Sundowning may become one of the most problematic symptoms for people with dementia. Symptoms such as increased confusion, anxiety, wandering, and agitation can become apparent towards the end of the day, making caregiving more difficult.
Though medication cannot induce dementia-related sundowning by itself, some medications are capable of intensifying symptoms, causing confusion, poor sleep, and agitation. Recognizing these medications is very crucial when dealing with sundowning at home
Can Medications Cause Sundowning?
While there is not one specific drug that causes sundowning, certain medicines may aggravate sundowning behaviour due to their effects on sleeping, confusion, or brain chemistry in older adults who have been diagnosed with dementia. A medication assessment might be advised if sundowning begins or gets significantly worse.
Medications That May Worsen Sundowning
Medications that could lead to increased confusion in the evenings include:
- Anticholinergic medications, including allergy medications, sleep aids, urinary medications, and muscle relaxants
- Benzodiazepines such as lorazepam (Ativan), alprazolam (Xanax), and diazepam (Valium) since they can increase confusion and risk of falling in older adults
- Over-the-counter sleep medications containing diphenhydramine (Benadryl), which have strong anticholinergic effects
- Certain sedatives or sleeping pills, which may disrupt normal sleep-wake cycles in some individuals
Do not change or discontinue any medications without first consulting with your doctor.
What Is the Best Medication for Sundowning?
Families often seek out the appropriate medication to alleviate sundowner’s syndrome, but the answer is not always straightforward.
Currently, there is no medication available on the market that is specifically approved to treat sundowning. The first approach to managing sundowning involves considering any possible causes of the condition like infections, constipation, medication side effects, or lack of adequate sleep.
In some cases, depending on the symptoms presented, the doctor may prescribe medication for the management of insomnia, depression, psychosis, or extreme agitation.
What Helps Sundowning Without Medication?
A lot of individuals benefit from concentrating on their routine and their surroundings. These may include:
- Maintaining a consistent routine every day
- Spending more time in natural sunlight
- Being active during the daytime
- Taking short naps during the day
- Avoiding over-stimulation during the evening
- Making sure rooms are well-lit as it becomes darker
- Going over their medications with a medical professional if symptoms become worse suddenly
When to Speak With a Healthcare Provider
Consult a healthcare professional if:
- There is a sudden worsening of sundowning symptoms
- New confusion develops without an apparent reason
- The individual becomes unsafe because of wandering or aggressive behaviour
- You think that some medication could be triggering symptoms
In some cases, an underlying illness such as a urinary tract infection or dehydration can be the reason for increased confusion rather than the development of dementia.
Need Support Caring for Someone With Dementia?
Dealing with sundowning can be challenging for family caregivers, but you do not have to go through this process on your own.
Learn more in our Dementia Guide , or Contact us today to learn more about how we can assist you and your loved one with individualized care.