"Why You Feel Worse in the Evenings — And How to Beat Sundowning Naturally."

(Flute intro and outro by Janna herself)

Janna: Hey, this is Janna and Alzheimer's ThriverTM, and I want to share with you today the phenomenon that a lot of us feel that is called sundowning. First of all, my hubby is going to give us a definition of sundowning, something which is not my favourite thing and not necessarily what you think it's going to be. Here he goes.

Larry: Sure. Well, sundowning is a symptom of Alzheimer's and other dementias where confusion, agitation, restlessness, worsened in the late afternoon and evening. Depression.

Patients may become more anxious, aggressive, or have trouble sleeping or like Janice's, be depressed. You can get disoriented and maybe feel a little drunk. Your brain is kind of shutting down a bit.

And even walk a little bit like you're drunk sometimes. Yeah. So it's thought to be linked to changes in the brain, exhaustion, and disruptions in your body's internal clock.

So go ahead and talk about it.

Janna: Well, first of all, although I have no condemnation against people that do drink, but I don't drink, but you think so sometimes to see me going around and kind of not being able to be stable, not being to be in the moment, being in another land, what to do to alleviate that. That's what we're after.

Larry: So during that time, don't you take, sometimes you take a nap, right? It could be 10 a.m. I mean, it doesn't have to be the afternoon, right?

Janna: Naps are my jam.

Larry: (Jokingly) And I have to say sometimes I'll take a nap with you because it feels so good.

Janna: You're so nice to support me in that way.( Laughs)

Larry: Yeah. Just to make me feel better. (Then Larry asks): How have you dealt with that?

Janna: Well, first of all, I have to reflect and think my Jesus has got me. I'm gonna be okay. I'm not being condemned. It's just what's happening. It's not like I try to take control of it, of course. I think everybody would. You don't want to feel bad. You want to feel good, but I find I just can't turn it around and make it happen. So I have to dissuade myself from being oh so worthless, oh so depressed and unable. So a lot of us just go ahead and go, well, I'm gonna break up this day and take a little nap for a few minutes. It helps a lot oftentimes. 

Larry: Well, Jan, you've always been a real go-getter ...someone that always is working hard.

And so when you first started sundowning, you were fighting it. So how did you get over that?

Janna: Yeah, it's like, what's wrong with me? How could this be happening? Well, first of all, acknowledge it and realize that dog on it, here I am and I don't know why, but my brain's not working so well right now. Maybe I need something and maybe it is to close my eyes for a couple minutes and get some energy. And lo and behold, isn't that what they say we should do?

Larry: Yeah, so when you heard actually from the doctor that he needed more sleep. 

Janna: I celebrated.

Larry: You just went for it.

Janna: So I'm thinking we should have a little talk about circadian rhythms and what? What in heck is that? It's your body's built-in clock that helps you to stay awake during the day and sleepy at night. With Alzheimer's, I'm told it leads to sleep disturbances, confusions, and changes in energy level. So to that end, I decided I'm going to start monitoring myself. When did I get up? How long have I been up? When did I start feeling droopy? Clock it. So by keeping track of how I feel and what time it is when I start to droop, I'll be able to strike a balance and feel like I understand what's going on in my body and I can make choices of whether it's time to take a nap or not. So that I can have a little bit of organized control, anticipating when is the time to rest and when is the time to be ...well, just out there.

If I begin the day looking ahead and thinking, okay, when am I going to have this activity, when am I going to have that? And when's the best time for me to show up for my best performance, which means I'm awake, I know who I am, I'm on the ball. We'll half way on the ball anyway. And anticipate it that way. Set up my appointments in that way. Advocate for myself in that way. It occurs to me that many of the times that people get together for social activities are, hey, let's have lunch. Hey, let's have lunch. And that sounds great to me until when I get there. It's like, oh, lunch that time that middle of the day. That's droopy, droopy time of day. I feel really droopy and heavy. And I can't think clearly.

Larry: I guess we just have to be mindful of the 20 to 30 minutes part, because you know, you could take a two hour nap or a three hour nap. That's really going to throw you off. So we need to get plenty of daylight exposure. I guess that helps regulate the clock, too.

The key would be to find a rhythm that helps you feel your best. Sometimes during the sundown you forget all the accomplishments that you've been able to do. And you forget what a great person you are and how your family loves you. And all of that gets pushed aside. And you just sort of are disoriented. So I really think sleeping is the answer, right? 

Janna: Everybody should do it.

Larry: Yeah. And you come back a little bit more invigorated.

Janna: Yeah. Able to get a smile.

Larry: Accepting it. And acceptance is a big thing here. There are certain things that you've had to accept.

Janna: The thing is, I feel like that everything I accept, I should believe. But I don't believe these things. I don't believe it when I am not thinking very well. But it's all right. Just let go of it. Just let go of it and let it be.

Larry: In some other episodes we're going to talk about the disciplines that you have, right? And so things that you've found have helped your brain to change the things you can change.

Janna: And you can do self-talk, too. Everybody doesn't have to get it. Even your husband or your spouse or your loved ones might not get what you're going through at any time. But they don't have to. I mean, they're not able to, let's be honest ...It's not them. But I can go ahead and own my feelings for myself and try to make the best of it, paint on a little bit of a smile for myself, see if I can get my feelings back going on the positive and do the tricks that help me. And if nothing works ...all right, let's do sundowning. Put the head down. Let's do it.

Larry: You've got so many epiphanies and we've just got to get them all down here on the podcast and I hope the people are going to get something encouraging out of it.

Janna: Yeah. And now that you know a little bit more about people did have Alzheimer's, maybe you'll have more empathy, not that you're being critical of people. I don't mean that, but you'll have a feeling for and an empathy for what's going on with the person with the Alzheimer's position.

Larry: I mean, a good example of that is when you went into a store and for the longest time, you know, you couldn't pick out an item in a field of items.

Janna: Right. Like go get the...

Larry: ...mustard.

Janna: Right. And yeah, of course I can go do that. But I'm walking back and forth and around and go and start sweating up and feel like ,why I can't even find this thing.

Larry: And so that's something that that happens to a lot of Alzheimer's people. Can't find things in a field. It's right in front of them. There's other objects. So finding that object is...

Janna: And then maybe something later on that we'll talk about is what about the getting lost because it happens.

Larry: There's so many things we can talk about and you've improved in so many areas.

Janna: (Embarrassed with compliments): Don't tell me. Don't... 

(Janna Pauses to say): This is Janna, an Alzheimer's ThriverTM, and you've been hearing this from the horse’s mouth, signing off until next time.

(Janna Playing Flute)

Here are a few website Links to studies related to Sundowning and the Alzheimer’s Thriver need for more sleep as time goes on:

Alzheimer's Society:

https://www.alzheimers.org.uk/blog/is-it-typical-people-dementia-sleep-lot-during-day

Boston University: 

https://www.bu.edu/alzresearch/files/pdf/VolicerSundowningandAD20012.pdf

ScienceDaily: 

(https://www.sciencedaily.com/releases/2023/07/230728113414.htm)