How does the end of daylight saving time affect dementia patients?

The end of daylight saving time brings an abrupt shift in the evenings – think darkness before dinnertime. For those living with dementia, that can create serious disruptions.

People with Alzheimer’s and other forms of dementia often suffer from what is called “sundowning” – an increase in disorientation beginning in late afternoon. This condition happens year-round and can express itself as anxiety, paranoia, restlessness, insomnia or hallucinations. But, as the clocks shift back, there’s a wider window of time each day for these symptoms to emerge.

Causes of sundowning

Sundowning isn’t a separate disease; it’s a term used to describe a set of symptoms or behaviors that dementia patients exhibit. About 20% of the more than 6 million people in the United States with Alzheimer’s will experience it at some point.

It’s unlikely that sundowning would be the first sign of dementia that you’d notice in a loved one – it generally is present in people who have at least moderate symptoms already.

It doesn’t have a known cause, but several factors can trigger it:

• Reduced visual sensory inputs due to darkness and shadows
• Mental or physical exhaustion
• Lack of sleep
• Side effects of medications
• Overstimulation

Can the end of daylight saving time trigger sundowning?

The additional dark hours in the evening do increase the risk of sundowning symptoms emerging. This can provide challenges for both patients and caregivers.

Knowing that this risk exists, there are several steps you can take to reduce the likelihood of sundowning triggers and to respond to them when they do emerge.

Tips for caregivers during the daylight saving time transition

The best advice is to keep to a routine. As the clock falls back an hour, consider keeping things like dinner and bedtime the same.

• Get your rest. Dementia patients can become stressed or agitated if you exhibit those behaviors, so it’s important that you’re able to regulate your own emotions.
• Keep the environment well-lit.
• Plan things like appointments and errands early in the day.
• Limit stimulation in the evening hours. Use that time to listen to soothing music or do simple tasks like playing a game with your loved one.
• Avoid physical restraint if the person becomes agitated. This will often exacerbate the problem.
• Consider medications such as antidepressants or anti-anxiety drugs if your healthcare provider deems them appropriate.
• Keep notes on what triggers your loved one and consult with their medical provider about how to respond.

As medical providers, we can often work with you to make a plan that helps lessen the frequency and severity of sundowning symptoms.