Aging Care LLC

Sleep Issues and Sundowning Part 1

People with Alzheimer's and dementia may have problems sleeping or increases in behavioral problems that begin at dusk and last into the night (known as sundowning).

Causes

Nighttime restlessness doesn't last forever. It typically peaks in the middle stages, and then diminishes as the disease progresses.

Scientists don't completely understand why sleep disturbances occur with Alzheimer's disease and dementia. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer's on the brain.

Some studies indicate as many as 20 percent of persons with Alzheimer's will experience increased confusion, anxiety and agitation beginning late in the day. Others may experience changes in their sleep schedule and restlessness during the night. This disruption in the body's sleep-wake cycle can lead to more behavioral problems.

Factors that may contribute to sundowning and sleep disturbances include:

1. End-of-day exhaustion (both mental and physical)
2. An upset in the "internal body clock," causing a biological mix-up between day and night
3.  Reduced lighting and increased shadows causing people with Alzheimer's to misinterpret what they see, and become confused and afraid
4.  Reactions to nonverbal cues of frustration from caregivers who are exhausted from their day
5. Disorientation due to the inability to separate dreams from reality when sleeping
6. Less need for sleep, which is common among older adults

Talk to a Doctor

Discuss sleep disturbances with the doctor to help identify causes and possible solutions. Physical ailments, such as urinary tract infections or incontinence problems, restless leg syndrome or sleep apnea (an abnormal breathing pattern in which people briefly stop breathing many times a night) can cause or worsen sleep problems. For sleep issues due primarily to Alzheimer's disease, most experts encourage the use of non-drug measures, rather than medication. In some cases when non-drug approaches fail, medication may be prescribed for agitation during the late afternoon and evening hours. Work with the doctor to learn both the risks and benefits of medication before making a decision.

Reprinted from:  http://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.asp?WT.mc_id=enews2016_10_28&utm_source=enews-aff-28&utm_medium=email&utm_campaign=enews-2016-10-28