Caring for seniors with dementia might get a little easier with light therapy for sundowners.
"Sundowners," a term often used to describe aggression, agitation, changed mood, confusion, and other symptoms in folks with dementia around twilight or nighttime, is very common, according to this article in Psychiatry Investigations. Multiple medical journals, dating as far back as 1941, have attempted to address this problem and provide solutions for it. As of now, the science is somewhat unclear about what sundowners is and how to treat it. Symptoms, times, and triggers can vary. It may be that folks with dementia require tailored treatments based on their various needs in order to improve the symptoms of sundowners.
However, light therapy for sundowners shows major promise for seniors with dementia. The
timing and amount of light therapy varies across studies, but it's clear that light therapy for
sundowners is positively associated with better sleep, less restlessness, and fewer sundowner episodes. If you or a loved one experience sundowners, or if you work professionally with folks who have dementia, you should consider adding light therapy to your caregiving routine.
Light therapy for sundowners consists of simple exposure to light during particular times of the day. This is not a ten-minute sit on the porch on a sunny day; this is intentional, prolonged exposure to (often very bright) light. Light therapy is used in many ways; folks in particularly cloudy or dark parts of the world, for example, often use light therapy to stave off seasonal depression which can result from a lack of sunlight.
Light therapy for sundowners does not "cure" dementia or its progression. However, it can
alleviate some reasons folks with dementia experience agitation, aggression, or restlessness before, during, and after sunset. By exposing someone to bright light for up to a few hours, you can help their body adjust to other changes related to dementia. This could mean better sleep, improved mood, decreased aggression or agitation, and, in general, a healthier, happier life.
Light therapy for sundowners is not for everyone and may work better for certain types of
dementia sufferers. Folks with impaired vision, for example, seem to respond better to light
therapy because it helps the body regulate what are called circadian rhythms--the rhythms
which govern our bodies' natural sleep and behavior cycles. Losing vision and seeing increased shadows, coupled with decreased light, can confuse those rhythms. That confusion can cause restlessness and agitation as the body struggles to adjust.
Other folks on multiple medications, or with difficulty using certain medications, might find
non-invasive treatments like light therapy more accessible and less risky. Light therapy for
sundowners has multiple benefits and can be done at home. This makes it ideal for folks aging-in-place or in early stages of dementia, though it can be used for anyone at any place or stage.
Light therapy also works well in conjunction with other treatment plans, such as natural sleep aids. Some studies have suggested a positive relationship with melatonin, for example, which our bodies produce naturally to get us to sleep. Doctors also suggest keeping folks with dementia active during the daytime, developing routines that keep them from becoming otherwise restless or bored. Activities during the day help stimulate the body's natural rhythms, which help support healthier routines as the day turns into night.
Before introducing any new kinds of treatments, consult your or your loved one's doctor. Once you develop a plan, you can introduce light therapy into the caregiving routine. Full-spectrum fluorescent lamps of the type used in some studies are available online for only a
few dollars--they are sometimes found in aquariums, for example, for under $10. You can also replace other bulbs with fluorescent bulbs like this one for about $4 each. You can expose yourself or a loved one to light for a few hours in the morning or adjust lights throughout the day to match or improve lights from outside.
You do not need to shine these lights directly into anyone's eyes--in fact, that could damage vision. Studies showed that placing lights near folks with dementia--a few yards away, where their eyes can absorb the light but won't be harmed by it--can improve some symptoms.
The most important aspect of light therapy is the routine. Using light therapy for sundowners once will not make any drastic changes. It will also not reverse dementia progression, though it may improve some symptoms, given its other health benefits like better sleep and less confusion. However, using light therapy for sundowners routinely and as instructed by a doctor may help support other routines and caregiving plans.
Khachiyants, Nina, et al. "Sundown Syndrome in Persons with Dementia: an Update." Psychiatry Investigation, Korean Neuropsychiatric Association, Dec. 2011,
PhD, Catharine Paddock. "Alzheimer's: How Light Therapy Could Protect the Brain." Medical News Today, MediLexicon International, 7 May 2019,
"Shining a Light on Sundowning;" Gazette, 12 Dec. 2018, www.post-gazette.com/news/aging-edge/2018/12/12/Shining-a-light-on-sundowning/stories/201812120144.