How to Cope with Sundown Syndrome (Sundowning)


Sundown Syndrome (Sundowning)

Many caregivers and family members of seniors with Alzheimer’s dread the setting of the sun. When that evening sun goes down, many people afflicted with Alzheimer’s disease begin to show signs of sundowning or sundown syndrome. As the sun sets, they become more agitated, restless, confused, angry, sad, moody and even aggressive and violent. They may pace around and scream and cry out in response to hallucinations and delusions and this kind of behavior may last all night. This is extremely stressful on caregivers who are tired from the end of the day and who are looking forward to a good night’s sleep.

Suspected Causes of Sundown Syndrome

While no one knows exactly why this occurs at sundown some have suggested:

  • Fatigue is setting in and this upsets the brain chemistry of people with Alzheimer’s.
  • With less light they are more prone to have hallucinations. For instance a light stand might in more dim light appear to them like a ghost.
  • They may be suffering from some kind of pain or physical discomfort. There may be an undiagnosed health problem like a urinary tract infection (UTI), obstructive sleep apnea (OSA) or insomnia. Agitation and confusion are often the first signs of a urinary tract infection. Check with the doctor about doing lab work to test for possible urinary tract infections.
  • They may fear the night coming on because they suffer from nightmares.
  • They may be suffering from insomnia. Many people with Alzheimer’s do not sleep all night and during the day they may be drowsy. There are medications and drugs that can cause insomnia as a side effect. Check with your doctor if any of your loved one’s medicines could be causing insomnia.

See our blog post from June 8, 2018 to read more about dementia and sleep disorders.

Try to Find the Trigger that Leads to Sundown Syndrome

Try to discover what seems to set your demented loved one off and then try your best to lessen these triggers. For example:

  • Does your loved one get disturbed as the house becomes more noisy and bustling at this time with people returning from work or their daytime activities?
  • Does the sound of the television seem to bother them? Make sure there are no violent movies on the television or the news which may be upsetting.
  • Do they become more agitated when people are talking in the room?
  • Does a different caretaker come on in the evening?

The National Institute on Aging (NIA) and the AARP Suggest Tips

The National Institute on Aging (NIA) and the AARP suggest tips for coping with sundowning:

  • Some caretakers have discovered that restricting foods containing caffeine like coffee, tea, coca cola, chocolate and also sugar help against sundowning.
  • The NIA advises restricting alcoholic drinks, as they may cause anxiety and confusion.
  • Try to stick to routines and do not introduce something new at this time. Many people with dementia have a fear of the new.
  • Try distracting them with a snack, something they like or a favorite object, pet, hobby.
  • Some experts suggest keeping the temperature of the bedroom below 70 degrees F. and keeping only dim lights on.
  • Others suggest, as the sun begins to set put on bright lights so that the darker it gets outside the brighter it gets inside the home. Make sure that the light is bright enough so that there are no shadows, as these can trigger all kinds of fears.
  • Try playing calming music like the sounds of the sea, birds singing and other music that is calming. Experiment with different types of music and see which is the most therapeutic to use and begin playing this music as the sun begins to set.
  • Some report success with aroma therapy such as frankincense and myth or lavender.
  • Try foot or hand massages in a warm foot bath with a few drops of lavender or rosemary, as some caregivers claim this works.
  • Some also report that acupuncture treatments sometimes help with dementia, so look for a professional who is experienced with this type of treatment

Last but not least some caretakers report that a big warm hug can also help!

Anti-anxiety Medicines

Check with your doctor about anti-anxiety medicines which might help them relax in order to fall asleep. Ask what side effects to look out for. Remember that a drug that works for one person may not work at all for someone else.

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Royal Suites Healthcare and Rehabilitation in scenic Galloway Township NJ has a very special impaired memory care unit with a state-of-the-art Snoezelen Room, which you can read more about in our blog from May 29, 2018.


Sundowning is very difficult for everyone in the picture. Check with your doctor to make sure there are no medical issues and try the tips in the hope that one or all of them will work.


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