Although not always associated with dementia, the mental condition can cause severe disruptions in circadian rhythms and sleep patterns, leading to chronic exhaustion and bouts of confusion based on transitions from day to night.

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How Circadian Rhythms Are Affected

The buildup of the protein-comprised plaque that is associated with Alzheimer's disease and other forms of dementia is thought to cause a disruption in the suprachiasmatic nucleus in the brain.

The suprachiasmatic nucleus is known for its association with maintaining regular sleep patterns via circadian rhythms, though this is mostly based on the presence of light or dark sensory cues. It is difficult to empirically prove that the plaque buildup has an effect on the way circadian rhythms work in dementia patients, mostly because an autopsy is necessary to investigate the presence in the brain. Once a patient has died, they have usually surpassed the stage in which circadian rhythms are affected.

Since a patient is typically in the middle stages of a degenerative brain disease, he or she is usually aware that his or her sleeping habits have become abnormal.

Sundowning And Sleep Disorders

Sundowning is a common psychological symptom of dementia, most commonly Alzheimer's disease, which typically develops as a new symptom in the middle stages of the condition. It is a form of confusion, generally manifesting when natural sunlight begins to fade and more shadows appear. Patients will also become frustrated with their confusion, which may result in mood swings and heightened irritability, especially with a caregiver.

Patients also often experience restlessness, especially at night, when their circadian rhythms are impaired. Patients, when trying to sleep, may find themselves experiencing a restless kind of insomnia, and may pace or wander outside of their quarters, increasing the likelihood of injury.

Treatments Available

Fortunately, there are many treatments available for this symptom of Alzheimer's disease and other forms of dementia, some of which are experimental. The first step is always trying to maintain a consistent and healthy sleep schedule, one that is comfortable for the patient and provides adequate sleep. Increasing daily activity is also beneficial in aiding a healthy sleep cycle.

Light therapy is one method of intervention, backed by recent scientific evidence, designed to restore normalcy to a patient's circadian rhythms. The practice involves using artificial bright light at certain times and in specific environments, to promote a natural restoration of patients' biological sense of time. While light therapy has not been shown to eliminate sundowning altogether, it has been shown to improve the regularity of sleep schedules, heighten daily activity and reduce both restlessness and confusion.

Melatonin therapy is another option available. It involves the administration of melatonin (a hormone that influences circadian rhythms) in patients, which has shown to be effective in aiding restful and regular sleep.

For patients suffering from dementia, sleep deprivation is a real threat. The disruption of circadian rhythms not only causes insomnia, but can cause panicked confusion through sundowning and dangerous wandering at night.

Fortunately, schedule regularity, light therapy and melatonin administration exist as effective forms of reducing the severity of these symptoms.

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