Disorientation at sunset, a behavior common among adults with dementia, is a difficult behavior for caregivers to manage. It is commonly referred to as sundowning, sundowner’s syndrome, sunsetting, or shadowing with sundowning being the most common. The syndrome causes confusion and restlessness in the late afternoons and evenings.

As the sun begins to set, adults with Alzheimer’s and other forms of dementia might become disoriented, anxious, or agitated. This can lead to wandering or attempts to wander from home.

About 20% of people with Alzheimer’s will experience sundowning. According to the Alzheimer’s Association, this condition usually peaks during the midstages of the disease.

Common Signs of Sundowning

During an episode of sundowning, an adult with dementia might suffer from insomnia, pace back and forth throughout the house, attempt to wander from home, or become highly agitated and aggressive. Sundowning syndrome is a common reason family caregivers experience burnout.

Other common symptoms of sundowning can include the following behaviors:

  • Paranoia
  • Hallucinations
  • Disorientation
  • Fear

Potential Causes of Sundowning in People with Dementia

While researchers haven’t yet confirmed what causes sundowning, they do have some strong suspicions:

  • Internal clock:

    The body’s internal clock can be disrupted by the damage the disease causes to the brain. This may cause the senior’s biological clock to be confused about night and day.
  • Sunlight:

    Exposure to natural sunlight helps regulate the body’s circadian rhythm. Adults with dementia often spend much of their day indoors out of natural light.
  • Fatigue:

    End-of-day fatigue from lack of sleep or too much late-day exertion may be another reason people with dementia experience agitation and anxiety related to sundowning.

Strategies for Managing Sundowning

Some simple lifestyle adjustments may help you prevent or minimize sundowning syndrome in a loved one with dementia:

  • Establish and stick to a routine:

    A consistent schedule gives adults with dementia a feeling of security. It also means they have to rely less on short-term memory, which is often damaged early in the disease process. Establish times for waking up, eating meals, administering medications, and other regular activities to the extent you can. It may help to prevent late-day anxiety and confusion.
  • Plan activities early in the day:

    Avoiding late-day activities and outings might help prevent your loved one from becoming overly tired just as the sun is beginning to set. Try to schedule appointments and errands for earlier in the day.
  • Discourage naps:

    Try to discourage afternoon naps or limit them to just 15 or 20 minutes. This will likely help the senior sleep better at night.
  • Maintain a healthy diet:

    Diet matters when it comes to managing agitation and anxiety caused by sundowning. Limiting sugar and caffeine to the morning hours might help. Avoiding heavy meals late in the day is another suggestion.
  • Peaceful environment:

    Turn off the television and try to limit other noise and confusion in the late afternoon and evening. It might help to pull the shades, turn the lights on brightly, and put on soothing music. Encourage visitors to stop by early in the day, in lieu of during the evening hours.

If you are a family caregiver struggling to manage the care of a loved one with dementia, it might be time to explore local memory care communities. These specialized care centers are designed to help adults with dementia live their best life despite the disease.

Call us at 800-304-8061 to learn more about memory care programs in your local community. As always, the advice of our senior care advisors is free!


Photo by Marc-Olivier Jodoin on Unsplash