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Tips for Managing Sundowning Syndrome in Seniors with Alzheimer's

Are you struggling to help a loved one with sundowning syndrome stay calm and safe? These tips may help.

As the sun begins to set, experiencing disorientation and agitation are common struggles for adults with Alzheimer’s disease. Both can be a challenge for family members to manage. Referred to as sundowning, sundowner’s syndrome, or sunsetting, this condition can cause seniors with Alzheimer’s to experience confusion, aggression, and restlessness in the late afternoons and evenings. Trying to keep a loved one who is sundowning safe and calm is a leading reason family caregivers experience burnout.

About 20 percent of people with Alzheimer’s disease will experience sundowning. According to the Alzheimer’s Association, the syndrome usually peaks during the mid-stages of the disease. As sunset draws closer, adults with Alzheimer’s and other forms of dementia become increasingly disoriented, anxious, or agitated. This can lead to attempts to wander from home.

Signs a Senior is Experiencing Sundowning

During an episode of sundowning, a person with dementia might suffer from insomnia, and seem to go days without sleeping. They may also pace back and forth around the house, try to wander from home, or become highly agitated and aggressive

Sundowning can cause a variety of difficult behaviors:

  • Nervousness

  • Fear

  • Paranoia

  • Hallucinations


What Causes Sundowning?

Like many other aspects of Alzheimer’s disease, the scientific community hasn’t yet been successful in determining what causes sundowning, but they do have some theories:

  • Disruption in one’s internal clock: The body’s internal clock can be upended by the damage Alzheimer’s causes to the brain. This may cause the senior’s biological clock to be confused about night and day.

  • Lack of exposure to sunlight: Exposure to natural sunlight helps regulate the body’s circadian rhythm. Adults with Alzheimer’s often spend much of their day indoors out of natural light.

  • Being overly tired: Because sundowning occurs toward the end of the day, fatigue from lack of sleep or too much late-day activity may be another potential cause.


Suggestions for Trying to Manage Sundowning

By making a few simple lifestyle adjustments, you might be able to prevent or minimize sundowning syndrome in a loved one with Alzheimer’s:

  • Establish a routine: A consistent schedule gives people with memory loss a feeling of security. When there is a routine, seniors rely less on short-term memory, which is often damaged early in the disease process. To the extent that you can, have set times for waking up, eating meals, taking medications, and performing regular tasks.

  • Plan activities early in the day: Avoid being overly busy later in the day, especially running errands and going on outings. This may help prevent your loved one from becoming stressed or fatigued just as the sun is beginning to set. Try to schedule your day so activities and appointments take place at an earlier time

  • Discourage naps: When a senior is suffering from insomnia, their days and nights can become mixed up. Taking an afternoon nap might seem like a good idea but could actually make things worse. Try to discourage or limit naps to just 15 or 20 minutes. This will likely help the senior reset their internal clock and sleep better at night.

  • Serve well-balanced meals: Making sure your loved one eats a healthy diet may also be helpful in managing sundowning-related agitation and anxiety. Limit sugar and caffeine to the morning hours. Also, avoid serving heavy meals late in the evening as research shows that can impede digestion and disrupt sleep.

  • Create a peaceful environment: In the late afternoon, as the sun begins its descent, turn off the television and try to limit other noises and activity. It might help to pull the shades, turn all of the lights on, and play soothing music. Encourage visitors to stop by early in the day, instead of during the evening hours.


If you are a family caregiver struggling to care for a loved one with Alzheimer’s disease, one solution might be to explore local memory care communities. At Sunrise, our memory care neighborhoods are designed to help residents live their best quality of life. Call the community nearest you to learn more!

Article By: Sunrise Senior Living

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