From the Research
The best treatment for sundowning syndrome involves a combination of non-pharmacological and, if necessary, pharmacological approaches, with a focus on creating a structured routine and environmental modifications to reduce symptoms, as recommended by the most recent study 1. The treatment of sundowning syndrome should prioritize non-pharmacological interventions, including:
- Creating a structured routine with consistent sleep-wake times
- Ensuring adequate exposure to bright light during the day
- Maintaining a calm, well-lit environment in the evening
- Physical activity during the day
- Limiting caffeine and alcohol
- Establishing a relaxing bedtime routine These strategies can significantly reduce symptoms of sundowning syndrome, which occurs due to disruptions in the body's circadian rhythm, neurological changes in dementia, and environmental factors that increase confusion as daylight fades, as discussed in 1 and supported by earlier studies 2, 3. If non-drug approaches are insufficient, medications may be considered, including low-dose antipsychotics like risperidone (0.25-0.5mg) or quetiapine (25-50mg), though these should be used cautiously due to side effect risks, as noted in 1. Melatonin (1-5mg) taken 1-2 hours before bedtime may also help regulate sleep cycles. It is essential to address the underlying factors contributing to sundowning syndrome through consistent routines and environmental modifications, which often provides the most effective and safest management approach, as emphasized in 1.