What sundowning medications can help with Sundown Syndrome?

4 answers | Last updated: Feb 06, 2018
A fellow caregiver asked...

What types of sundowning medications are there, and how can they help with Sundown Syndrome?

Expert Answers

Paula Spencer Scott is the author of Surviving Alzheimer's. A Met Life Foundation Journalists in Aging fellow, she writes extensively about health and caregiving; four of her family members have had dementia.

Sometimes antidepressants and antipsychotics are prescribed to counter the aggression and combativeness that can characterize sundown syndrome, the decline in behavior in someone with Alzheimer's that often occurs after sunset or in the early evening. It's not known what causes sundowning, but fatigue and the internal body clock may be involved. Sometimes melatonin is used to treat sleep disturbances with Alzheimer's, but over-the-counter sleep medications are not recommended because they can interact negatively with Alzheimer's medications.

Because they can have serious side effects, drugs to treat aggression are considered a last resort. Their  use also needs to be monitored carefully. Longterm use of antipsychotics, for example, is associated with twice the risk of death.

Sometimes there are behavioral approaches that can help with difficult behaviors. Some tips for dealing with sundowning:

* Organize the day so that taxing events (outings, visits) happen early in the day.
* Exercise during the day to encourage tiredness come evening.
* Try closing the draperies before the sun goes down, so the person is less aware of the day-to-night transition.
* Distract with soothing activities. Music often works well.
* Wind down the evening gently, such as with warm milk or a sponge bath (if it's tolerated and enjoyed, not if it’s problematic).

Be sure to consult the person's physician as well and explain the specific problems in detail.

Community Answers

Light seeker answered...

Me and my Wife or the care givers for my Mom and we or in the last stages of Alzheimes. My Mom is not violent and has never been, to the best of our knolege she is not stressed or has any problems, except the fact that she has come to a point that she does not sleep unless medicated. Even when she does sleep she still moves around. I feel like I have been up with her for weeks now and I provide 4 hour care with help from my wife. She don't sleep! I am looking for a type of medication that will not leave her druged up and yet able to get some sleep. Would love to find a list of medications others have tried that they may have had good experiences with, so I can check it against the medication we have already used.


Asha answered...

I have worked in this special field for 20yrs, and from what I see is going on with your dad his biological clock is going the other way his days are nights and vice versa. There is a solution and can be changed if you can plan to take him to Day Care, be sure to tell them u really want him involved in activities even if he is walking then when he comes home put some soft music with dim lights or a movie of his time, after all the activities his brain will not be able to accept any heavy loud noise. If he falls asleep on the couch let him, just cover him with warm blankies and leave the t.v. or music on as those are his sleeping buddies. Yes! During the day activities are very imp. Till today I am in this field and I do see the difference I make and help so try it. May God bless you for taking care in such a great way but take care of yourself. Asha Baptista

Careing4two answered...