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What is Sundowning?

If you have a loved one with Alzheimer’s disease or other form of dementia, you may notice they become agitated or angry during the early evening. What could be going on is known as Sundowner’s Syndrome. What is sundowning? It’s a set of neuropsychiatric symptoms that often occur in seniors with advanced dementia. The exact causes of Sundowner’s Syndrome aren’t well known, but it’s possible that a range of different triggers can make it more likely:

  • Tiredness, hunger, pain, or other unmet physical needs
  • Not enough exposure to sunlight during the day
  • Overstimulation during the day, such as from a noisy or busy environment
  • Disturbance to the person’s “body clock” caused by damage to the brain
  • Disturbed levels of hormones that vary over the course of the day
  • Hearing or sight loss
  • Mood disorders like anxiety or depression
  • Side effects of prescribed drugs


Sundowning symptoms can include: 

  • Mood swings
  • Confusion
  • Disorientation
  • Suspicion
  • Irritability
  • Restlessness 
  • Sadness
  • Anxiety
  • Anger
  • Aggression
  • Hallucinations
  • Delusions
  • Pacing
  • Rocking
  • Yelling
  • Crying


If your loved one is expressing these sundowning behaviors, here are 11 things you can do to help:


  1. Track their behavior: If you think your family member is exhibiting symptoms of Sundowner’s Syndrome, start keeping a journal. Write down their symptoms, time of day, what helps ease them and what seems to make them worse. People with dementia can express Sundowner’s symptoms in different ways.
  2. Stay regular: Your loved one might have difficulty with unfamiliar places and things, which could cause feelings of stress, confusion and anger. To help, set and stick to a schedule for waking up, eating meals, and going to sleep. 
  3. Be an early bird: Try to schedule their appointments, outings, visits, bath time and regular exercise in the earlier part of the day, when they’re likely to feel their best.
  4. Set a calm vibe: As evening approaches, create a calming environment. Close curtains and blinds and turn on lights. Set the thermostat at a comfortable temperature. Put on relaxing music, read, play cards, or go for a wind-down walk. Tell other family members or visitors not to make too much noise and turn down phones, stereos, or TVs. Your loved one may also enjoy looking at photos or snuggling with a cat or other pet.
  5. Follow the light: To help set your loved one’s internal clock, make sure they get a lot of sunlight in the morning. Take a walk together outside or buy a light box and put it near their bed or chair. Their body may recognize that it’s morning and react accordingly during the day, so they’ll be calmer by evening.
  6. Keep active: Too much daytime dozing and inactivity can make it harder for your loved one to fall asleep at bedtime. To promote a good night’s sleep, help them stay active during the day.
  7. Eat light dinners: Large meals at night can increase your loved one’s agitation and may keep them awake. Instead, encourage them to have a larger meal at lunch and a lighter one in the evening. That will help them feel more comfortable and rest easier at night.
  8. Curb their energy: Having a spike in energy later in the day can be a sign of Sundowner’s Syndrome. If your family member experiences this, consider restricting their caffeine intake to the morning hours. 
  9. Create a safe place: Make sure your loved one has a safe and comforting place to rest and sleep. Adding night lights to their bedroom, the bathroom and hallway can help minimize confusion if they get up in the middle of the night. 
  10. Check their medication schedule: Taking some prescribed medications in the late afternoon or evening may trigger sundowning. If you’re noticing your loved one is experiencing sundowning regularly, check with their doctor about changing their medication schedule. 
  11. Take care of yourself: Dealing with sundowning can be exhausting for both your loved one and you. As a caregiver, it’s important to take care of yourself. When you’re rested and healthy, you’ll then be able to give your family member the patience and support they need. Try to eat a well-balanced diet, exercise regularly and get enough sleep at night. You can also ask other family members or friends to spend time with your loved one, so you can take a break. 

At Heritage Senior Living, All Care Is  Personal

Our specially trained memory care staff members are on hand 24/7 to provide compassionate, individualized care while ensuring your loved one’s unique needs are met. To learn more about our memory care options at a community near you, contact us here