top of page
  • Kathryn Watson

Sundowning: Why It's Happening, What To Do About It, And How To Avoid It

Sundowning is a common and sometimes dangerous condition that occurs during the late afternoon and early evening. It's also known as sundowning syndrome, restlessness, and confusion.

What Causes Sundowning?

The exact cause of sundowning is unknown, however, it is believed to be caused by a combination of physical, medical, and psychological factors. Possible causes may include changes in hormones that occur at the end of the day, a disruption in one's sleep-wake cycle, confusion due to unfamiliar environments or people, and increased anxiety levels.

Additionally, sundowning can be triggered by physical fatigue or pain.

Physical fatigue or pain is a common symptom of sundowning, a phenomenon that occurs in individuals suffering from dementia. This symptom can be particularly difficult to deal with, as it often leads to further agitation and confusion in the individual. It is important for caregivers to understand the signs of physical fatigue or pain in order to provide the necessary support and comfort to those suffering from sundowning. Additionally, medication and environmental modifications can be used to help reduce the physical discomfort associated with this condition.

Medication and environmental modifications are two of the most common ways to manage sundowning, a symptom of dementia that causes confusion and agitation in the late afternoon and into the evening. Medications can be prescribed to help reduce sundowning symptoms.

Environmental modifications such as increased lighting, low noise levels, and minimized distractions can be effective in helping to reduce sundowning symptoms. Additionally, providing comfortable furniture and ensuring access to outdoor spaces can also help create a calming atmosphere for those who are struggling with sundowning. Creating an environment that is conducive to relaxation can be a valuable tool in supporting individuals with sundowning.

It is important for caregivers to be aware of the possible causes of sundowning in order to provide better support for those affected by this condition. Can you identify any triggers that could be causing the behavior changes?

What Are The Symptoms Of Sundowning?

Symptoms of sundowning can include restlessness, confusion, and even hallucinations.

Sundowning is a phenomenon that occurs in people with dementia and Alzheimer's disease, usually in the late afternoon or early evening.

Symptoms can include:

  • Confusion

  • Anxiety

  • Pacing

  • Restlessness

  • Aggression

  • Difficulty sleeping

It is important to take note of any changes in behavior during this time as these can be indicators of sundowning. If these symptoms are observed, it is recommended to reach out to a healthcare provider for further guidance.

It can also lead to delusions, hallucinations, and disorientation. Sundowning can often be triggered by changes in hormones that occur at the end of the day. It is important to recognize the signs of sundowning in order to provide proper care and support to those who are affected.

What Are The Effects Of Sundowning?

The effects of sundowning can be life-threatening. If you or a loved one experience any of the following symptoms, please seek immediate medical attention: hallucinations, agitation, seizures, or coma.

Sundowning is a phenomenon in which people with dementia become increasingly agitated and confused as the day draws to an end. In extreme cases, it can lead to agitation seizures, or even coma. Sundowning is thought to be caused by a combination of factors, including disorientation, fatigue, disturbed sleep-wake cycles, and decreasing natural light levels. It is important to note that not all people with dementia experience sundowning and that the intensity of the symptoms can vary greatly.

Hallucinations are a common symptom of sundowning, a phenomenon in which aging adults experience increased confusion and restlessness as the day progresses. This symptom often manifests itself in the form of seeing or hearing things that are not there. In some cases, these hallucinations can be quite severe and may lead to further agitation or distress. It is important for caregivers to recognize this symptom and take steps to reduce its effects.

How Can I Avoid Sundowning?

There is currently no known cure for sundowning. However, by following a few simple guidelines, you may be able to minimize the risk of experiencing it:

Avoid taking sleep medications before bed.

For those who suffer from sundowning, a phenomenon in which agitation or confusion increases as the day goes on, it is important to take extra care when considering sleep medications. While these medications are often used as a way to help people with sundowning, they can have potential side effects and should only be used under medical advice. Non-drug therapies such as music or massage can also be effective in helping with sundowning symptoms without the risk of side effects.

Avoid drinking alcohol or caffeine near the end of the day

For those experiencing sundowning, and an increase in confusion and agitation in the evening, it is important to avoid drinking alcohol or caffeine late in the day. These substances can make sundowning symptoms worse and may lead to further difficulties in managing the condition. Caffeine and alcohol can interfere with the body's natural sleep cycle, leading to further confusion and agitation. It is important for those dealing with sundowning to monitor their caffeine and alcohol intake throughout the day in order to reduce the risk of worsening symptoms.

Make sure that you are physically and mentally restful during the late afternoon and early evening

Late afternoon and early evening can be a difficult time for those with sundowning, but there are ways to make it more restful. Creating a soothing and calming environment is key, such as reducing noise levels, dimming lights, and avoiding activities that are too stimulating. Additionally, providing comfort items like weighted blankets that can help reduce agitation is also important.

Weighted Blankets Can Help

Weighted blankets are quickly becoming a popular tool to help manage sundowning, a symptom of dementia, and other cognitive conditions in which patients experience increased agitation or confusion at night. Studies have shown that deep-pressure stimulation from weighted blankets can help with anxiety, insomnia, and restlessness. Weighted blankets are available in various sizes and weights and can be used safely for adults and children alike.

While sundowning can be challenging, with the right strategies in place it is possible to create a physically and mentally restful environment during this time of day.


Sundowning is a condition that can be difficult to treat. Reach out for help from a professional for more suggestions.

In honor of our founder Pat Mack, we are carrying on the tradition of caring for our residents in "The Light Heart Way" Light Heart Memory Care homes are specially designed for 8 residents. This gives us the ability to give personalized care to each and every resident.

Contact us to learn more about Light Heart Memory Care, or book a free consultation. Book A Free Consultation

Phone: 281.282.0770 Email:

192 views0 comments


bottom of page