What is Sundown Syndrome?

July 30, 2021

Alzheimer’s disease and other forms of dementia are known for causing a multitude of mood and behavior changes. One common example of this is sundown syndrome. Sundown syndrome, also known as sundowning or late-day confusion, is a term used to describe a notable increase in restlessness, agitation, irritability, or confusion that typically lasts through the evening hours of the day.

Your loved one is most likely to experience sundowning during the middle stages of dementia. And although sundowning is most common in the evening, it can also occur in the early morning, and may occur more frequently during winter months when the days are shorter.

Doctors aren’t sure what causes sundown syndrome, but some evidence suggests it may be related to disruptions in circadian rhythm (the internal process that regulates the body’s sleep–wake cycle) – which can be affected by light exposure levels.


Tips for Managing Sundowning Symptoms

Caring for a loved one going through a sundowning episode can be challenging, even frustrating. However, it’s important to be comforting and patient. Remember: sundown syndrome is not something your loved one can control.

The first step in managing sundown syndrome is paying attention to your loved one’s environment and activities to identify triggers that exacerbate sundowning symptoms. Once you know their triggers, it will be easier to avoid situations that promote agitation and confusion. You can also try making the following changes to minimize symptoms:

Stick to a daily schedule

Try to maintain a predictable routine for daily activities. Dementia can make it hard to cope with novel events and surroundings. Your loved one may experience feelings of stress or confusion when there are changes to their routine or environment – which can be compounded by sundowning. If you do need to make changes, introduce them gradually.

Encourage an active lifestyle

Too much inactivity or napping during daylight hours can promote restlessness and other sundowning symptoms at night. Plan more activities through the day to keep your loved one awake and engaged.

Use evenings to wind down

During the evening, try to cultivate a quiet environment and limit stimulating activities, like television. This can help ease your loved one’s transition into a restful sleep and avoid triggering their sundowning symptoms.

Make dietary changes

Large meals and certain types of foods can make it more difficult to rest in the evening. Avoiding caffeine and alcohol, or enjoying them earlier in the day, can make a big difference in sleep quality. A heavy lunch followed by a light dinner with limited evening snacking can also help your loved one feel more comfortable and rest easier at night.

Sundown syndrome can be exhausting for both you and your loved one. If sundowning continues to be a problem, don’t be afraid to ask for help. Your loved one’s doctor may discover underlying conditions that can worsen sundown syndrome such as pain, sleep apnea, or medication side effects. They can also help you identify possible triggers tactics for managing symptoms.

As one of Florida’s official memory disorder centers, MIND Institute at Miami Jewish Health is devoted to empathic diagnosis, brain fitness, innovative research, and one-on-one care and support for individuals and their families. If you have questions about sundown syndrome and memory care options for your loved one, contact us at 305.514.8710.


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