Time Change Can Affect Sleep Behaviors

For many, the end of daylight saving time on Nov. 6 means losing an hour of sleep, a less than ideal scenario. However, for more than 580,000 Floridians living with Alzheimer’s, the change can increase the disorientation that comes with “sundowning.” 

What is sundowning? 

It’s common for people living with Alzheimer’s disease to experience increased confusion, anxiety, agitation, pacing and disorientation beginning at dusk and continuing throughout the night. Commonly referred to as “sundowning,” this syndrome can disrupt the body’s sleep-wake cycle, causing more behavioral problems late in the day. Changes to this clock, such as daylight savings time or traveling to different time zones, can increase problems. 

Factors that may cause sundowning:  

  • Mental and physical exhaustion from a full day trying to keep up with an unfamiliar or confusing environment.  
  • Nonverbal behaviors of others, especially if stress or frustration is present, may inadvertently contribute to the stress level of a person living with Alzheimer’s.  
  • Reduced lighting can increase shadows and may cause the person living with the disease to misinterpret what they see and, subsequently, become more agitated. 

Tips that may help caregivers manage sundowning:  

  • Get plenty of rest so you’re less likely to exhibit unintended nonverbal behavior.  
  • Schedule activities such as doctor appointments, trips and bathing in the morning or early afternoon hours when the person living with dementia is more alert.  
  • Make notes about what happens before sundowning events and try to identify triggers.  
  • Reduce stimulation during the evening hours (i.e., TV, doing chores, loud music, etc.). These distractions may add to the person’s confusion.  
  • Offer a larger meal at lunch and keep the evening meal lighter.  
  • Keep the home well lit in the evening. Adequate lighting may reduce the person’s confusion.  
  • Do not physically restrain the person; it can make agitation worse.  
  • Allow the person to pace back and forth, as needed, under supervision.  
  • Take a walk with the person to help reduce his or her restlessness.  
  • Talk to the physician about the best times of day for taking medication.  
  • When behavioral interventions and environmental changes do not work, discuss the situation with your doctor. 

For more on sundowning and sleep issues, visit the Alzheimer’s Association website or download our handout in English and Spanish.

For support, day or night, call the Alzheimer’s Association 24/7 Helpline at 800.272.3900.

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