Sundowning

Sundowning (sometimes called sundown syndrome) refers to a pattern of worsening confusion, anxiety, agitation, or restlessness that tends to happen in the late afternoon and into the evening. It is particularly common in people living with Alzheimer's disease and other forms of dementia, though it can vary greatly in severity and presentation.

A person experiencing sundowning may become unusually anxious, confused, or irritable as the day progresses. They may pace, wander, become suspicious of family members, have difficulty sleeping, or insist on leaving the house. These behaviours can be distressing for both the person experiencing them and their caregivers.

While the exact causes of sundowning are not fully understood, several factors are thought to contribute. Fatigue from a long day, reduced lighting that creates shadows and confusion, disruption to the body's internal clock (circadian rhythm), hunger, and overstimulation can all play a role. Some medications or underlying health issues like urinary tract infections can also worsen symptoms.

There are practical strategies that many families find helpful. Keeping a consistent daily routine helps your loved one know what to expect. Ensuring good lighting in the evening reduces shadows that can cause confusion. Limiting caffeine and sugar in the afternoon, encouraging gentle physical activity earlier in the day, and creating a calm environment in the evening can all help ease the transition into night-time.

If sundowning is significantly affecting your loved one's quality of life or your ability to provide care, speak with a healthcare professional. They can check for treatable causes and suggest further strategies tailored to your situation.