Sundowner’s Syndrome

The Alzheimer’s Association reports on studies that show “as many as 20 percent of persons with Alzheimer's will experience increased confusion, anxiety and agitation beginning late in the day. Others may experience changes in their sleep schedule and restlessness during the night.”  This condition is often referred to as sundowning or sundowner’s syndrome.   

In addition to the anxiety and agitation, other symptoms for the syndrome include anger, depression, pacing, fear, restlessness, hallucinations, paranoia, wandering and violence.  The cause of sundowning is not known but researchers speculate that the condition may be triggered by a number of factors such as fatigue or an overreaction to the day’s sensory stimulation.  Some think that sundowning could be the result of anxiety caused by the inability to see well in the dark.  Another reason may be hormonal imbalances that occur at night.  Also because people with sundowner’s symptoms experience a disruption in their sleep-cycles, that can create more behavioral problems.     

The Alzheimer’s Association advises that any sleep disturbances should be discussed with a doctor but experts do offer some helpful tips to cope with sundowner’s syndrome.  One of the suggestions is to keep the home well-lit during the evening hours.  They also recommend scheduled meal times and bedtimes.  If the person needs a nap, it should be taken early in the day.  Furthermore, doctor appointments and other activities should be scheduled for the morning or early afternoon as it allows for plenty of downtime before evening.    

Furthermore, the person’s biggest meal should be at lunch and only a light dinner.  It is important to avoid nicotine and alcohol, and any caffeine consumption should be restricted to morning hours.  At night, help keep the person safe by providing nightlights and make sure doors are windows are locked.  If wandering is a big part of their sundowning behaviors, use door sensors and motion detectors.   

For informational purposes only, please consult your health care provider if you have any questions regarding your health.  

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Sources: agingcare.com/Articles/sundowners-syndrome-133187.htm

alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning