Why do people with dementia feel disoriented in bright lighting

People with dementia often experience disorientation and discomfort in bright lighting, particularly in the evening. This phenomenon is closely linked to sundown syndrome, a condition where individuals with Alzheimer’s and related dementias exhibit behavioral changes as the day progresses into late afternoon or evening. These changes can include confusion, restlessness, agitation, and anxiety.

One of the main reasons bright lighting can be problematic is that it can overstimulate the senses. People with dementia may become more sensitive to their environment as they tire, and bright lights can exacerbate this sensitivity. Additionally, bright lighting in the evening can interfere with the body’s natural sleep-wake cycle, which is regulated by exposure to light and darkness. When the body receives signals that it is daytime due to bright lights, it can struggle to wind down and prepare for sleep, leading to restlessness and disorientation.

Another factor is the disruption of the circadian rhythm. Natural daylight during the morning and early afternoon helps regulate the body’s internal clock, signaling it to stay awake and alert. However, as evening approaches, dimming the lights can help signal to the brain that it is time to relax. Bright lights in the evening can confuse this natural process, contributing to feelings of disorientation and agitation.

To manage these issues, caregivers often recommend using soft, indirect lighting in the evening to create a calming environment. This approach helps reduce overstimulation and supports a smoother transition into the evening hours. Maintaining a consistent daily routine and limiting evening stimulation can also help alleviate symptoms of sundown syndrome and improve overall comfort for individuals with dementia.