Sundown syndrome is a state of confusion affecting people with dementia that occurs in the late afternoon or evening. Sundowning can cause confusion, anxiety, and aggression, as well as wandering, all of which can pose challenges for caregivers.
Here are some tips for managing sundowning, along with factors to look out for that can aggravate sundown syndrome in your friend or family member.
What Causes Sundowning?
Many factors can aggravate sundowning, but The Mayo Clinic notes the most prevalent causes include:
- Increasing shadows
- Low lighting
- Disruption of a regular daily schedule
- Fatigue or illness
- Disruption of a person’s body clock
- Difficulty separating reality from dreams
Related Read: 6 Tips for Transitioning an Older Adult to Memory Care
How To Cope With Sundowning
First, it’s important for caregivers to stay patient and maintain a calm demeanor when supporting someone experiencing sundowning. If the person begins to feel agitated or upset, try speaking in a soothing tone, offering reassurance, and acknowledging their feelings without trying to correct their perceptions.
Sometimes, simply sitting with them, holding their hand, or providing gentle comfort can ease anxiety.
Remember, each person is unique, so it may take some trial and error to find what works best. Stay flexible, observe their cues, and adjust your approach accordingly.
Tips For Preventing Sundowning
1. Maintain a predictable routine
Structured daily activities can help reduce agitation. When planning a routine, consider their likes, dislikes, interests, and what times of day they function best. A routine can help them feel more comfortable and prepared for what’s coming next in their day.
2. Get enough rest at night
When a person living with Alzheimer’s disease doesn’t get enough sleep, they can often become agitated and restless, increasing their chances of experiencing sundowning. For that reason, make sure they get enough sleep and have proper sleep hygiene.
Related: How to Overcome Low Energy and Fatigue Related to Dementia >>
3. Avoid alcoholic drinks or caffeine
Both substances can cause confusion and anxiety in a person with Alzheimer’s disease. Instead, focus on helping your friend or family member stay hydrated and eat nourishing foods.
4. Get exposure to natural light during the day
Sitting near a window or going for a walk may help reset the body’s clock and encourage nighttime sleepiness. Conversely, avoid excessive blue light exposure from screens before bedtime, which can hinder sleep.
5. Create a soothing environment at night
Aim to reduce clutter, noise, and the number of people in the room to help create a calm atmosphere. Turn off the TV and radio, and save the use of machines or appliances for other times. Noise can increase agitation and distraction.
Use a night light to prevent your friend or family member from becoming anxious due to dark, unfamiliar surroundings. Familiar, gentle music and white noise machines can also help.
Related: Relaxation tips for people with dementia >>
If Sundowning Symptoms Persist
If symptoms of sundowning appear, change, or worsen, seek medical advice. Your friend or family member’s doctor may be able to find an underlying cause, such as an infection or a side effect from medication.
Facing a diagnosis of Alzheimer's disease or dementia can be overwhelming. You may wonder where to start and what to expect.
Our free resource guide can help. Packed with 20+ pages of information, you’ll learn about some of the most common behaviors associated with dementia and get tips for handling them.
This blog was originally published in 2018. It was updated in 2025.
