Sundowning – What Is It And Why Does It Happen?

If you have ever cared for someone with dementia, you might have noticed a change in their behavior that is extremely out of character for them as the sun starts to set. That change is referred to commonly as sundowning.

Sundowning is a cluster of symptoms that usually includes agitation, restlessness, irritability, and confusion that occurs in individuals with Alzheimers/Dementia and typically occurs as day turns into night. Sundowning typically amps up around dinner time and continues into the night. “Although the exact reason why sundowning happens is not known, researchers believe it’s a disruption to a person’s natural body clock. Circadian rhythms signal when to wake up and to sleep at night. When this is disrupted, it can be both irritating and frustrating, which is acted out through their behaviors.”

Signs of Sundowning:

Just as unique as every person, signs and symptoms can vary.

• Agitation
• Discomfort
• Suspicion
• Hallucinations
• Confusion
• Bad mood, anger, temper
• Ignoring
• Can’t follow directions
• Demanding

Factors that can agitate Sundowning:

While the exact cause of Sundowning is unknown, some factors tend to worsen symptoms. 

• Lack of sleep, fatigue, or mental exhaustion
• Caffeine and alcohol close to bedtime
• Faded light, low light, and increased shadows that cause confusion and fear
• Upset in their circadian rhythms, confusing day and night
• Underlying health issues, such as an infection, discomfort, or pain
• Dehydration or hunger
• Stress, depression, or boredom

How to cope with Sundowning:

“A variety of factors can worsen an individual’s symptoms, however there are proven methods for minimizing Sundowning behavior. Paying attention to what is aggravating the individual’s symptoms can help you decide which of the following caregiver tips is most appropriate.”

Light Therapy

A dawn simulator is a user-friendly and affordable way to help reset a person’s circadian rhythms by signaling the start and end of their day with increasing and decreasing light intensity.

Regular Schedule During the Day and Evening

Establish a regular and habitual routine every day. People with memory loss find comfort in a daily routine, which can help start the day and, more importantly, signal when it’s nighttime.

Go Outside

Whether it is sunny or overcast, exposure to natural light will help set their internal clock.

A Good Night’s Sleep

Focus on getting your loved one the best night’s sleep possible by reducing stimulants in the evening, avoiding caffeine and alcohol, and establishing a calming bedtime ritual.

Talk to Their Doctor

Consult with your loved one’s doctor about their evening Sundowning issues, especially if these have come on quickly. You want to rule out if there is an underlying issue causing these symptoms.

Thank you to Aegis Senior Living for the information in this article.