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The Bristal Assisted Living Blog

Posted by The Bristal  |  August 10, 2021

What are the Symptoms of Sundowning?

If you have a loved one with Alzheimer’s disease or dementia, you may have noticed unusual behavior that occurs in the evening hours and/or nighttime. It could be what’s known as “sundowning,” which the Alzheimer’s Association defines as “increased confusion ... and disorientation beginning at dusk and continuing through the night.”

According to Brandon Dennis, a neuropsychologist with Norton Neuroscience Institute, sundowning is common among those with dementia.

Symptoms of Sundowning

According to Mayo Clinic, the symptoms of sundowning may include:

  • Confusion
  • Anxiety
  • Aggression
  • Ignoring directions
  • Pacing
  • Wandering

Additional symptoms include hallucination, paranoia, and shadowing (following you from room to room). The symptoms and their severity, however, vary from person to person.

Is it Sundowning?

Many of the above symptoms characterize Alzheimer’s disease in general. How do you know, then, if they indicate sundowning?

The best way to determine this is to keep track of the occurrences. If your loved one is displaying the same extreme behaviors around the same time each day, typically late in the afternoon and into the evening, then it is likely that he or she is experiencing sundowning.

Related: Tips For Preventing, Coping With Sundowning >> 

Causes of Sundowning

Although exact causes are unknown, there are numerous theories about what triggers sundowning. They include:

  • Exhaustion
  • Hormonal imbalance (such as melatonin levels)
  • Disturbance in sleep patterns
  • Decreased daylight (particularly in winter)
  • Inability to distinguish dreams from reality
  • Reactions to verbal or nonverbal communication (such as frustration)
  • Loss of routine

Another possible contributing factor is that evening is a period many seniors may have grown accustomed to experiencing as busy times, filled with obligations. Children came home from school, spouses returned from work, meals were being prepared and served.

Sundowning may even be prompted by more straightforward causes; perhaps the senior has an unmet need that he or she cannot express. Such needs might include a visit to the bathroom, a snack, a glass of water, or the alleviation of pain.

Managing Sundowning Symptoms

There are effective methods of managing sundowning symptoms. Take the scenario of an unexpressed need, for instance. In such cases, the caregiver may be able to figure out exactly what that need is and redirect the behavior accordingly.

If this approach does not work for you, do not give up. There are many more promising techniques you can try. They may require some trial and error, but it is feasible to achieve success.

Support for Caregivers

You may also wish to consider support groups for caregivers who are coping with a loved one’s Alzheimer’s, including problems relating to sundowning. If you found this article helpful, you may also be interested in learning more about strategies for first-time caregivers or common complications related to Alzheimer’s and dementia.