Sundown syndrome—also called sundowning or sunsetting—is a behavior common in people with Alzheimer’s disease. It describes the episodes of confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night.

Contributing factors

While the exact cause of sundown syndrome is not known, experts believe there are several contributing factors:

  • Physical and mental exhaustion (after a long day)
  • An upset in the internal body clock causing a biological mix-up between day and night
  • Medication that can cause agitation or confusion
  • Disorientation due to the inability to separate dreams from reality when sleeping
  • Less need for sleep, which is common among older adults

Suggestions for helping a loved one with sundown syndrome

Sundown syndrome can be draining for the person with Alzheimer’s disease and his or her caregivers. Some suggestions include:

  • Schedule the day so that the more difficult tasks are done early in the day, when the person is less likely to become agitated.
  • Restrict sweets and drinks with caffeine to the morning hours. Try serving the person a late afternoon snack or an early dinner.
  • To help the person relax, try decaffeinated herbal tea or warm milk.
  • Keep the house or room well lit. Close the drapes before the sun goes down, so the person doesn’t watch it become dark outside.
  • Try distracting the person with activities he or she enjoys. Soothing music or a favorite video may help, as well.
  • Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
  • Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep.
  • Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it’s most comfortable. Also, keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.

Once the person is awake and upset, experts suggest that caregivers:

  • Approach their loved one in a calm manner
  • Find out if there is something he or she needs
  • Gently remind him or her of the time
  • Avoid arguing or asking for explanations
  • Offer reassurance that everything is all right and everyone is safe

Let Continuum work the night hours and provide assistance home care so a family caregiver can get a solid night of rest in order to be refreshed and ready for a new day of care.   

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Tips courtesy of WebMD and The Alzheimer’s Association