Some Alzheimer’s patients experience agitation, restlessness and confusion at evening and overnight. Know why it happens and what we can do will help us to give better care.
Late afternoon and near the end of the day; it is time to rest and go preparing to sleep, but for some people with Alzheimer totally opposite mood, characterized starts confusion, behavioral disorder and turmoil . It is the evening syndrome, also known as crepuscular or syndrome sundowning. We tell you what this phenomenon, how to recognize it and what to do.
What is the evening syndrome?
This disorder is defined as a period of extreme agitation and irritation that begins during the afternoon, producing both the beginning and in his last hours, and then continues at night. According to the Alzheimer’s Association in Chicago, several studies indicate that the evening syndrome affects up to 20% of Alzheimer’s patients, usually arises in the intermediate stage of the disease, and everything suggests that the main cause is dysfunction circadian rhythm, the kind of internal clock that controls sleep-wake cycles.
Circadian rhythms are regulated by the suprachiasmatic nucleus and melatonin. Alzheimer’s disease damages the brain area and also decreases the production of sleep -related hormone altering the biological clock and causing confusion between the time of sleeping and waking.
The Twilight syndrome is also due to other factors such as environmental changes, mental and physical fatigue, lighting or generating some diseases in the elderly discomfort and pain.
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What are your symptoms?
As mentioned, confusion and agitation are the representative symptoms of this disorder and can be displayed in various ways. These are some of the most common:
- Throwing objects compulsively.
- Grabbing or try to break his clothes.
- Deambulatorias behavior.
- Try to hurt.
- Cries or musitaciones (targeting other or in monologue).
- A high activity night and sleep during the day.
At dusk some people with Alzheimer believe it is time to go home after work or class, which can lead to the start of the demonstrations mentioned.
How to treat the syndrome evening
Measures to address the sundowning address several aspects, from environmental to nutritional, through medical and pharmacological. The experts dementia them into account both care centers and at home, and their application can lead to a reduction of behavioral problems, as well as a way to better cope for the rest of family.
Tips for day to day:
- Exposing the patient to natural sunlight (or artificial if not possible) in the early hours of the morning to regulate the biological clock and light enough stay overnight, if necessary, to give you peace of mind.
- Reduce ambient noise and try if you calm relaxing music.
- Convey tranquility, he speaks calmly and loving.
- Keep the person with Alzheimer sleep during the day, keeping busy with simple activities. Exercise will also help you rest better at night.
- Completely eliminate caffeine and follow a healthy diet, reducing the consumption of sweets. Avoid heavy dinners, better take a light snack mid – afternoon.
- Set fixed times to eat, take medicines, activities, etc. Create routines.
- During the night, not subjecting the patient to physical restraints, causing further turmoil, avoid unjustified of psychotropic drugs, which can have unwanted side effects or generate interactions with other treatments use, and accompany him on his evening walks to ensure their safety.
- If the elder is in a nursing home, take objects that are familiar and comforting. As far as possible try to avoid frequent changes of environment and atmosphere.
- The walks outdoors with caregivers or family members have positive effects on Alzheimer’s patients, resulting in a better rest.
In addition to implementing these recommendations, the help of a specialist will determine the necessary medical and pharmacological treatments and nutritional guidelines to follow.