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What is Sundowning Syndrome?

Alzheimer’s Family Center (AFC) will be launching its new Evening Program on Wednesday nights starting in October. Besides offering the same high-quality services as our weekday program, AFC’s evening services will also introduce protocols to help address sundowning. But what exactly is sundowning syndrome and how does it affect patients with dementia?

Sundowning is a phenomenon that may occur in patients with Alzheimer’s disease, and is often referred to as “late-day confusion.” Sundowning is most frequently present during the middle to late stages of the disease, but can happen at any stage. Sundowning is likely due to an interruption in the body’s “internal clock” leading to anxiety, disorientation, or aggression. Some people who experience sundowning may have difficulty separating reality from dreams, and difficulty interpreting shadows and light. This may lead to pacing or wandering behaviors, or the person may become restless or irritated.

The phenomenon of Sundowning is important to recognize as it may interfere with communicating with your loved one like you normally do. You may notice that later in the day, as the light is fading, they may have increased agitation, confusion, and be less receptive to respond to you or cooperate with a task. You may also notice a change in their sleep cycle in which they become sleepy or fatigued in the later afternoon, and may not sleep as well through the night.

Tips for Helping with Sundowning

To improve the chances of having positive and effective communications, avoid introducing stressful situations, new requests, tasks or concepts in the late afternoon. The morning is often the best time to communicate important information, as many individuals with memory loss tend to be clearer in the morning hours. If your loved one is experiencing symptoms of Sundowning, try the following:

  1. Stay active during the day to promote good sleep habits at night.
  2. Brighten the lights when your loved one feels confused or agitated in the early afternoon or evening.
  3. Avoid stressful activities and noisy or overstimulating environments during Sundowning episodes.
  4. Use familiar items to comfort them- a familiar keepsake, blanket, or other item.
  5. Keep a routine. A regular schedule of waking up, activities, and going to sleep will help promote a regulated sleep schedule for both caregivers and their loved ones.


This excerpt was taken from our eighth caregiver e-book titled Communicating With Your Loved One. To download it and our nine other books, click here.