Sundowning: Difference between revisions
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Sundowning or '''sundown syndrome''',<sup>[1]</sup> is a neurological phenomenon associated with increased confusion and restlessness in patients with delirium or some form of dementia. Most commonly associated with Alzheimer's disease, but also found in those with other forms of dementia, the term "sundowning" was coined due to the timing of the patient's confusion. It's also known as “late-day confusion". The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. It can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Also, it can lead to pacing or wandering. For patients with sundowning syndrome, a multitude of behavioral problems begin to occur in the evening or while the sun is setting.<sup>[2][3]</sup>[4 | Sundowning or '''sundown syndrome''',<sup>[1]</sup> is a neurological phenomenon associated with increased confusion and restlessness in patients with delirium or some form of dementia. Most commonly associated with Alzheimer's disease, but also found in those with other forms of dementia, the term "sundowning" was coined due to the timing of the patient's confusion. It's also known as “late-day confusion". The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. It can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Also, it can lead to pacing or wandering. For patients with sundowning syndrome, a multitude of behavioral problems begin to occur in the evening or while the sun is setting.<sup>[2][3]</sup>[4 | ||
== | == Causes of sundowning == | ||
The specific causes of sundowning have not been empirically proven, some evidence suggests that circadian rhythm disruption increases sundowning behaviors. In humans, sunset triggers a biochemical cascade that involves a reduction of dopamine levels and a shift towards melatonin production as the body prepares for sleep. In individuals with dementia, melatonin production may be decreased,<sup>[7]</sup> which may interrupt other neurotransmitter systems. It is thought that with the development of plaques and tangles associated with Alzheimer's disease there might be a disruption within the suprachiasmatic nucleus (SCN).<sup>[4]</sup> The suprachiasmatic nucleus is associated with regulating sleep patterns by maintaining circadian rhythms, which are strongly associated with external light and dark cues. A disruption within the suprachiasmatic nucleus would seem to be an area that could cause the types of confusion that are seen in sundowning. However, finding evidence for this is difficult, as an autopsy is needed to definitively diagnose Alzheimer's in a patient. Once an Alzheimer's patient has died, they have usually surpassed the level of dementia and brain damage that would be associated with sundowning. This hypothesis is, however, supported by the effectiveness of melatonin, a natural hormone, to decrease behavioral symptoms associated with sundowning. | |||
Other possible causes of sundowning include: being overly tired, unmet needs such as hunger or thirst, depression, pain, boredom | |||
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Revision as of 10:37, 11 May 2019
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Introduction[edit | edit source]
Sundowning or sundown syndrome,[1] is a neurological phenomenon associated with increased confusion and restlessness in patients with delirium or some form of dementia. Most commonly associated with Alzheimer's disease, but also found in those with other forms of dementia, the term "sundowning" was coined due to the timing of the patient's confusion. It's also known as “late-day confusion". The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. It can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Also, it can lead to pacing or wandering. For patients with sundowning syndrome, a multitude of behavioral problems begin to occur in the evening or while the sun is setting.[2][3][4
Causes of sundowning[edit | edit source]
The specific causes of sundowning have not been empirically proven, some evidence suggests that circadian rhythm disruption increases sundowning behaviors. In humans, sunset triggers a biochemical cascade that involves a reduction of dopamine levels and a shift towards melatonin production as the body prepares for sleep. In individuals with dementia, melatonin production may be decreased,[7] which may interrupt other neurotransmitter systems. It is thought that with the development of plaques and tangles associated with Alzheimer's disease there might be a disruption within the suprachiasmatic nucleus (SCN).[4] The suprachiasmatic nucleus is associated with regulating sleep patterns by maintaining circadian rhythms, which are strongly associated with external light and dark cues. A disruption within the suprachiasmatic nucleus would seem to be an area that could cause the types of confusion that are seen in sundowning. However, finding evidence for this is difficult, as an autopsy is needed to definitively diagnose Alzheimer's in a patient. Once an Alzheimer's patient has died, they have usually surpassed the level of dementia and brain damage that would be associated with sundowning. This hypothesis is, however, supported by the effectiveness of melatonin, a natural hormone, to decrease behavioral symptoms associated with sundowning.
Other possible causes of sundowning include: being overly tired, unmet needs such as hunger or thirst, depression, pain, boredom
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