During sundowning, these individuals may have more anxiety, agitation, confusion, and sleeping problems.
This article discusses what you should know about sundowning, including contributing medications, triggers, and treatment options.
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What Is Sundowning?
Getty Images /Bloomberg/ Contributor
Sundowningisn’t a disease.
Can Medications Worsen Sundowning and Dementia?
Some medications may contribute to sundowning by interrupting the sleep-wake cycle and interfering with behavior regulation.
Certain medications may worsen these issues.
They generally work by blocking the activity of a naturally occurring chemical in the body calledacetylcholine.
As a result, anticholinergics can trigger sundowning symptoms, like agitation, as a side effect.
Examples of anticholinergic drugs include:
This isn’t a complete list of anticholinergic medications.
If you’re unsure whether your medication is an anticholinergic drug, talk to a healthcare provider or pharmacist.
Older adults experience changes to a part of the brain connected to sleep-wake cycle medical conditions.
Benzodiazepine examples includeXanax (alprazolam)and midazolam.
This isn’t a complete list of benzodiazepines.
If you’re unsure whether your medication is a benzodiazepine, talk to a healthcare provider or pharmacist.
Other Factors That Trigger Sundowning
Aside from medications, other factors may trigger sundowning.
Medications and Supplements for Sundowning
There are treatment options for sundowning.
These levels are lower in older adults and people with certain conditions like Alzheimer’s disease.
This is the logic behindmelatoninsupplementation in people who have a disrupted sleep-wake cycle.
However, more high-quality clinical trials to confirm this are necessary.
Cholinesterase Inhibitors
Brain cells transfer information to each other using several naturally occurring chemicals, including acetylcholine.
In fact, cholinesterase inhibitors that block acetylcholine breakdown showed fewer behavioral issues in people with dementia.
One example of a cholinesterase inhibitor is Aricept (donepezil).
Antipsychotic medications are often taken for sundowning.
Hypnotics
Hypnotic (sleep-inducing) medications may include benzodiazepines, such as Ativan (lorazepam).
Though these medications have been taken for sundowning, little data supports this use.
Though it sounds contradictory, these medications may also exacerbate behavioral issues.
Examples may include aurinary tract infection (UTI),restless leg syndrome, andsleep apnea.
Summary
Sundowning isn’t a medical condition.
Though the exact cause of sundowning isn’t clear, an interplay of multiple factors may trigger it.
For example, certain medications may worsen sundowning.
Other than identifying and removing triggers, there are nondrug ways to help prevent and manage sundowning.
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