What is Sundowning? : 7 Shocking and Surprising Facts You Need to Know

What is Sundowning
Posted On: February 18th, 2023
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What is Sundowning?

The behavioral changes that frequently take place in patients with Alzheimer’s disease and other forms of dementia are referred to as “sundowning,” also known as “late-day confusion.” These alterations might last well into the night and often take place the late afternoon or early evening.

What Causes Sundowning?

It is not entirely known what causes sundowning. Yet, studies have revealed that variations in the circadian rhythm, which regulates the sleep-wake cycle, can contribute. The body’s internal clock tells the brain that it is time to wind down and get ready for bed as the day goes on. These signals can be messed up in dementia patients, resulting in bewilderment, anxiety, and restlessness.

Sundowning may also be caused by sensory overload, exhaustion, hunger, and dehydration. Also, several drugs that are frequently prescribed to treat dementia can have adverse effects that could make sundowning symptoms worse.

Symptoms of Sundowning

Depending on the person, sundowning may take many different forms. Typical signs include:

  • Confusion and disorientation
  • Agitation and restlessness
  • Increased anxiety and fear
  • Delusions and hallucinations
  • Pacing or wandering
  • Difficulty sleeping

You should consult a healthcare professional if you or a loved one exhibits any of these symptoms. They can aid in determining any underlying problems and provide suitable treatment alternatives.

What is Sundowning

Treatment Options for Sundowning

Sundowning cannot be cured, but there are several management techniques that can help. A few efficient remedies are:

  • establishing and adhering to a regular sleep routine
  • creating a soothing evening ritual that includes activities like taking a warm bath or listening to soft music
  • lowering the level of sensory input at thatnightnighth as by dimming the lights and decreasing the noise
  • ensuring that you have enough food and water throughout the day
  • Regular physical exercise during the day to promote sleep and lessen agitation
  • In some circumstances, medications to treat symptoms, such as antipsychotics or antidepressants, may be utiliutilized

It’s crucial to collaborate closely with a healthcare professional to create a customized treatment plan that addresses the individual’s unique needs.

Circadian Rhythm DisruptionConfusionRegular Sleep Schedule
Sensory OverloadAgitationCalming Bedtime Routine
Medication Side EffectsAnxietySensory Reduction
Delusions/HallucinationsAdequate Nutrition/Hydration
Pacing/WanderingRegular Physical Activity
Difficulty SleepingMedications

Tips for coping with dementia sundowning

Here are some suggestions to consider if you or a loved one is suffering from fromntia sundowning:

  • Keep to a regular sleeping pattern and refrain from taking naps during the day.
  • In the evening, stay away from stimulants like alcohol and coffee.
  • Promote the use of relaxation techniques including music therapy, meditation, and deep breathing.
  • To avoid shadows or confusion, use nightlights or otheranotherlevel lighting.
  • Provide solace-inducing materials like cherished mementos or pictures.
  • Avoid arguing with or correcting the person with dementia and instead, remain calm and reassuring.
  • If necessary, ask family members, friends, or qualified carers for a break or support.

What is Sundowning

Understanding Sleep Issues in Dementia

People with dementia frequently experience sleep problems, which can negatively affect their general health and well-being. Individuals who have dementia may notice changes in their sleep habits, such as trouble falling asleep, frequent nighttime awakenings, and very early morning awakenings. Also, they could feel sleepy during the day, which might make it difficult for them to participate in activities and social interactions.

Insomnia in dementia can be caused by a several circumstances, including:

  • Disrupted circadian rhythm: A circadian rhythm that has been disturbed in dementia patients may have an impact on their sleep-wake cycle.
  • Physical discomfort: Individuals who have dementia sometimes struggle to fall asleep because of pain, discomfort, or other physical symptoms.
  • Medications: Certain drugs used to treat dementia or other ailments can have an impact on sleep.
  • Anxiety or depression: Anxiety or depression areismmon in people with dementia, and these emotions can interfere with sleep.

What is Sundowning

Managing Sleep Issues in Dementia

Although the various approaches canp, managing sleep problems in dementia can be difficult. Here are some recommendations for assisting a loved one with dementia to sleep soundly at night:

  • Establish a regular sleep routine: Strive to develop consistent sleep and wake-up schedules and stick to them every night.
  • Create a sleep-conducive environment: Ensure that the bedroom is cosy, quiet, and dacozy To create a quiet setting, think about utilizing blackout utilizing earphones, or a white noise machine.
  • Limit caffeine and alcohol: In the evening, stay away from caffeine and alcohol because they can disrupt your sleep.
  • Encourage physical activity: In dementia sufferers, regular exercise can aid with general health and sleep quality.
  • Manage pain and discomfort: Before going to bed, make sure your loved one is at ease and pain-free. Discuss potential therapies with their healthcare professional if they are in pain or uncomfortable.
  • Consider medication: In some circumstances, using drugs is important to treat dementia-related sleep problems. Speak with the healthcare professional caring for your loved one about your alternatives.

How is dementia sundowning diagnosed?

A complete medical history, physical examination, and assessment of cognitive and behavioral symptom behavioral to make the diagnosis of dementia sundowning. To rule out any medical issues that could resemble or worsen sundowning, your healthcare professional could also advise additional testing, like blood work or imaging investigations.

Understanding Sundowning in Dementia

The word “sundowning” is used to describe the increased agitation and confusion dementia patients may experience in the late afternoon and evening. Both the dementia patient and the person providing care may find this conduct disturbing. Although if sundowning is not completely understood, several things, several

  • Fatigue: As the day wears on, dementia sufferers may become more exhausted, which may increase their susceptibility to disorientation and agitation.
  • Disrupted circadian rhythm: As was previously noted, people with dementia may experience a change in their circadian rhythm, which may have an impact on how they behave throughout the late afternoon and evening.
  • Low light levels: As the day wears on, light levels drop, which may make dementia sufferers more agitated and confused.

What is Sundowning

Managing Sundowning in Dementia

Although there are certain I a certain measures can managing sundowning in dementia can be difficult. The following advice can assist you in managing sundowning in a loved one with dementia:

  • Stick to a routine: Set up a schedule for your everyday activities, including mealtimes and bedtimes. Confusion and agitation can be decreased with consistency.
  • Limit stimulation: In the late afternoon or early evening, stay away from activities or chores that could make you stressed out or agitated. This could be doing mentally demanding activities or viewing the news.
  • Increase light exposure: Bright light exposure during the day can aid in circadian rhythm regulation and lessen anxiety and confusion in the late afternoon and evening.
  • Consider medication: To control sundowning in dementia, medication may be required in some circumstances. Speak with the healthcare professional caring for your loved one about your alternatives.
Sundowning TriggersCauses
Changes in the sleep-cycle disruptionDisruption of the body’s internal clock
Environmental factorsLoud noises, unfamiliar surroundings, and too much stimulation
MedicationsSide effects of cert-drugs physical physical
Physical and emotional stressPain, discomfort stress pain, and depression


Sundowning Management StrategiesDescription
Establishing a regular routineProviding structure and predictability can help reduce anxiety and confusion
Minimizing environmental triggersReducing noise, clutter, and excessive stimulation can create a calm environment providing
Providing reassurance comfortingUsing verbal and physical cues can help calm and soothe individualising
Using medicationsCertain drugs can be used to manage symptoms of sundowning, but this should be done under medical supervision

Here are 7 surprising facts you need to know about sundowning:

  1. A typical symptom of dementia and Alzheimer’s disease is sundowning. Although the cause of sundowning is unknown, it is believed that up to 66% of dementia patients experience it.
  2. Although the precise etiology of sundowning is uncertain, it is thought to be connected to changes in the brain brought on by dementia. The natural cycles of the body might be upset by these shifts, which can cause confusion, agitation, and restlessness.
  3. Sundowning is not the same as delirium, which is a sudden, severe, and uncontrollable shift in one’s mental state that can be brought several of things several changes in medication, an illness, or other medical disorders.
  4. Sundowning can be made worse by a number of factors, such as weariness, hunger, discomfort, and changes in routine. Bright lights and loud noises can also be particularly upsetting for persons who experience sundowning.
  5. For those who experience sundowning, it’s crucial to establish a pattern because having a set schedule helps ease confusion and worry. A regular sleep pattern, avoiding caffeine and alcohol, and partaking in relaxing activities like taking a warm bath or listening to music can all be beneficial.
  6. Sundowning symptoms can occasionally be managed with the use of medications, but these should only be used under the supervision of a healthcare provider. Non-pharmacological treatments including music therapy, light therapy, and aromatherapy may also be beneficial.
  7. Both the person who is experiencing sunseting and their carers may become anxious. It is crucial for carers to get the support and help they need, as well as to look after their own physical and mental health. This may entail taking breaks, obtaining adequate rest, and getting qualified assistance as required.

What is Sundowning


In conclusion, sundowning is a prevalent disorder that affects many patients with Alzheimer’s disease and other forms of dementia. Although if the precise aetiologs unclear, symptoms can also be influenced by other variables, such as changes in the circadian cycle. If you or a loved one is experiencing symptoms of sundowning, it is crucial to speak with a healthcare physician to uncover any underlying causes and devise an appropriate treatment strategy.


What are sun-downers?

Sun-downers can refer to a species of flower known as “sundowner” or it can refer to the phenomena of heightened agitation and disorientation in dementia patients in the late afternoon or early evening.

What is sundowning in people with Alzheimer’s disease?

In patients with Alzheimer’s disease, the term “sundowning” describes the heightened agitation and confusion that frequently happens in the late afternoon or early evening.

Do humans with dementia experience sundowning?

Indeed, sundowning, which is marked by increasing agitation and disorientation in the late afternoon or early evening, can occur in people with dementia.

What causes sundowning in dementia patients?

Although the precise reasons for sundowning in dementia patients are not entirely understood, it is believed to be connected to circadian rhythm disturbances, exhaustion, or changes in the concentrations of specific hormones and chemicals in the brain.

As it relates to dementia and/or Alzheimer’s disease, what does that term “sundowning” the?

In dementia and/or Alzheimer’s disease, the term “sundowning” describes the heightened agitation and confusion that frequently happens in the late afternoon or early evening.

Does sundowning occur with dementia?

Indeed, especially in advanced stages of the disease, sundowning can happen to adults with dementia.

What is “sundowning” behavior in elderly people suffering from dementia? How do you deal with it?

Elderly individuals with dementia who engage in sundowningbehaviorr exhibit increased disorientation, agitation, restlessness, and wandering in the late afternoon or early evening. To deal with it, carers can work to create a routine, reduce stimulation and noise in the evening, make sure there is enough lighting, and offer the dementia patient reassurance and comfort.

Why is it called sunset and not sundown?

Sundown is the time of day when the sun starts to set, whereas “sunset” is the time of day when the sun falls below the horizon.

Can seniors experience “sundowning” in the morning as opposed to the evening?

Sundowning often happens in the late afternoon or early evening, however,r some dementia sufferers may become more agitated and confused earlier in the day.

What are some good methods to help dementia patients through sundowning?

Establishing a routine, reducing stimulation and noise in the evening, maintaining enough lighting, offering reassurance and comfort, and, if necessary, considering medication or other interventions are all effective ways to assist dementia people through sundowning.

Is it possible to have signs of dementia and sundown syndrome or just 1 or the other? The symptoms don’t always manifest at night. 90% of the time, they do, but not always.

Yes, it is possible to experience sundowning without also having dementia symptoms. Sundowning symptoms frequently appear in the late afternoon or early evening, though they may not always appear at night.

Can sundowning happen without dementia?

Sundowning is most frequently linked to dementia or Alzheimer’s disease, although it can also afflict older adults who do not have dementia as well as those with other brain or nervous system disorders.

How can you manage sundowning in dementia?

Establishing a schedule, reducing stimulation and noise in the evening, maintaining proper lighting, offering reassurance and comfort, and, if necessary, adopting medication or other interventions are all ways to manage sundowning in dementia.

What time is sundown?

Sundown happens in the late afternoon, though the exact timing depends on the region and time of year.

Medications that cause sundowning 

As a side effect, some drugs can produce sundowning. Certain sedatives, antidepressants, antipsychotics, and drugs for the high blood pressure may be among them.

Vascular dementia sundowning 

Those who have vascular dementia, a form of dementia brought on by decreased blood supply to the brain, may experience sundowning.

What are the early signs of sundowners? 

Confusion, anxiety, agitation, restlessness, and mood swings are some of the early warning signs of sundowning in dementia patients.

What stage of dementia is sundowning? 

Although though it happens more frequently in the later stages of dementia, sundowning can happen at any time.

Sundowning delirium 

Some dementia sufferers experience sundowning delirium, a severe case of disorientation and agitation, in the late afternoon or early evening. It is thought to be connected to interference with the body’s normal circadian rhythms.


  1. “Sleep Issues and Sundowning in Dementia”, Alzheimer’s Association, accessed February 17, 2023, https://www.alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning.

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