Community Outreach

Sundowner’s Syndrome: Recognizing and Managing It

  • This article was found on the activity connection website; By Ava M. Stinnett and was retyped as helpful information for visitors of the Golden Crest website

Daylight savings time (DST) was first suggested by Benjamin Franklin in 1784 with the purpose of making better use of daylight and conserving energy. The idea didn’t take off until much later, with numerous variations of DST throughout history. Many folks dread changing their clocks twice a year, especially in the fall. With limited daylight, some people get the winter blues, characterized by irritability, lethargy, a change in sleep patterns, difficulty concentrating, and depression. Some physicians refer to this as seasonal affective disorder (SAD).

Sundowner’s syndrome (or sundowning), which shares some of the same characteristics as SAD, sometimes affects people with Alzheimer’s or other forms of dementia. Sundowning isn’t a disease but a group of symptoms that occur at a specific time of day, specifically beginning at dusk and into the evening. You may notice confusion, anxiety, aggression, or ignoring directions. Sundowning can also lead to suspicion, delusions, pacing, or wandering. The exact cause of this behavior is unknown; however, researchers have noted the following triggers:

  • End-of-day exhaustion (both mental and physical)
  • Upset in the internal body clock, causing biological mix-up between day and night
  • Reduced lighting, which can make already challenged vision even more challenging
  • Diminished levels of melatonin–a naturally occurring hormone that induces sleepiness
  • In a care facility, activity during staff shift changes or the lack of structured activities in the late afternoon and evening

Tips for Managing Sundowning

  • Always keep in mind that fatigue plays a major role in sundowning
  • Routines help those experiencing sundowning to feel safe. Try to maintain a predictable schedule for waking, meals and activities, and bedtime.
  • As the sun goes down, keep rooms well lit so that your loved one can see while moving around. Night lights often help reduce stress if they need to get up in the night for any reason
  • Try to reduce background noise and stimulating activities, including TV viewing. Play familiar gentle music in the evening or relaxing sounds of nature, such as the sound of waves or a rain forest.
  • Keep orienting people confused by sundowning to where they are and what is happening so that they feel secure and well protected.
  • Do not argue with the person. This rule of thumb becomes more crucial with sundowning’s intensifying behaviorial problems.
  • Try whatever works to calm the person, from a favorite pastime to simply folding clothes.

It’s important to always keep in mind that people with Alzheimer’s do not have control over their behavior and that their occassional exasperating behavior stems from the inability of the brain to sort out a confusing environment.

Back to Community Outreach