As the sun begins to set, many families caring for a loved one with Alzheimer’s or another form of dementia notice a troubling shift—sudden confusion, agitation, or restlessness that seems to come out of nowhere. This pattern, often occurring in the late afternoon or evening, is known as sundown syndrome, or sundowning.
If this sounds familiar, you’re not alone. Sundown syndrome is a common—and often distressing—experience for both individuals with dementia and their caregivers. Understanding what it is, why it happens, and how to respond can make a real difference in managing these challenging moments with compassion and confidence.
What Is Sundown Syndrome?
Sundown syndrome refers to a group of symptoms that tend to worsen as daylight fades. While each person’s experience may be different, common signs include:
- Increased confusion, especially compared to earlier in the day
- Agitation, irritability, or mood swings
- Pacing, wandering, or repetitive movements
- Yelling, arguing, or becoming aggressive
- Hallucinations, delusions, or paranoia
- Resistance to redirection or care
These behaviors can start as early as late afternoon and may continue well into the night. For caregivers, this sudden shift can be both emotionally exhausting and heartbreaking.
Why Does Sundowning Happen?
Researchers are still working to understand exactly what causes sundown syndrome, but several factors are believed to contribute:
1. Disrupted Internal Clocks (Circadian Rhythms)
Dementia can interfere with the brain’s ability to regulate sleep and wake cycles. As a result, people may become disoriented or confused about the time of day.
2. Fatigue and Sensory Overload
By the end of the day, the person may simply be tired or overwhelmed by everything they’ve experienced. That fatigue can make it harder for them to cope with even small changes or frustrations.
3. Low Lighting and Shadows
As the natural light fades, shadows may appear, and familiar spaces can begin to feel unfamiliar or even frightening. This can trigger fear, anxiety, or confusion.
4. Unmet Physical Needs
Pain, hunger, thirst, or the need to use the bathroom can all contribute to agitation—especially if the person has trouble expressing those needs.
5. Environmental Triggers
A noisy TV, a rushed dinner, or even a shift change in a care setting can create stress and uncertainty, especially in someone already struggling to make sense of their surroundings.
How Families Can Help: Calming the Evenings
While sundown syndrome can’t always be eliminated completely, there are many gentle, practical strategies that can help reduce its intensity and frequency. Every person is different, but here are some approaches that often bring comfort:
1. Stick to a Consistent Routine
Familiar schedules are grounding. Try to keep mealtimes, medications, activities, and bedtime consistent every day to reduce confusion and build a sense of security.
2. Limit Caffeine and Sugar Intake
Try to avoid offering caffeinated drinks or sugary snacks—especially in the afternoon or evening. These stimulants can disrupt sleep and may heighten anxiety or agitation.
3. Limit Napping and Encourage Daytime Activity
Too much daytime sleep can make nighttime restlessness worse. Gentle physical activity and meaningful engagement during the day can help improve sleep at night.
4. Create a Calm, Soothing Environment
As evening approaches, dim the lights gradually, reduce noise, and avoid overstimulating activities. Soothing music, quiet conversation, or calming scents like lavender can help set a peaceful tone.
5. Offer Reassurance and Familiar Comforts
Sometimes all a person needs is to feel safe. Sit with them, hold their hand, offer a warm blanket, or put on a favorite show. Familiar objects, such as a cherished photo album or well-loved sweater, can be very reassuring.
6. Use Lighting Strategically
Turning on lights before sunset and leaving night lights on can help minimize shadows and reduce fear or disorientation as daylight fades.
7. Monitor for Triggers Every person is different. By observing and noting when and how sundowning behaviors arise, caregivers can often spot specific patterns or stressors—and adjust routines, environments, or communication styles accordingly.
When to Seek Additional Support
If sundown syndrome becomes more frequent or severe, it’s important to speak with a doctor or memory care professional. Sometimes underlying issues like infections, dehydration, medication side effects, or untreated pain can make symptoms worse. Getting the right support can bring much-needed relief—for both your loved one and yourself.
You’re Not Alone
Caring for someone with dementia is filled with emotional highs and lows. Sundown syndrome can feel like an especially overwhelming part of the journey—but know this: many families face this same challenge, and there is support, guidance, and relief available.
At longtermcarefinder.com, we’re here to help you navigate these complex moments with clarity and compassion. Whether you’re looking for home care support, memory care options, or simply reassurance that what you’re experiencing is normal, our trusted directory and resource center are here for you—every step of the way.