What is Sundowning?

by | May 1, 2022 | Alzheimer's Disease, Dementia, Dementia Behaviors

Sundowning is a very real phenomenon that affects people and their moods. In simple terms, Sundowning is a state of confusion or bewilderment that usually occurs during the late afternoon.  It begins with the setting of the sun, hence the name.

Although Sundowning isn’t characterized as a proper disease, it does have very real symptoms that often affect people who are afflicted with Alzheimer’s disease and other types of dementia. This state is often referred to as the ‘sundowner’s syndrome.’ During this state, the condition of people with cognitive impairment tends to worsen.

Sundowner’s Syndrome affects about 1 in 5 Alzheimer’s disease patients, which is why its proper management is imperative. The effect of this is more pronounced in dementia patients, probably due to a disturbance in the patient’s biological clock.

Symptoms of Sundowning

The signs and symptoms of Sundowning start to appear late afternoon and dementia patients will start to exhibit changes in mood and behavior during this time.

Some of the common symptoms of Sundowning include:

  • Confusion
  • Anger
  • Anxiety
  • Disorientation
  • Disturbance in the sleep cycle
  • Pacing
  • Reduced attention
  • Restlessness
  • Paranoia
  • Mood changes
  • Hallucinations


When it comes to Sundowning, dementia caregivers need to understand that symptoms will vary from patient to patient depending on the time of the day and the stage of dementia the patient is at. You may find that dementia patients are harder to deal with during Sundowning.

A dementia patient may start shouting or yelling at their caregiver as a result of Sundowning, so be prepared for the possibilities. They may also appear more disoriented than usual and refuse to talk to you at all despite being familiar with you.

What Causes Sundowning?

While the exact causes of Sundowning are unknown, there are some possible explanations behind this state that most dementia patients tend to experience. Sundowning is when there is low light, which often acts as a trigger for depression. Exposure to the sun is important for dementia patients, especially if they live in areas where they get reduced daytime.

Sun increases vitamin D content, which often has a positive effect on mood. Lack of sunlight and vitamin D can lead to increased behavioral changes in dementia patients who already feel disoriented most of the time. Alzheimer’s patients experience mind-related changes that interfere with their biological clock. This is the main reason why Sundowning is a real threat to dementia patients.

Sundowning becomes more acute during winter when there is reduced daytime and increased darkness. This is why Sundowning tends to worsen in dementia patients during the cold and rainy seasons.

Some other factors that contribute to the effects of Sundowning in dementia patients include:

  • Boredom
  • Depression
  • Physical pain
  • Exhaustion
  • Winter season
  • Unmet needs like hunger and thirst
  • Change in environment
  • Isolation

Tips for Dementia Caregivers to Cope with Sundowning

Dealing with dementia patients is not easy as they tend to display a host of behaviors. Unfortunately, Sundowning makes these symptoms worse, and you may find it harder to deal with them during this time. If you are not a professional, you may find yourself clueless as to how to help them deal with this in the best possible way.

  • Remain as calm and patient as possible. Understand that this state is not in their control.
  • Seek professional help if need be. Even as a dementia caregiver, you may not be equipped to take care of your loved ones, so reach out for your sanity and their best interest as well.
  • Do not get angry or ignore them as this may worsen their condition and even cause them to harm themselves.

What To Do during Sundowning?

Here are some of the things dementia caregivers can do to alleviate symptoms of Sundowning in dementia patients.

1.     Increase Exposure to Light

Make sure you take out the dementia patient outdoor when there is sun outside. Even a 15-minute walk will help them catch the maximum goodness of the sunlight and also boost serotonin levels, a hormone that acts as a natural mood booster. If you live in an area that does not receive sunlight or if it’s currently winter, you can increase the light in the dementia patient’s room, which will lessen the effect of Sundowning.

2.     Communicate With Them About Their Unmet Needs

Dementia patients tend to recede from conversations, and this becomes even worse during an episode of Sundowning. Since unmet needs act as a trigger for Sundowning, you should try to communicate with dementia patients whether they are hungry, thirsty, or feeling tired.

3.     Engage them in Activity

You should try to engage your dementia patient in calming activities during the late afternoon so that they get distracted from the effect of the sun setting. You can watch a movie with them or try some music therapy to have a calming effect on them. You can even try to play any card or board game that they like playing.

4.     Adhere to their Routine

Make sure your loved ones adhere to a strict routine so that they don’t experience restlessness or insomnia as a result of Sundowning. Make sure you wake them up early when the sun is out and help them go to sleep by creating a peaceful setting shortly after the sun sets.

5.     Seek Medical Help

If you notice drastic changes in your dementia patient’s behavior due to Sundowning, you should consult a medical professional to see if you can give them some medication to induce sleep or calm their nerves, whatever the more concerning issue may be. You can even ask your medical professional if you can give your dementia patient vitamin D capsules to make up for the reduced exposure to the sun.

Final Word

Dementia caregivers should know and understand Sundowning so that they can relay the best care to their loved ones, who may appear more volatile than usual. This guide walks you through signs of Sundowning and what you can do to help your loved ones cope with this syndrome.

We Are Here To Help

At Sycamore Creek Ranch Memory Care we are here to help. We want families to make the best decision for their situation

Furthermore, the staff at Sycamore Creek Ranch is proactive. That means we are not waiting for a problem to arise. Instead, we are actively engaged with each and every resident. And with only 16 residents we can do that!

If you are looking for Memory Care in The Woodlands or Memory  Care in Spring, Texas come for a tour at Sycamore Creek Ranch! See how we can help.

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