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WHEN DAY IS NIGHT AND NIGHT IS DAY: A Conversation about Sundowner's Syndrome

Updated: Jun 30, 2022

Beth Innis, DVM


Sundowner’s Syndrome is observed in some Alzheimer’s patients.  Symptoms such as restlessness, anxiety and confusion occur and are often in the late afternoon and evening.  I have observed many of our elderly patients struggle with something similar.

This can manifest as pacing, vocalizing, the inability to settle down and trouble getting to sleep.  It can be heartbreaking and exhausting to witness and manage.  

There are some tricks I’ve collected over the years from people who work with this population in humans and from my creative clients who have ceaselessly looked for good solutions.

I have listed some of these tricks below:

1.  Keep things as routine and predictable as possible (meals, outdoor time, waking time and bed time at the same times each day).

2.  During the daylight hours, keep your pet as active as possible to encourage lots of awake and alert time.

3.  Take a brisk walk (or if your pet is mobility challenged, just some fresh air time outside) when the restless hour strikes (this can help tire him or her out, and also be distracting which can sometimes help).

4.  Do some soothing bedtime routines in the same places (dim lighting, soft voices and gentle body rubs are often appreciated).

5.  Try a thunder shirt, a tight fitting shirt or sweater (for those who do not run hot).

6.  Have some lavender diffusers around the sleeping area.  

7.  Try a nightlight for those who are visually impaired.  (If this doesn’t work, try total darkness!  Sometimes one or the other works best.  )

8.  Supplements such as melatonin (a sleep and wake cycle regulating hormone), Rescue Remedy (a homeopathic Bach Flower Remedy that aids in stress) and Composure (a colostrum based supplement that reduces anxiety) can be helpful.  Ask your veterinarian before starting one, but do ask!

Above all, remember, this is a tough situation for you both to be in, so be gentle on your pet and be gentle on you - everyone needs their sleep.  If you feel frustrated, ask another family member or friend to pitch in every once in a while, so you can get some rest and recoup.  If it is wearing your pet and you out and none of the above helps, it may be something that medication may assist, ask your veterinarian for help and let them know the things you have tried already.

Wishing you all a pleasant sleep tonight!  


Dr. Beth

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