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Management of the dawn phenomenon varies by patient and thus should be done with regular assistance from a patient's physician. Some treatment options include, but are not limited to, dietary modifications, increased exercise before breakfast and during the evening, and oral anti-hyperglycemic medications if a patient's HbA1c is > 7%.
Chronic Somogyi rebound is a contested explanation of phenomena of elevated blood sugars experienced by diabetics in the morning. Also called the Somogyi effect and posthypoglycemic hyperglycemia, it is a rebounding high blood sugar that is a response to low blood sugar. [1]
Somogyi effect Michael Somogyi (March 7, 1883 – July 21, 1971) was a Hungarian-American professor of biochemistry at Washington University in St. Louis and the Jewish Hospital of St. Louis . He prepared the first insulin treatment given to a child with diabetes in the US in October 1922.
Sundowning, or sundown syndrome, [1] is a neurological phenomenon wherein people with delirium or some form of dementia experience increased confusion and restlessness beginning in the late afternoon and early evening.
The natural light provided by the sunrise may contribute to a reduction in sleep inertia effects. Research simulating increase of light at dawn was shown to potentiate the cortisol awakening response (CAR). [5] The CAR is a spike in blood cortisol levels following awakening, and is associated with the return to an alert cognitive state.
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Waking up earlier in the morning increases the response. [11]Shift work: nurses working on morning shifts with very early awakening (between 4:00–5:30 a.m.) had a greater and prolonged cortisol awakening response than those on the late day shift (between 6:00–9:00 a.m.) or the night shift (between 11:00 a.m.–2:00 p.m.). [12]
Dawn simulation has also proven to be effective; in some studies, there is an 83% better response when compared to other bright light therapy. [25] When compared in a study to negative air ionization, bright light was shown to be 57% effective vs. dawn simulation 50%. [31]