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Sundowning – Symptoms and Possible Solutions

August 16, 2015

It is common for adults to experience some sort of fatigue and a sense of being overwhelmed at the end of daytime. Meanwhile, it is also common for seniors suffering from Dementia or middle stages of Alzheimer’s to experience a syndrome that greatly affects the human mind referred to as “Sundowning” or “Sundown Syndrome”. Its can be defined as “a state of confusion and agitation that generally strikes at the end of the day and into the night”. The human brain is a fascinating organ that never ceases to astonish us. It is complex by nature and when it is challenged with a particular syndrome or a disease, it becomes even more complex.


If you ask a caregiver when is the most difficult time to care for an elderly patient with Dementia or any other cognitive disease, they will most likely say the end of the day when it starts to get dark outside, however, for certain people it is much more than that. The most common symptoms for Sun Downing include:

  • Agitation
  • Confusion
  • Suspicion
  • Restlessness
  • Irritation
  • Disorientation
  • Mood swings
  • Yelling and demanding

Scientists are not sure why Sun Downing occurs or what are the exact reasons for it. One theory maybe that Alzheimer’s disease causes the area of the brain that signals when you’re awake or asleep to break down which in turn leads to sundowning. There are certain factors however that may play a role in triggering it, they include:

  • Fatigue
  • The effect of Dementia or Alzheimer’s on the internal body clock
  • Hunger or thirst
  • Decrease in daytime light
  • Increase of shadows
  • Depression or boredom
  • Difficulty separating reality from dreams (this can lead to confusion)
  • Disturbed sleep patterns

Sun downing may become worse as the night goes on, fortunately there are some tips that can help both the patient and their caregiver get through this difficult time. Some of these tips are:

  • Trying to maintain a fixed sleeping schedule that does not allow for over napping during the day as this may disturb the night time sleeping rhythm
  • Trying to create a daily routine that consists of exposure to sunshine, physical activities and exercise which will in turn lead to a better night sleep
  • Limiting caffeine and sugar intake at night
  • Encouraging quiet and relaxing activities during the evening to soothe the patient down for example listening to calm music
  • Making sure the patient is in a well lit room that is free of clutter during the darker hours of the night to avoid agitation
  • Placing familiar objects around them –especially in unfamiliar environments- such as photos to avoid confusion
  • Avoiding large meals during the later hours of the evening; a big lunch and a light dinner is preferable
  • Caregivers should stay calm and avoid arguing with the patient during this time. They should speak gently to them and assure them that everything is fine.


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