Sundowning, or “Sundown Syndrome”, is a phenomenon that affects sufferers of dementia, Alzheimer’s disease and similar conditions. It typically causes them to become more confused, restless and agitated as the day comes to a close, and is made even worse after a change to their nightly routine.

Other symptoms of sundowning include anger, outbursts, anxiety, pacing, fear, sadness, stubbornness, paranoia and restlessness.

The cause of sundowning isn’t yet known, but some experts believe it may have something to do with a change in dementia sufferers’ circadian rhythm (i.e. their body clock), changes to hormone levels or simply tiredness at the end of the day. It’s also possible that the day’s sensory stimulation (and the sudden lack of activity after dark) has built up to the point that it becomes overwhelming to them.

How to manage sundowning in a loved one

If you’re responsible for the care of a partner, parent or other loved one with dementia, it’s not unlikely that you will experience sundowning at least once during your time as caregiver. Here are four things you can do to help manage their level of agitation.

1. Expose them to bright light in the morning – studies have shown that exposing sufferers to light from a full-spectrum fluorescent lamp (between 2,500 and 5,000 lux) for a couple of hours in the morning can get their circadian rhythm back on track.
2. Let them rest in the early afternoon – after an active morning and then lunch, give them a chance to rest or take a nap. If nightly fatigue is a factor in their sundowning, it should reduce their tiredness and lowers the chance of outbursts.
3. Keep them busy in the evening – allowing them to engage in similar activities to the morning could help sundowners. Otherwise, giving them tasks like closing the blinds, setting the table or helping prepare dinner could help distract them from their symptoms.
4. Find the cause of their symptoms – ask yourself, why are they agitated? Are they hungry? Bored? The more you understand about the reason behind their restlessness, the more you will be able to target symptoms, provide a solution and help calm them down.

Tell us in the comments below, are you a caregiver for a loved one with dementia? Have you ever experienced sundown syndrome before?

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