Obviously, there is no conclusive answer to the question of "sundowning;" 
however, there are a number of studies that implicate a decrease in melatonin 
as in the following abstract.  Not great research, but when you have no certain 
answers, I guess you have to start somewhere.

Bob Wildblood


The use of melatonin in Alzheimer's disease.
Cardinali DP, Brusco LI, Liberczuk C, Furio AM.

Departament of Physiology, Faculty of Medicine, University of Buenos 
Aires,Argentina. cardinal at mail.retina.ar

About 45% of Alzheimer's disease (AD) patients have disruptions in their sleep 
and sundowning agitation. Since melatonin secretion is greatly inhibited in AD 
patients we have used melatonin to treat sleep disorders in AD patients since 
1995. In a first study [21] we reported, in 7 out of 10
dementia patients treated with melatonin (3 mg p.o. at bed time), a decreased 
sundowning. In a second study [22] we examined 14 AD patients who received 9 mg 
melatonin daily for 22 to 35 months, observing a significant
improvement of sleep quality with stabilization of behavioral and cognitive 
parameters. In a third study [23] we reported two monozygotic twins with AD and 
similar cognitive impairment, one of them receiving 6 mg melatonin at
bedtime daily for 3 years. Melatonin treatment improved sleep quality and 
suppressed sundowning. We now report the effect of melatonin (4-month-long 
treatment with 6 mg/day) in 45 AD patients with sleep disturbances.  Melatonin 
improved sleep and suppressed sundowning, an effect seen regardless of the 
concomitant medication employed to treat cognitive or
behavioral signs of AD. Melatonin treatment seems to constitute a selection 
therapy to ameliorate sundowning and to slow evolution of cognitive impairment 
in AD patients.
Bob Wildblood, PhD, HSPP
Lecturer in Psychology
Indiana University Kokomo
Kokomo, IN  46904-9003
[EMAIL PROTECTED], [EMAIL PROTECTED]

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