That the fall of the day causes you a little feeling of ephemeral blues, that is common. But in some people, this period of the day arouses special anxiety called vesperal anxiety,, twilightOr sundowning in English. And can create real agitation that is necessary to take care of
Definition: What is vesperal anxiety?
Under this little known name hides a phenomenon of anxiety, confusion or even anxiety, which tends to worsen at the end of the day when the day falls. Vesperal anxiety generally occurs at the end of the afternoon or evening, with maximum intensity at the time of twilight (we also speak of “twilight syndrome). Far from being trivial, this syndrome is frequently observed in the elderly, and more particularly patients with neurodegenerative diseases like Alzheimer’s disease, which plunges them into deep confusion.
“It is estimated that two thirds of the people affected by this syndrome have Alzheimer’s disease or other forms of dementia, namely disorders that affect organic clock and amplify disorientation and agitation at the end of the day”, Indicates Léa Futeral, neuropsychologist in Paris, in Health Magazine.
Finally, they are not the only ones who can feel this state: residents of retirement homes or hospitals, even in good mental health, are also more likely to experience this anxiety, in the absence of a stable routine. Finally, young people, suffering from neurological or psychiatric disorders can be subject to Sundowning.
How to recognize this anxiety in a loved one?
Vesperal anxiety then results in various notable behaviors:
- Aggressive behavior;
- Anxiety;
- Confusion, on names, oversights;
- Difficulties in performing tasks that the person did easily earlier in the day;
- The occurrence of delusional ideas;
- Physical agitation (the person starts to walk back and forth);
- Impulsive reactions;
- Difficulty understanding others;
- Difficulties falling asleep in the evening.
In people with a more severe decline, this can also result in runaway. The time for these troubles is also important, since as its name suggests, this change occurs when twilight appears. It is a good way of knowing if the person faces this type of anxiety.
Why does this anxiety intervene in the evening, apparently for no reason?
If the exact mechanism of the syndrome is not yet well detailed, several factors are now advanced.
- A disruption of the circadian rhythm in the elderly;
- Social isolation, with a lack of human interactions during the day;
- The fatigue accumulated during the day, whether physical or mental, can amplify symptoms;
- The drop in brightness at nightfall can also disrupt orientation and worsen anxiety;
- Unusual stimulations at bedtime such as light screens, and shadows that can frighten;
- The lack of activities in the afternoon compared to the morning can lead to bustle at the end of the day;
- Taking certain drug treatments is finally likely to alter biological rhythms.
How to soothe a person with Sundowning?
Fortunately, there are ways to appease a person affected by vesperal anxiety, especially if it is a person affected by Alzheimer’s disease.
Minimize triggers
The first thing to do is already to observe and minimize triggers. See what causes an anxiety to the person, is it when it has caffeine too late, a meal too sweet, or when it receives visits at the end of the day? Or after taking a medication? In this case, do the necessary to change routine (with the doctor’s agreement if it is a question of treatment)
Structure your day, and limit naps
By organizing more physical activities earlier during the day, cognitive stimulation will also be more suitable in the morning or early afternoon (after a short nap).
It may also be necessary to reduce naps when they seem too long and prevent the person from finding sleep in the evening. Finally also reduce stressful activities at the end of the day.
“”Giving a rhythm to your loved one may be difficult at the beginning, but in the medium term, it will make him feel good and it will allow you to sleep at night rather than watching his actions “, INdiques France Alzheimer.
Respect a regular daily routine
Whether children or the elderly, routines soothe agitated people, finding a form of safety in their habits. If you find the right formula, try to keep them as well as possible (meal time, activities and relaxation phase in preparation for the night …). We feel safe in our habits.
Turn out his attention
Try to divert attention from disturbing thoughts and anxieties by redirecting it to activities, food, animals or people can also work. In this case, evoking memories is often of good help.
Enjoy the parts sufficiently
When the pieces become dark, a person with dementia can easily be anxious, in front of unknown shadows. Sensations of fatigue and depression can also appear. The brightness will allow the person to realize that the day is not over, and that it can still have activities.
To read: The influence of light on our biological clock
Play on relaxation
Finally try to appease the person with soft and relaxing activities to cross this end of the day. Music, soft lyrics, contact, meditation, even a massage can calm the person.
If the symptoms are severe and persistent despite non -pharmacological measures, it may also be necessary to consult a doctor to consider drug treatment. But he should not bring the person to sleep more during the day, at the risk of accentuating this anxiety.