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What is Sundowners Syndrome?

As a committed caretaker of a senior with dementia or Alzheimer’s, you likely rigorously track their daily habits. From maintaining their Power of Attorney to tracking their eating habits – you know the importance of staying attuned to daily shifts to keep on top of their needs.

Alzheimer’s reveals escalating symptoms as the condition progresses from the early to the late stages. One common behavioral change is sundowning, a set of symptoms that affect people in the mid-to-late stages of Alzheimer’s. Amidst so many factors to track, you may be wondering, “What is sundowning exactly? What are the signs I should look for? And how will it affect my loved one?” Here we will outline common characters and provide tips for things you can do to alleviate the symptoms of sundowning.

What is Sundowning/Sundowners Syndrome?

If you’ve noticed a shift in your loved one’s behavior from daylight to nighttime, you’re likely witnessing sundowning. Sundowning is an evident behavioral change in the late afternoon or evening hours as the sun begins to set. Confusion sets in and causes erratic behavior that is uncharacteristic for the dementia or Alzheimer’s senior.

When in foreign environments – such as visiting an unfamiliar house or visiting a hospital – they can also demonstrate sundowners syndrome. While sundowning can happen during the day, symptoms are most likely to occur at night when there is a decrease in light.

Though the precise cause of sundowner’s syndrome is unknown, researchers posit that it is caused by interference to a person’s natural body clock. Short winter days are more likely to aggravate sundowning symptoms, as is travel to a different time zone.

What Are the Early Signs?

The early sundowners syndrome symptoms may be difficult to recognize due to the mixed behavioral shifts from day to day. Symptoms can be unpredictable and varied. For example, one evening, your loved one may be defiant and refuse to get dressed for bed. In contrast, the following evening, they may be sad and unresponsive to questions. The signs can be subtle, so it may take time to notice the behavioral changes.

The common early signs of sundowners syndrome include:

  • Inability to follow directions
  • Pacing, nervousness, and anxiety
  • Confusion
  • Shadowing the behavior of others
  • Feeling melancholy
  • Repeatedly asking questions and interrupting the response
  • Rapid shifts in mood

More severe symptoms include:

  • Wandering
  • Having delusions
  • Paranoia
  • Hiding objects
  • Violent behavior

How to Reduce and Treat Sundowners Symptoms

Every dementia patient is different, so there is no one-size-fits-all approach to alleviating symptoms. It may take you time to integrate a few different techniques to see how your loved one responds best. Some of the optimal options include:

Establish a Routine and Stick With It

Predictability allows the senior to feel secure by allowing them to anticipate what’s next. Inconsistent routine is likely to cause confusion and even distress, so empower your loved one with a clear daily course of action. Plan meals, walks, and TV time around the same time every day.

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Increase Light Exposure

A daily stroll may help alleviate sundowner symptoms. Daily light exposure helps maintain the body’s natural clock and regulate the circadian rhythm. In winter months that have longer stretches of darkness, eliminate shadows that can induce fear and confusion. Using technology – such as daylight lamps and full-spectrum light boxes – is also an effective way to control the light setting in the room and make your loved one feel more at ease.

Create a Bedtime Ritual

Establishing a nighttime routine will help the senior feel rooted in predictability and also aid them in sleeping better at night. Cut out the caffeine and alcohol at night and integrate habit-forming rituals – such as a bath, stretching, or deep breathing – will ease your loved one into a good night’s sleep.


At Civitas Senior Living, we’re committed to providing you and your loved one the resources to maintain a high standard of living. Our cozy rooms at The Cottage – our dementia and Alzheimer’s wing – were designed to enhance familiarity and make our residents feel right at home. Plenty of natural sunlight and a consistent routine foster a comforting atmosphere. Contact us with your questions about sundowners syndrome or any other concerns about elderly care.

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