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‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

  • Significant personality changes can beset dementia sufferers towards the end of the day; they may become angry, agitated, panicked and unable to sleep
  • The syndrome may reflect a glitch in the circadian system that regulates sleep and emotions; an expert provides tips for alleviating its symptoms

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A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock
This is the sixth instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
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It happens at roughly the same time of day: sundowning. But this is more than the slip of day to dusk. In the case of dementia, “sundowning” is the significant personality change that can beset sufferers towards the end of the day.

The person may become angry, agitated, confused, panicked, resistant to instruction and restless. In my mother’s case, she recently had a near-psychotic episode with hallucinations and marked distress.

Pummelling her stomach with a closed fist, she refused offers of help or fluid.

My mother can be so wired by these episodes that they prohibit her sleep, and ours. The last one kept her awake for 36 hours. We were all spent at the end of it.

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“Nurses talk about it like almost a light switch,” says Trey Todd, a neuroscientist at the University of Wyoming in the United States. He says conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

It is often the reason families seek full-time professional care for their loved ones – a sort of final straw.

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