'll Learn
- Sleep and light exposure: Reducing light exposure in the evening helps your body prepare for sleep
- Sundowning: People with Alzheimer's or dementia may experience increased confusion and sleep issues from dusk through the night
- Sleep and temperature: Keeping your space well-ventilated and cool may improve sleep quality
- Sleep and technology: Reducing screen time before bed can prevent stimulation and disruption of your body's internal clock
- Sleep and alcohol: Increased alcohol consumption during summer can adversely affect sleep patterns
Sleep and light exposure: Reducing light exposure in the evening helps your body prepare for sleep
Our body clock, located in our brain, uses light and darkness as signals for day and night. The longer we are exposed to light, the longer our body clock will signal to our body that it's daytime and that it needs to stay awake. Therefore, decreasing your exposure to light in the evening can help your body prepare for sleep.
During the summer, when the days are longer, we tend to stay awake for longer, and our social calendars can take away time from sleep. This can cause frequent nighttime waking or overtiredness during the day. To counter this, it is recommended to keep curtains shut during the day and open windows in the evening to create a breeze and cool the room. Keeping your space well-ventilated may improve sleep quality. The ideal temperature for sleep is believed to be around 65°F (18.3°C).
In the lead-up to bedtime, it is beneficial to keep the lights dim. Using a small, low-power lamp can aid in the transition to bedtime and pitch darkness. Low illuminance and warm color temperatures may also help with relaxation and getting into the right mindset for sleep.
It is also important to reduce or eliminate technology in your bedroom. Screen time can keep your mind stimulated, delaying bedtime, and the light can disrupt your body's internal clock, melatonin production, and overall sleep. If you can't avoid using electronics in your bedroom, turn down their brightness as much as possible, avoid using them before bedtime, and keep them silenced during the night.
Developing good sleep habits can also help. This could include taking a warm bath, reading a book, or writing in a gratitude journal. By repeating these habits, your brain will learn to associate them with sleep.
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Sundowning: People with Alzheimer's or dementia may experience increased confusion and sleep issues from dusk through the night
Sundowning is a phenomenon that causes increased confusion and sleep issues for people with Alzheimer's or dementia from late afternoon or dusk through the night. Also called "sundowner's syndrome," it is not a disease but rather a set of symptoms or dementia-related behaviours that may include difficulty sleeping, anxiety, agitation, hallucinations, pacing, and disorientation. While the exact cause of sundowning is unknown, it may be due to disease progression and changes in the brain. Some possible contributing factors include:
- A mixed-up "internal body clock." The body's internal clock uses light and darkness as signals for day and night. As the sun sets, the body releases the hormone melatonin, signalling that it's time to sleep. However, in sundowning, the internal clock may be shifted, causing tiredness during the day and alertness at night.
- Environmental factors: Low lighting can create shadows, causing confusion and hallucinations.
- Daily activities: Mental and physical exhaustion from a full day of activities can contribute to sundowning.
- Stress and frustration: Noticing stress or frustration in others may cause the person with dementia to become stressed as well.
- Reduce stimulation during the evening: Avoid activities that may be distracting or add to the person's confusion, such as watching TV, doing chores, or listening to loud music.
- Adjust lighting: Keep the home well-lit in the evening to reduce shadows and confusion. Use bright light during the day and dim, warm lighting in the evening to signal the transition to bedtime.
- Modify meals: Offer a larger meal at lunch and a lighter meal in the evening.
- Identify soothing activities: Engage in calming activities such as listening to music, looking at photographs, or watching a favourite movie.
- Go for a walk: Physical activity can help reduce restlessness.
- Medication: Consult the person's doctor about the best times of day for taking medication.
- Limit daytime naps: Reduce daytime napping if the person has trouble sleeping at night.
- Avoid stimulants: Limit or avoid alcohol, caffeine, and nicotine, which can disrupt sleep.
- Establish sleep habits: Develop a bedtime routine with relaxing activities such as reading or listening to soothing music.
- Light therapy: If the above suggestions do not help, discuss light therapy or other treatments with the person's doctor.
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Sleep and temperature: Keeping your space well-ventilated and cool may improve sleep quality
Sundowning is a term used to describe the increased confusion that people living with Alzheimer's or dementia experience from late afternoon through the night. It is not a disease but a set of symptoms or dementia-related behaviours that may include difficulty sleeping, anxiety, agitation, hallucinations, pacing, and disorientation. To manage sundowning, it is recommended to reduce stimulation during the evening hours, keep the home well-lit, and limit daytime naps if night-time sleep is a problem.
Now, let's discuss the role of sleep and temperature and how keeping your space well-ventilated and cool may improve your sleep quality.
The temperature of your bedroom plays a crucial role in the quality of your sleep. While personal preferences vary, most doctors recommend keeping your bedroom cool and well-ventilated for optimal sleep. Ideally, your bedroom temperature should be between 60°F and 68°F (15.6°C to 20°C). This range may vary slightly depending on individual preferences and circumstances, but keeping the temperature within this range can help facilitate stable REM sleep.
During sleep, your body's core temperature naturally decreases as part of the sleep initiation process. If your bedroom is too hot or humid, it can lead to restlessness and trouble falling or staying asleep. Warmer temperatures can cause discomfort, and your body may struggle to regulate its temperature, impacting the quality of your sleep.
To optimise your sleep environment, consider reducing heat build-up during the day and turning down the thermostat at night. Open windows or use fans and air conditioning to maintain a comfortable temperature. Additionally, invest in cooling bedding materials and breathable pajamas, bed sheets, and blankets to help regulate your body temperature.
While a cold bedroom is not as detrimental as an overly warm one, it can still cause discomfort and impact your REM sleep and blood pressure. If your bedroom is too cold, your body may struggle to regulate its temperature, leading to constricted blood vessels and increased pressure on your cardiovascular system.
By keeping your space well-ventilated and maintaining a slightly cooler temperature, you can improve your sleep quality and enhance the stability of your REM sleep.
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Sleep and technology: Reducing screen time before bed can prevent stimulation and disruption of your body's internal clock
Sundowning is a term used to describe the increased confusion that people living with Alzheimer's or dementia may experience from late afternoon through the night. This can cause difficulty sleeping, anxiety, agitation, and hallucinations. For those living with this condition, reducing stimulation in the evening is important. This includes limiting screen time, which can keep the mind stimulated and delay bedtime.
Similarly, for the general population, reducing screen time before bed can help prevent stimulation and disruption of the body's internal clock. Our body clock uses light and darkness as signals for day and night, releasing the hormone melatonin when it's time to sleep. The longer we are exposed to light, the longer the body will stay awake. Therefore, decreasing light exposure in the evening can help your body prepare for sleep.
Artificial light from screens can disrupt the body's internal clock, or circadian rhythm, which can cause insufficient sleep, excessive sleepiness, mood problems, and elevated risk of accidents. Reducing screen time before bed can help mitigate these issues. Instead, activities such as taking a walk, listening to calming music, reading a book, or writing in a journal can help relax the mind and signal to the body that it's time to sleep.
In addition to reducing screen time, keeping the bedroom as dark as possible can promote better sleep. This includes using blackout curtains, dim lights, or low-power lamps to create a darker environment. These practices can help transition to bedtime and promote relaxation. Overall, limiting screen time and reducing artificial light exposure before bed can help prevent stimulation and disruption of the body's internal clock, leading to improved sleep quality.
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Sleep and alcohol: Increased alcohol consumption during summer can adversely affect sleep patterns
Sundowning, or sundowner's syndrome, is a set of symptoms experienced by people living with Alzheimer's or dementia. It involves increased confusion and sleep issues from late afternoon through the night. While sundowning is not a disease, it can cause difficulty sleeping, anxiety, agitation, hallucinations, pacing, and disorientation. The exact cause of sundowning is unknown, but it may be related to disease progression and changes in the brain. To manage sundowning, it is recommended to reduce stimulation during the evening, provide a lighter evening meal, and engage in soothing activities like listening to calming music or walking. Additionally, limiting alcohol, caffeine, and nicotine can help improve sleep.
Now, let's discuss the impact of alcohol consumption on sleep patterns during the summer. Increased alcohol consumption during the summer can indeed adversely affect sleep patterns. Alcohol use and sleep are interconnected, and the relationship between the two is complex. While many people believe that alcohol helps them fall asleep, it can compromise sleep quality and quantity. Heavy drinking and alcohol dependence are associated with difficulty falling asleep and maintaining restful sleep throughout the night. This can result in a cycle of caffeine consumption during the day to counteract sleepiness, further disrupting the sleep-wake cycle.
The disruption to the sleep-wake cycle is partly due to alcohol's interference with circadian rhythms, the biological patterns that operate on a 24-hour clock. Alcohol can decrease the body's sensitivity to cues like daylight and darkness, which trigger shifts in body temperature and the secretion of the sleep hormone melatonin. These fluctuations are crucial for regulating sleep and wakefulness. When these cues are weakened or absent, individuals may experience alertness when they want to sleep and sleepiness when they want to be awake.
Longitudinal studies have found that increased alcohol consumption predicts poor sleep later in life. This association between heavy drinking and poor sleep quality was observed to be stronger with binge drinking. Additionally, in a large population-based study of older adults, men who drank more than 21 units of alcohol per week were more likely to experience disturbed sleep, including waking up several times a night. These findings suggest that alcohol consumption can adversely affect sleep patterns, particularly in older adults.
To promote better sleep during the summer or any time of year, it is essential to address alcohol consumption. Reducing alcohol intake, especially close to bedtime, can help improve sleep quality and overall health. Additionally, creating a soothing bedtime routine, minimizing screen time, and maintaining a well-lit environment during the evening can support a restful night's sleep.
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Frequently asked questions
Sundowning is a set of symptoms including confusion, anxiety, agitation, hallucinations, pacing, disorientation, and sleep issues that people living with Alzheimer's or dementia may experience from late afternoon through the night.
Some strategies to manage sundowning include reducing stimulation during the evening, keeping the home well-lit, identifying soothing activities, and limiting daytime naps.
Light exposure affects the body's internal clock, which uses light and darkness as signals for day and night. Decreasing light exposure in the evening can help the body prepare for sleep, while exposure to light during the day can impact sleep quality.
To improve sleep during the summer, it is recommended to keep curtains closed during the day, open windows and use fans to create a breeze and cool the room, and develop good sleep habits such as reading or writing in a gratitude journal.
Shift workers are at risk of circadian rhythm disorders due to misaligned sleep schedules. This can lead to insufficient sleep, excessive sleepiness, mood problems, and an elevated risk of accidents. Light therapy can be used to treat circadian rhythm disorders by retraining the body's internal clock.
