Sleep Issues & Sundowning

Sleep issues can be caused by a number of factors. Although the cause of a sleeping disorder may differ, the end result of all sleeping disorders is a disrupted sleep during the night’s resting and sleeping hours. Some factors that can cause sleep issues include:
·         Medical issues such as asthma
·         Physical disturbance such as pain or irritation
·         Psychiatric issues or disorders such as stress or depression and anxiety
·         Environmental issues such as alcohol and stimulant use
Acute or short-term insomnia is a sleeping disorder caused by stress such as job change or loss and death of loved ones, extreme temperatures, environmental factors such as pain, discomfort and chronic stress and illness.
Chronic or long-term insomnia is a sleeping disorder that may last for weeks and months. Such condition is caused by chronic stress, depression and discomfort or pain at night.
Other factors that may cause sleep issues include:
·         Genetics- according to researchers, genetic basis for narcolepsy can affect wakefulness and control of sleep. Narcolepsy is a neurological disorder.
·         Medications- some drugs such as blood pressure medication, antidepressants and over-the-counter cold drugs can interfere with your sleep.
·         Aging- According to statistics, about half of adults older than 65 experience sleep issues. Some parts of aging such as dementia or older people medications may be the major cause of sleeping problems.
·         Night shift work- Working at night has been also seen to cause sleeping issues. This is because people who work at night cannot sleep even if they feel drowsy.
·         Sundowning- This is a late-evening confusion that is mainly experienced by people suffering dementia. Factors that may contribute to sundowning include:

o   Frustration or reaction to non-verbal cues from other people
o   Disorientation caused by inability to differentiate between dreams and reality when asleep
o   Less need to sleep which is a common problem with many older adults.
o   An upset coming from the internal body clock. This may cause biological mix-up between night and day
o   Reduced lighting that may increase shadows making people with dementia afraid and confused
o   Mental and physical exhaustion after the end of the day
Major symptoms of sundowning include:
·         Demanding
·         Agitation
·         Confusion
·         Restlessness
·         Disorientation
·         Suspicion
Dealing with Sleep Issues
Below are 8 coping strategies you can apply to avoid sleeping issues and sundowning:
1.       Make your sleeping environment safe and comfortable
To avoid sleeping disorders you should sleep in a comfortable temperature. You should for example use nightlights and also apply other ways to keep you safe such as good window and door locks. Motion detectors and door sensors can be used to alert you in case someone is wandering.
2.       Keep your home or house well lit in the evening
Proper lighting will help you avoid agitation that may occur due to dark and unfamiliar surroundings.
3.       Be active in the day
According to research, people who rest most of the day are likely to be stuck awake at night. You should therefore do away with afternoon napping and plan for more challenging activities such as trips, doctor appointments and shopping in the morning and early afternoon. You should also engage in regular daily exercise but about 5 hours before you sleep.
4.       Maintain a schedule
If you have dementia and you experience sleep problems, you should adhere to a routine of meals. This will help give you a restful sleep during the night.
5.       Be mindful
You should be mindful of your own mental & physical exhaustion. In case you have stress in the evening, you may pick up on it and become confused and agitated. You should therefore turn your thoughts to sleeping and have a restful night to get more energy for the next day.
6.       Identify what triggers sleep issues
You should try and identify the cause of your sleep issues or sundowning by limiting environmental distractions during sleep hours. Such distractions include loud music, evening chores, children, and TV light.
7.       Avoid big dinners and stimulants
You should always avoid stimulants and big dinners in case you experience sleep problems. You should avoid alcohol and nicotine and adapt to caffeine and sweet beverages in the morning only. You should also have a big lunch and make your dinner simple.
8.       Share your sleep experience with others
You should try and share your experience with friends and family members and at time get connected to communities of other people such as yourself. Here you can share your experiences and strategies that have worked to get rid of sleep issues and as well get more ideas from others.
9.       Natural Remedies
Some natural remedies that can help deal with sleep issues and sundowning include:
·         Warm milk
Milk contains an amino acid known as tryptophan that is responsible in inducing sleep. Warm milk at bedtime can make you comfortable and boost sleep without production of sleep-boosting serotonin.
·         Bedtime snack
Eating foods rich in glycemic index carbohydrates hours before bedtime can help you get a perfect sleep.
·         Herbal Tea
Lemon balm, chamomile, passionflower and hops are beverages believed to have sleep-inducing properties. Although herbal tea is not scientifically proven to induce sleep, many people have tried it with success. Drinking too much at night may also lead to nocturnal trips to the washroom.
The Bottom Line
Sleeping issues and sundowning can make it hard for you to get a perfect and restful sleep. You therefore need to take care of yourself to make sure you get more energy for the next day activities.
To avoid it, you can:
·         Take breaks during the day to get enough rest
·         Ask your loved ones to fill in for you during the night
·         Hire a caregiver
·         Get a daytime nap if you can
You can also take care of yourself by eating healthy, exercising and spending time with friends. Consider also connecting with caregivers.

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