Sundowning is a common challenge for people living with dementia, where confusion, agitation, and restlessness increase in the late afternoon or evening. To reduce sundowning, it helps to create a calm, predictable environment and follow routines that support the person’s natural body clock.
One of the most effective ways to manage sundowning is to maintain a consistent daily schedule. This includes regular times for waking up, meals, activities, and bedtime. Predictability reduces anxiety and fear of the unknown, which can trigger agitation[1][2]. Encouraging gentle physical activity earlier in the day can also improve sleep quality and reduce restlessness at night[2][3].
Lighting plays a crucial role. Exposure to bright natural light or bright light therapy in the morning helps regulate the sleep-wake cycle, which is often disrupted in dementia[1][5][6]. In the evening, keeping the environment well-lit but avoiding harsh or blue light from screens can prevent shadows and confusion. Using a nightlight can help reduce fear caused by darkness without creating complete darkness, which might worsen hallucinations[1][4].
Reducing noise and overstimulation in the late afternoon and evening is important. Soft music, quiet activities like puzzles or folding towels, and avoiding loud TV shows or stressful tasks can help keep the person calm[2][3][4]. Limiting caffeine and sugar intake, especially later in the day, supports better sleep and reduces sundowning symptoms[1][2][3][4].
Caregivers should also watch for triggers by tracking when sundowning symptoms worsen. This can help identify specific causes such as hunger, pain, or boredom, which can then be addressed[2][4]. Creating a soothing bedtime routine with dimmed lights and calming scents like lavender may further ease the transition to sleep[2].
Medications are sometimes used to manage severe symptoms, but these should only be considered under medical supervision[3][4]. Overall, a combination of routine, light management, reduced stimulation, physical activity, and attention to diet can significantly reduce sundowning in people with dementia.
Sources
https://relish-life.com/blogs/articles/activities-to-combat-sundowning-in-individuals-living-with-dementia
https://www.youtube.com/watch?v=DyZdmfMyaJM
https://www.visitingangels.com/articles/sundown-syndrome-practical-tips-for-seniors-and-families/24814
https://caringseniorservice.com/blog/sundowning/
https://www.alzheimers.org.uk/blog/supporting-people-with-dementia-when-the-clocks-change
https://www.droracle.ai/articles/447145/what-agents-can-help-slow-down-sundowning-in-dementia
