Sundowning describes an increase in agitation, confusion or irritability that sets in towards the end of the day as the light starts to fade, and gets worse during the evening and night.

Experienced by as many as 1 in 5 people living with Alzheimer’s Disease, it is most common in the mid to later stages of the disease, and although particularly associated with Alzheimer’s it also affects people living with other forms of dementia as well.

Coming as it does at the end of the day or middle of the night when carers are already tired and less able to cope with the inevitable frustration and interruption to sleep, it is often cited by loved ones as one of the most upsetting and troubling effects of dementia.​

Medics are unsure about the causes of sundowning but most agree that fading light in the evening and darkness at night are the main triggers.

Signs of sundowning to watch out for

Confusion

Irritability

Agitation

Distress

Disorientation

Becoming demanding or suspicious

Hearing or Seeing things that aren’t there

Yelling or Pacing

Factors that might contribute to sundowning behaviour

Less light and more shadows in the house can lead to confusion and fear.

An upset to the ‘internal body clock’, resulting from the disease’s damage to the brain, can cause a biological mix-up between night and day.

Disorientation resulting from an inability to distinguish between dreams and reality.

Reduced need for sleep and disturbance in sleep patterns common in older age.

Reaction to unintended body language from a carer as frustration and tiredness kick in at the end of a long and busy day of caregiving.

Discomfort (caused by thirst, hunger, pain), depression or boredom could all make the symptoms worse.

Coping strategies for dealing with sundowning behaviour

* First and foremost seek help…

In exactly the same way that airlines instruct those looking after others to put on their own oxygen mask before attending to others, carers need to look after their own needs first. If you are emotionally drained and physically exhausted, you won’t be in the best position to stay calm and collected under pressure.

All carers need help, either from other family members or a home care provider to give you a little respite. Take a nap if possible during the day, and try to keep in touch with friends and/or a support group to keep your spirits up.

* Talk to your doctor.

It is important to rule out physical ailments (such as urinary tract infections, sleep apnea, incontinence etc) that could be contributing to sleep problems, and then discuss possible ways forward to help your loved one.

*Try to work out the particular triggers that prompt the agitation and confusion, and attempt to alleviate them.

Ways to help

Here are our some tried and tested coping strategies that can really help…

Alzheimers Research UK have developed a virtual reality app that helps you experience the world through the eyes of someone living with dementia.

A Walk through Dementia​

A Walk Through Dementia is an Android-exclusive app which gives users a 360-degree video experience that shows how simple tasks can become extremely complex for people suffering from the disease.

Featuring 3 everyday situations - At the Supermarket, On the Road, and At Home - the app aims to demonstrate how dementia goes beyond simply forgetting things, but compromises your senses and thereby affects your perception of the world around you.

Narrated by Olivier Award-winning actress Dame Harriet Walter, the 5 star rated app is free to download from the Google Play Store. It is available as a video version which you can view on your phone or tablet, or by purchasing a cardboard headset, you can experience the film in full virtual reality.

Watch the launch clip for the app here.

Trina Armstrong, who is living with posterior cortical atrophy, a form of Alzheimer’s disease, and advised on the project, said:

“Anyone living with dementia will experience it uniquely, but I hope A Walk Through Dementia will provide people with an idea of what the world is like for me. Everyday things like popping to the supermarket or making a cup of tea are things I used to take for granted, but dementia presents a real barrier to my everyday life in ways that people often don’t realise.

It’s been empowering for me to feed some of my symptoms and experiences into the app and see them re-created. I hope it will encourage the public to think differently about dementia and the people living with the condition they might meet.”

SCIENTISTS are urgently seeking people to take part in dementia research amid a surge in studies into the disease.

The number of drug trials to treat Alzheimer’s disease has almost doubled worldwide since 2013 with 19 studies on potential treatments currently underway in the UK alone, putting pressure on scientists to recruit enough suitable participants to help develop new therapies.

Changes in the brain in diseases like Alzheimer’s can start many years before symptoms show, so studying people with mild memory problems gives researchers the best chance of understanding how dementia develops and finding ways to stop it.

There have been no new drugs to treat dementia in over a decade however.

Wendy Mitchell, who has young onset dementia, is among the volunteers.

She said: “There currently is no cure and without willing volunteers to try out new drugs there will continue to be no cure. Taking part in research is my way of feeling useful again and contributing to finding that elusive treatment which in turn will create a better world for my children.”