Have you noticed a change in your loved one’s behavior when the sun sets?

It is not uncommon for persons with Alzheimer’s and other forms of dementia to display erratic or confused behavior as daylight fades. This phenomenon is commonly referred to as sundowning, short for Sundowner’s syndrome. 

Sundowning is not a sickness in and of itself, but rather a symptom of progressing dementia that manifests during the evening hours and into the night and may cause abrupt changes in cognition and mood. 

While everyone’s symptoms vary, sundowning is most typically experienced in the latter stages of dementia and Alzheimer’s. It is relatively common, affecting up to one in every five Alzheimer’s patients. 

Note: Content on this blog is for informational purposes and should not be mistaken for medical advice. Please consult a physician or other medical professional or specialist for all health matters.  

Sundowning Symptoms 

Although no one really knows why it happens, it’s believed that Sundowner’s syndrome may be caused by tiredness felt at the end of the day, and worsened by hunger, thirst, or pain. Sundowning may cause abrupt changes in cognition and mood as evening approaches. 

Seniors with dementia often have difficulties expressing their feelings, which may become more noticeable in the evening hours, resulting in the behaviors we associate with sundowning.  

Changes in behavior might vary from person to person, but may include: 

• Disorientation 

• Anxiety 

• Hallucinations 

• Suspicion  

• Aggression or anger 

Those who are experiencing the symptoms of Sundowner’s syndrome may exhibit behaviors as a response to stress such as pacing, rocking, yelling, or even becoming aggressive. Some behaviors may fade quickly, while for others, they might linger for hours and significantly disrupt their sleep routines.  

Coping Tips for Caregivers of Seniors Experiencing Sundowning Symptoms

Seeing a loved one experience these symptoms may be heartbreaking and leave you feeling helpless. However, there are several approaches you may take to help manage these symptoms and reduce their intensity, such as:

• Get some sunshine during the day. The phenomena of sundowner’s syndrome appear to be related to evening time and the setting sun. Getting daytime sun—both by venturing outside during the day and by leaving curtains open in the daytime can help establish your loved one’s internal clock, helping them feel more energized during the day and sleep better at night.  

• Encourage physical activity. Integrating physical activity into the day can help guarantee your loved one has energy during the day and is ready to sleep when the evening arrives. Stick to something easy – even a daily stroll can help prevent sundowning. 

• Avoid anything that is excessively exciting or noisy during evening hours. Use the evenings to unwind and create a soothing environment for your loved one. Instead of watching television, try playing some soothing music. Evening visitors should be restricted as well. Encourage visitors to visit during the day or late afternoon rather than just before bed. 

• Avoid heavy meals, caffeine, alcohol, and sweets, especially late in the day. Make sure your loved one eats enough to avoid being hungry in the evening but avoid eating a particularly large meal near the end of the day. Additionally, if your loved one does not have sugar, caffeine, or alcohol in their system, they are far more likely to fall and remain asleep. 

• Maintain a consistent sleep routine. Avoid or reduce daytime napping so your loved one may obtain a full night’s sleep at night. Make your sleeping patterns as regular as possible.  

• Learn what triggers symptoms for your loved one. While sundowning may manifest in similar ways in many seniors, each person is unique, and your loved one may be predisposed to react differently to certain triggers. Making a note of what happened that day is one of the simplest ways to discover what may be causing your loved one’s symptoms. What did they have for dinner? What did they do before going to bed in the evening? You may be able to identify the events that regularly contribute to sundowning for your loved one, allowing you to avoid them in the future. 

If, despite your efforts, your loved one continues to experience the symptoms of sundowner’s syndrome, consult your doctor. They may be able to prescribe drugs to help with the symptoms, and help you mitigate the consequences of sundowning.