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Sundowner Syndrome, also called “Sundowning,” is a group of symptoms which are often exhibited among people with Alzheimer’s disease or dementia towards the end of the day. People with Sundowner Syndrome may become increasingly confused, disoriented, demanding, suspicious, irritable, etc., in the late afternoon or evening. They may pace or wander around the house at night.


What causes Sundowner Syndrome?

Experts do not know the cause of this behavior, but some factors that may aggravate late-day confusion include:

  • The person with Alzheimer’s disease gets tired at the end of the day and is less able to cope with stress.
  • The person with Alzheimer’s disease can’t see well in low light and becomes confused, or is confused by the shadows cast in dim light.
  • The person with Alzheimer’s disease is involved in activities all day long and becomes restless if there is nothing to do in the late afternoon or evening.
  • The person with Alzheimer’s disease naps during the day and is not tired at night.
  • The caregiver is tired at the end of the day, and the person with Alzheimer’s disease senses or experiences the result of this stress and fatigue.

What can be done to reduce the symptoms of Sundowner Syndrome?

According to the Alzheimer’s Association, some ways to reduce behaviors of Sundowning include:

  • Make afternoon and evening hours less hectic.
  • Schedule appointments, trips, and activities such as baths or showers early in the day.
  • Help the person to use up extra energy through exercise. For the person who tends to pace or wander in the evening, you may want to arrange at least one or two brisk walks during the day.
  • Control the person’s diet. Reduce foods and beverages with caffeine (chocolate, coffee, tea, and soda) or restrict them to the morning hours to reduce agitation and sleeplessness. An early dinner or late afternoon snack may also help.
  • It’s important to provide regular activities, and you may want to discourage napping during the day if nighttime sleeplessness is a problem.
  • You may want to reduce the level of noise from radios, televisions or stereos, control the number of people who visit in the evening hours, or confine noisier family activities to another area of the house.
  • Consult with your physician. Your physician may be able to prescribe medication to encourage sleep. At the same time, your physician can check for signs of depression or physical problems such as prostate difficulties that might lead to frequent urination. This condition can make sleep uncomfortable.
  • Make it easy for the person to use the bathroom. Consider a bedside urinal or commode. Or encorage the person to use the bathroom before going to bed.
  • Keep rooms adequately lit. Good lighting may reduce the person’s confusion. A nightlight may prevent the person from becoming agitated in unfamiliar surroundings.

MOST IMPORTANTLY, the caregiver should remain flexible and remember to take care of themselves, too.

For more information

Alzheimer’s Association California Southland Chapter
(800) 272-3900 24-hour helpline

Mayo Clinic