Sundowner's Syndrome: Causes, Symptoms, Suggestions

“The nights are the hardest.” I’ve heard this phrase from many people I’ve known—family members who’ve lost loved ones, friends recovering from addictions. Somehow in nighttime, with its relative quiet and vivid darkness, it’s nearly impossible to hide from one’s own mind. For people in the early stages of Sundowner’s Syndrome, Alzheimer’s, and forms of dementia, nighttime can be so much more than a bit too dark and quiet. In fact, sundown may be a trigger for extreme agitation and confusion that lasts throughout the night, preventing sleep, exacerbating Sundowner’s symptoms (in this case) and rendering it impossible to be alert the following day.

Symptoms of sundowning, also known as Sundowner’s Syndrome, occur in the late afternoon or early evening and, according to the Sundowner’s Facts website, can include increased confusion, disorientation, agitation, anger, depression, restlessness, paranoia and rapid mood changes. Some resultant behaviors to look out for are rocking, crying, pacing, hiding things, acting out violently and wandering. The individual may even experience hallucinations. A person who is sundowning will likely spend a great deal of time wandering, trying to come to terms with her surroundings and mental state, and therefore is highly unlikely to be able to sleep.

The Sundowner’s Facts website lists some possible causes of sundowning. Decreased energy could be a trigger for Sundowner’s symptoms. After of a full day of activities and stimulation, feeling drained can make a person anxious and aggravated by her inability to perform chores, such as cooking dinner and tidying around the house—chores once done effortlessly. Nightfall can be disorienting, not only because it gets darker, but also because most people change their environment from day to night. Some experts theorize that Sundowner’s symptoms are related to darkness; studies have shown that symptoms decrease within an hour of daylight. While there is no known cure, there are a few measures that can be taken to help alleviate Sundowner’s symptoms.

Practical Advice for Dealing with Sundowner’s Syndrome

The Alzheimer’s Foundation of America suggests:

  • Allow for light exposure in the early morning to help set internal clock.
  • Discourage day-time napping to regulate sleep cycle.
  • Encourage exercise throughout the day to expend excess energy.
  • Limit caffeine intake, particularly in the evening to avoid potential Sundowner’s symptoms.
  • Plan activities for the daytime so there is sufficient time to adjust to night.
  • Have a quiet nighttime activity ready and a private space for relaxing.
  • Consider purchasing a bedside commode. Leaving his or her bed to use the restroom can start the cycle all over again, making it hard to get back to sleep.
  • Schedule regular medical appointments to ensure he or she is not in any physical pain and to check for worsening Sundowner’s symptoms.
  • Take precautions to provide a safe space for him or her at night so that you can get a solid night’s rest, even if he or she needs to stay awake and wander.

Even the coziest, quietest home can be suffocating and treacherous for someone in a further confused, unfamiliar state. Whether or not you fully understand psychiatric illnesses, there’’s no denying the look of terror that accompanies dissociation, and no ignoring it when it comes from someone you love.

SEE ALSO: Find Memory Care Near You

Here’s to preserving the midnight oil—

Read more about Improving the Quality of Life of an Elder with Dementia or about Validation Therapy and Redirection Techniques.

Find what you need to create an Alzheimer’s friendly home.





over 1 year ago, said...

What can i do to improve the home for a person who has sun downers and dementia sun downers are more of the signs my patient has.


over 3 years ago, said...

Dealing with overly agressive patients


about 4 years ago, said...

Its horrible when its happening to your 43 yr old fiance. He is much too young to be experiencing such a horrific disease.


over 4 years ago, said...

The Dor Locke Mainly,I've got All the Rest. Thanks for the Tips.


almost 5 years ago, said...

I'd question, question, and keep questioning why a woman with no family is not allowed to have visitors and maybe ask a state agency to look onto her care, since her only connections to the outside world--her firends--are not allowed to see her. It may be that she truly is unable to tolerate visitors or has asked that no one visit, but it seems worth checking out to be sure.


almost 5 years ago, said...

I have a dear friend in a nursing home and was recently diagnosed with Sundowner...but the nursing home will not allow her to have any visitors..she has no family and there are four of us that go and see her..I cannot understand why the nursing home will not allow her to have visitors...


about 5 years ago, said...

Nothing great as is!


about 5 years ago, said...

This article ws very helpful and informative. i look forward to more of this caliber. Thanks


over 5 years ago, said...

Yes it was helpful it explains a few new issues thats occurribg with my mother,Thanks Alot .


over 5 years ago, said...

I fell very scared I do believe my husband suffers from sundowners, but here is the problem he is a retired Army Col. several times he has got up looking for his guns, he says that he heard something but is almost deaf, Im so afriad he will come in my room and not knowing what he is doing and hurt or even kill me. he almost never remebers what he did or said the next day and is like a differant person, he can remember names phone numbers the day and date almost normal behavior. so really not sure what to do. oh and he already takes 25mg seriquil at nite.


over 5 years ago, said...

My Mother is 92 and has been in rehab/nursing home for two years due to Parkinson's . She is still very alert and has her mind but not able to walk. Lately I've noticed when I am about to leave her in the early evening she is disoriented. She ask if she is going home or if I'm going to stay with her all night. She is very sweet , never agitated just seems overly tired. The nurse told me she has Sundowners. Sad. Makes me want to pick her up and carry her to my home!


over 5 years ago, said...

I have just been told by someone that what my mother-in-law is experiencing may be sundowners, but I cannot find too much about the symtoms she is having. Since her husband passed away over a year ago she has been seeing people. At first, just a sight that looked like him, and then others. It has gotten worse. Every night seeing people in her room. Other than the halucinations, she seems fine with her mind?? It is so bad she barely sleeps now. I wonder if this is part of the sundowners?? We will now find a doctor to console.


almost 6 years ago, said...

someone just told me today that my mom probably has sundowners. This is the first time I have heard of this. She seems to remember pretty good most of the time but after dinner it is almost like she is totally out of it. She is 91 years old. She is totally devoted to family and sometimes I feel so guilty because she is in a nursing home.


almost 6 years ago, said...

It validates what is happening with our mother so we can understand it more rather than just being frustrated.


almost 6 years ago, said...

hi all!