Twilight transitions: managing sundowning during Daylight Saving Time

 

As the sun begins to set earlier in the fall and winter months, and the nights become longer, you may notice some changes in your overall mood and energy levels. For those living with memory conditions, like Alzheimer’s disease, this transition can have a more significant impact. Daylight Savings Time (DST) can also be disruptive for individuals living with memory challenges. The change in time can result in feelings of disorientation and confusion, highlighting the importance of taking proactive steps to support the wellbeing of those living with memory challenges and their care partners. In today’s post, we will explore the connection between time changes and memory concerns, offering practical solutions for managing these transitions as the seasons change.

It’s important to understand that the relationship between seasonal shifts and memory concerns is complex. While the changing seasons don’t directly cause memory problems, they can worse certain symptoms associated with memory conditions. Let’s delve deeper into how and why these impacts occur.

What is sundowning?

Sundowning is a state of behaviour patterns, including confusion, agitation, and disturbed sleep, that occurs in people living with memory disorders or other cognitive impairments. It typically occurs later in the day, during the late afternoon or early evening, hence the term “sundowning.” Symptoms can range from mild to severe and may include pacing, wandering, yelling, or exhibiting other challenging behaviours. Sundowning can be especially disruptive for sleep patterns because it often makes calming down or relaxing in the evening a greater challenge for those living with dementia.

While the exact cause of sundowning is not known, health experts believe that it is related to changes in the brain, particularly in areas that control the circadian rhythm (i.e., your internal body clock). Fatigue, sensory overload, hunger, thirst, or the effects of medications can also play a part in sundowning behaviours. Environmental factors, such as low lighting or increase shadows, can contribute to the symptoms. These environmental factors are especially notable when we change our clocks for Daylight Savings Time and for a few weeks following the time change.

Reduced exposure to natural light

As the sun sets, it's a natural signal for our bodies to begin winding down for the day and for us to prepare to sleep. This is because natural light plays a big role in telling our internal clock what time it is. This internal clock is also known as our "circadian rhythm." Think of it as the body's own daily schedule– it helps us know when it's time to be awake and when it's time to rest. As the sun sets earlier due to the change in seasons, and natural light decreases, your internal clock may not be following its usual schedule. This deviation can result in mixed signals, leaving you feeling out of sync until it can recalibrate. For some, this adjustment might take a few days, while others may require closer to a week. For those living with a memory condition, this period of adjustment may take a bit longer. They may experience disruptions in their sleep patterns, heightened feelings of confusion, and disorientation in both their perception of time and awareness of their surroundings.

Disruptions in daily structure and routine

Changes in daylight hours can interfere with the daily routines that many individuals depend on. For example, maybe you are someone who likes to wake up with the sunrise, have a coffee, and get ready to take your dog for a walk. As the weather shifts in the Fall to Winter months, and daylight hours change, you may instead find yourself waking up when it's still dark outside. This interruption to your morning flow may affect the rest of your day and cause you to feel frustrated until you can readjust your routine. For those living with memory concerns, the frustration may come with feelings of fear or disorientation when their familiar patterns are changed.

How can you minimize the side-effects of time changes on sleep and behaviour?

Utilize adequate lighting

  • Make sure your home environment is well-lit during the day, and gradually dim the lights as evening approachs.

  • Maximize natural light during the daytime by opening curtains and blinds. When possible, try to go outside for maximum sun exposure during the day time to maintain a healthy circadian rhythm (natural internal sleep cycle).

  • Use artificial lighting when natural light is limited. Brighter indoor lighting can help regulate the body’s internal clock! There are even indoor lights available that can mimic the natural feel of the sun.

Utilize visual aids

  • Visual cues can be especially helpful for those living memory concerns. Consider using memory aids such as calendars, clocks, and labels to help individuals keep track of time and daily activities.

  • Large, easy-to-read wall calendars with large date squares are helpful. There are also digital clocks available with clear displays that show both the date and time, and whether it's morning, afternoon, evening, or night that can help someone living with memory concerns orient themselves throughout the day.

  • When choosing visual memory aids, it’s important to consider the specific needs and preferences of the person you are helping. What works best may differ between individuals, particularly based on their sensory needs (e.g., if you are helping someone with memory concerns who also has limited vision, memory aids with sound-based cues, like digital alarms, would be more useful).

  • Be patient and flexible when choosing memory aids and adjust as needs change.

Rely on professional help

  • Turning to healthcare professionals for guidance can be an essential tool when managing symptoms related to time changes.

  • Our Cognitive Behavioural Therapy for insomnia (CBT-I) program is specifically aimed at addressing chronic insomnia by our expert, credentialed health care professionals using the latest evidence-based sleep science. This comprehensive 6-week program is designed to help you fall asleep faster, stay asleep, and achieve a more restorative sleep experience so you can wake up refreshed and ready to take on the day.

Previous
Previous

Embracing Alzheimer's Awareness Month: paving the way for early diagnosis and support