What Is Sundowners Syndrome? Causes, Symptoms, & Treatment

If you have a loved one with dementia, you’ve probably heard of the term “sundowners syndrome.” But what does it mean? Keep reading to learn about what sundowners syndrome is along with common symptoms and treatment methods.

What Is Sundowners Syndrome?

Sundowners syndrome is a group of symptoms caused by Alzheimer’s and other forms of dementia. It occurs when an individual—typically one who is elderly—becomes more irritable, anxious, and irrational after the sun sets each evening.

What Are the Causes of Sundowning?

Sundowners syndrome has no direct cause that can be prevented. With that said, the following factors are known to trigger these sudden changes in behavior.

  • End-of-Day activities: Engaging in activities outside of one’s normal routine later in the day can aggravate confusion and anxiety.
  • Fatigue: Exhaustion hinders memory. When a person with dementia gets tired at the end of the day, they’re more likely to become forgetful and frustrated.
  • Low Lighting: When the sky becomes darker in the evening, it can make interior spaces look different than normal. A person with dementia may not recognize where they are, which will exacerbate confusion and frustration.
  • Loss of Hearing: A lack of hearing can cause your loved one with dementia to become nervous and confused.
  • Winter Blues: Winter months are characterized by fewer daylight hours in the evening. More time spent awake when it’s dark outside can heighten the effects of sundowning.

Read More: 7 Ways To Support A Person With Dementia During The Winter

Symptoms of Sundowners Syndrome

Here are some of the most common symptoms associated with sundowners syndrome:

  • Agitation
  • Anger
  • Anxiety 
  • Depression
  • Irritability
  • Frustration
  • Confusion
  • Sadness
  • Fear
  • Stubbornness
  • Repeating questions
  • Sudden mood swings

In more severe cases of sundowners syndrome, the individual may experience the following symptoms:

  • Hallucination
  • Hiding objects
  • Paranoia
  • Violence
  • Wandering 

Can Sundowning Go Away on Its Own?

While sundowning symptoms come and go, sundowners syndrome doesn’t subside on its own. It requires targeted behavioral treatments, along with medication in some cases.

Read More: 6 Risk Factors For Sundowing & Ways To Respond

At What Stage of Dementia Does Sundowning Occur?

Sundowners syndrome usually develops in the middle to late stages of dementia. However, symptoms can present themselves during the earlier stages as well. No two cases of sundowners syndrome are the same. Symptoms will appear at different stages for different people.

Can You Have Sundowners and Not Have Dementia?

Although sundowning is most common among adults with dementia, those without dementia can still experience it. The brain naturally loses mass as you age, which can increase feelings of confusion and disorientation. Those with Parkinson’s may also suffer from sundowners syndrome.

Read More: When Is The Right Time To Move Your Loved One Into A Memory Care Community?

What Can You Do to Minimize Sundowning Symptoms?

The key to minimizing sundowning symptoms is to minimize common triggers. Here are four practices you can implement to minimize the effects of sundowners syndrome.

    1. Follow a Routine: Setting a daily routine for your loved one with sundowners syndrome and ensuring they follow it is one of the best ways to minimize symptoms. It helps your loved one know what to expect so they aren’t taken by surprise. Try to keep them from napping during the day, as this can discourage a good night’s sleep.
    2. Monitor Diet Closely: Caffeinated and sugary beverages can keep dementia patients up at night and prevent them from falling asleep, which enhances their irritability.
    3. Minimize Noise Levels: Loud noises are often distracting and irritating to people with dementia. Reduce noise levels as much as possible to keep your loved one calm.
    4. Illuminate Spaces: Since darkness can make someone with dementia more confused, letting natural light in when possible and turning on lamps can reduce confusion at bay.
    5. Take advantage of Sunlight and Fresh Air:  Being outside in the sunshine helps modulate circadian rhythms and creates a bigger contrast between day and night which can help reduce sundowning symptoms.  

Compassionate Memory Care Solutions

Does your loved one with dementia need more specialized care than what you alone can provide? Terra Vista is here to help. As an award-winning memory care assisted living community, we offer personalized, around-the-clock care for those living with Alzheimer’s and dementia. Whether your loved one needs short-term rehabilitation, respite care or a long-term living solution, we can provide the memory care services they need.

Request a memory care consultation today to get started.

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Meet the Author

NATALIE MCFARLAND, BSN, RN, CDP

Natalie has compiled over eighteen years experience providing outstanding care to people with Alzheimer’s disease and dementia. In addition to being a certified Alzheimer’s and dementia care trainer, McFarland is a licensed continued education instructor for nurses and social workers through the Illinois Department of Professional Regulations. She has also developed several Alzheimer’s research partnerships. Included in those projects were Dr. Virginia Cruz, Ph.D., RN, Associate Professor of SIUE and Dr. George Grossberg, M.D., Medical Director of the Department of Psychiatry and Neurology at Saint Louis University. Natalie is a graduate of Southern Illinois University.