If a loved one with dementia becomes more agitated as evening nears, it may be sundowning. Here's what it is and why it happens.
What does sundowning look like?
Sundowning describes a cluster of behaviors that worsen in the late afternoon and evening. Signs include increased confusion, restlessness, pacing, anxiety, irritability, suspicion, and sometimes aggression or attempts to wander or leave. Some people become more demanding or have trouble settling for sleep. The National Institute on Aging notes these symptoms tend to ease overnight or by morning. Sundowning is not a disease itself but a pattern seen in many people with Alzheimer's and other dementias, often in the middle stages. Recognizing it helps caregivers respond calmly and adjust routines. For help finding senior care support, call 1-800-MEDIGAP.
What causes sundowning?
The exact cause isn't fully understood, but several factors contribute. End-of-day fatigue and mental exhaustion, disruption of the body's internal clock, reduced lighting and increased shadows, hunger or thirst, pain, and overstimulation all play a role. Unmet needs, boredom, and the caregiver's own end-of-day tiredness can intensify it. Some medications and disrupted sleep schedules make sundowning worse. Identifying a person's specific triggers, through a simple log of timing and circumstances, helps caregivers prevent episodes. A doctor can also rule out infections or pain that may be driving the behavior. To find resources and support, call 1-800-MEDIGAP at 1-800-633-4427.