Understanding sundowning syndrome and how to manage it

Sundowning syndrome, often called sundowning, is a condition that affects many older adults, especially those with Alzheimer’s disease or other types of dementia. It usually happens in the late afternoon or evening and causes symptoms like confusion, restlessness, anxiety, irritability, and sometimes even aggressive behavior. People experiencing sundowning might pace around nervously, have mood swings, struggle to sleep well at night, or in severe cases experience hallucinations.

The exact cause of sundowning isn’t fully understood. However, it seems linked to changes in the body’s internal clock—called circadian rhythms—that regulate sleep and wake cycles. As daylight fades and shadows grow longer in the evening hours, these changes can confuse someone with dementia. Other triggers include fatigue from a long day without enough rest; too much noise or stimulation during daytime; disruptions to daily routines; hunger or dehydration; and physical needs like needing to use the bathroom but not being able to communicate it clearly.

Managing sundowning involves creating a calm and predictable environment as evening approaches. Here are some practical ways caregivers can help:

– **Keep a consistent daily routine** so the person knows what to expect throughout the day.

– **Ensure plenty of natural light exposure during daytime** because bright light helps regulate sleep-wake patterns.

– **Reduce noise and distractions later in the day** by turning off loud TVs or radios.

– **Watch for signs of tiredness early on** so you can encourage rest before agitation starts.

– **Offer small meals or snacks regularly**, staying mindful that hunger can worsen symptoms.

– **Create a soothing atmosphere with soft lighting**, avoiding harsh shadows which may increase confusion.

– If possible, engage your loved one in gentle activities earlier in the day rather than late afternoon when they might become overstimulated.

Sometimes simple adjustments like these make a big difference by easing anxiety and helping maintain better sleep at night for both those affected by sundowning and their caregivers. Understanding this syndrome as part of how dementia affects brain function allows families to respond with patience rather than frustration during difficult evenings.