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Tips on How to Deal with Sundowner's Syndrome

Get tips on how to deal with Sundowner's Syndrome from Seniorly. Easing Sundowner symptoms can help make your loved one more comfortable at the end of the day.

By Marlena del Hierro · Updated Jan 25, 2023
Reviewed by Nipun Chopra · Reviewed Dec 15, 2022

What is Sundowner's Syndrome?

Sundowner’s Syndrome is an ailment that affects many older adults in the mid to late stages of Alzheimer’s Disease or dementia. It can cause feelings of confusion, agitation, and overwhelming sadness. When these feelings are triggered, it can be called “Sundowning” or “Sundown.” Most patients experience the most troubling symptoms during the late afternoon, evening, and nighttime hours when the sun starts to set; hence the name “Sundowner’s Syndrome”.

Some doctors believe that Sundowner’s Syndrome is a result of overwhelming sensory stimulation during the day, others suspect that hormonal imbalance is involved, while a third hypothesis suggests that Alzheimer’s affects the brain region important to normal day-night cycle. Disorders such as depression may worsen the symptoms of Sundowning, leading to unbalanced emotional states that affect dementia patients, family members, and dementia caregivers alike. Fortunately, there are methods to deal with Sundowner’s symptoms and mitigate this stress.

What Triggers Sundowning?

Sundowning symptoms will likely show themselves as the day progresses and particularly when the sun starts to go down. The timing of its occurrence depends on your loved one’s circadian rhythm; their internal body clock will determine when they will start to experience feelings of confusion or depression.

Generally, there are a few known events that can trigger Sundowning, including:

  • Fatigue and lack of sleep
  • Too much stimulation or activity later in the day
  • Internal or hormonal imbalances
  • Low light and heightened darkness in winter months
  • Disorienting or new routines

How to Deal with Sundowner’s Symptoms

So how can you get help for Sundowner’s Syndrome? Managing Sundowning symptoms involves anticipating the time of day, daily routines, and mood swings for those with Alzheimer’s or people with dementia.

Here are five methods that have proven successful in calming or managing Sundowner’s symptoms:

  1. Reducing caffeine and alcohol earlier in the day
  2. Establishing a routine for bedtime
  3. Providing light at night
  4. Surrounding loved ones with comforting objects
  5. Potential supplement or medication support

Since Sundowning is most common at night, ensuring that your loved one is ready for the evening and bedtime by supporting daily habits is important. Below outlines each method to ease Sundowner’s in greater detail.

  • Reduce caffeine and alcohol

It may be wise to stop caffeine and alcohol intake after dinner, so that your elderly loved one is ready for sleep at night when the time comes.

  • Establish a routine

Establishing a bedtime routine may also help alleviate symptoms by making your loved one feel more comfortable and calm in the evening time before they fall asleep.

  • Provide light

Purchase a lightbox or a nightlight to keep your loved one’s room somewhat lit as the house gets dark. Having some light can help reduce confusion associated with dementia and make your loved one feel safer in their bedroom when it’s dark.

  • Offer comforting objects

You can try surrounding your loved ones with familiar objects before they fall asleep at night, whether these are favorite books or pictures or childhood toys. These meaningful objects can help comfort your loved one through a difficult time and connect them to memories that can calm nerves and make them feel more secure in their own skin.

  • Seek medical attention

If you are concerned about a loved one, and you are at a loss for how to deal with Sundowner’s symptoms, talk to a physician about possible underlying conditions that may be affecting sleep patterns and increasing agitation at night. Doctors specializing in memory loss will be able to assess the specific form of dementia or provide medication for people with Alzheimer’s to help reduce Sundowning symptoms.

The important thing to remember is that you can alleviate the individual's anxiety and depression by providing a calm, predictable daily routine. Incorporating familiar, joy-filled objects into their day can also help reduce Sundowning feelings at night, especially for older people with memory-loss issues.


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written by:
Marlena del Hierro

Marlena del Hierro is Vice President of Partnerships and Seniorly’s Lead Gerontologist. Marlena earned her Master of Arts degree in Gerontology from San Francisco State University and her Bachelor of Arts degree in Human Development from California State University. She also serves in an advisory capacity for Jukebox Health. As Seniorly’s first employee, Marlena is a vocal advocate for evolving the aging paradigm, and is a frequent contributor to public discussions about aging. She has served as a resource for media outlets like WGBH, FOX News, CNBC and the Today Show.

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View other articles written by Marlena

Reviewed by:
Nipun Chopra

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