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Sundowning: Identifying the Signs and Managing the Symptoms

Does your loved one get increasingly irritated when the sun starts to set? The connection between their declining mood and fading daylight is no coincidence. This common condition, called sundowner’s syndrome (or sundowning for short), among individuals with dementia occurs at sunset and causes changes noticeable changes in temperament, including agitation, confusion and more.

See the signs and learn how to manage the symptoms.

Signs of Sundowning

While the cause of sundowning is unknown, neuroscientists believe it’s due to a disruption of the circadian rhythm. This rhythm, which is synchronized with the daylight and nighttime, governs sleep and wake times. However, when the two are out of synch, sleep is negatively impacted. As a result, your loved one may have difficulty managing their tiredness and may exhibit the following when it gets dark:

  • Irritability
  • Confusion
  • Agitation
  • Aggression
  • Anxiety
  • Restlessness
  • Stubbornness

They may also wander, have hallucinations or delusions, or engage in repetitive behaviors.

Managing Symptoms

There is no cure for sundowning but many ways to minimize it.

Establish a predictable schedule.

A consistent daily routine can provide comfort to a person with memory loss and help signal the start and end of their day.

  • Schedule appointments, visits and difficult activities for early in the day
  • Avoid going out in the late afternoon and early evening
  • Create a quiet, peaceful environment in the evening and try to have your loved one go to bed at the same time each night

Alleviate stress with calming activities.

Frustration and stress over difficult tasks can increase your loved one’s irritability. Keep them calm with simple or relaxing activities.

  • Reduce restlessness with a walk or physical exercise
  • Give them easy tasks, like folding laundry or sorting beads
  • Go for a short ride
  • Play quiet, calming music or read to them

Prevent overstimulation and tiredness.

Exhaustion will make your loved one’s sundowning symptoms worse. Make sure they are rested throughout the day and getting adequate sleep at night.

  • Encourage one early afternoon nap (30-60 minutes)
  • Ask friends and family to visit early in the day
  • Do more difficult or upsetting activities earlier in the day.

Modify their environment.

People with dementia often lose track of where they are and a change in environment can increase confusion. Provide a comfortable, familiar space for your loved one to occupy.

  • Give them a safe place to pace, removing rugs and clutter from walking paths
  • Expose them to natural light during the day and make sure rooms are well lit at night
  • Reduce bothersome sights and sound, such as ringing phones, loud radios, etc.

Offer support and reassurance.

When a person doesn’t understand what they’re seeing or hearing, life can become very scary. Find ways to reassure them of their concerns and help them feel safe and secure.

  • Speak in a firm, calm voice
  • Do not argue or try to reason with them; use redirections and therapeutic stories
  • Calm them with soothing physical touch, like holding hands

If you are experiencing sundowning with your loved one, be sure to work with your physician to rule out any underlying issues. You can also partner with James L. West to help alleviate the symptoms. Contact our dementia care experts at caregiver@jameslwest.org or 817-877-1199 .