Sundown syndrome causes symptoms of agitation and confusion as daylight fades. It may also be referred to as “sundowning syndrome” or simply “sundowning.”
A person experiencing sundown syndrome may pace, wander, yell, or have difficulty sleeping. If home remedies don’t provide relief, talk with your loved one’s doctor.
This article provides ways to manage sundown syndrome.
If someone with dementia becomes agitated in the late afternoon or early evening, listen carefully and quietly to their concerns. Sometimes, unmet physical needs like hunger or thirst can contribute, and you may be able to meet those needs by listening to the person.
Reassuring your loved one and providing distractions, such as small snacks or favorite activities, may also help. Avoid arguing, acting upset, or using physical restraint — if words don’t work, with supervision allow the person to pace.
Learn more about how to talk with a parent with dementia.
You may be able to prevent sundown syndrome or reduce the symptoms by helping a person with dementia avoid sugary treats and caffeinated beverages later in the day. According to the Alzheimer’s Association, alcohol may also contribute to sleep problems, so avoiding it can be beneficial.
In addition, consider adjusting your schedule so the largest family meal occurs at lunch and dinner is simpler and calmer, requiring less energy to prepare and consume. This could help your loved one maintain a calmer frame of mind later in the day.
Keep notes or a log of what happens before sundown syndrome begins to occur. You may identify activities or situations that make your loved one’s symptoms worse, such as disturbing TV shows, visits from children, or loud music.
Then take steps to avoid these factors in the late afternoon and evening hours. Try to schedule any visits earlier in the day and keep the evening’s activities quiet and calm.
4. Encourage physical activity
Moving more throughout the day can help a person rest more easily at night. Build in time for physical activity, but try not to do too much within a few hours of bedtime.
A study involving 60 people with Alzheimer’s disease found that walking in the morning and afternoon was a safe and effective way to relieve sundown syndrome, with afternoon walking having faster benefits. The study also noted that longer walks seemed to be more beneficial.
If you need help determining safe ways for your loved one to get regular physical activity, talk with their doctor.
Learn 7 caregiver tips for calming Alzheimer’s agitation.
5. Wind down as the day goes on
Cut back on stimulation as night falls to help everyone relax. Schedule quiet activities, such as playing soothing music, reading, or talking with a loved one.
Close the curtains at dusk and turn on indoor lights to minimize confusion. Use nightlights in the bedroom, hall, and bathroom so a person who does need to pace stays safe.
Learn more about how Alzheimer’s caregivers can cope with dementia mood swings.
People with Alzheimer’s disease and other dementia subtypes may experience excessive daytime sleepiness. Resting during the day can help a person avoid exhaustion, but taking naps too close to nighttime may disrupt their sleep and make sundown syndrome worse.
Schedule regular downtime between activities. It’s best to try and avoid daytime naps if possible, but if a person needs to nap, try to keep their naps short and limit them to the morning and early afternoon hours.
Learn more about how Alzheimer’s disease can affect sleep.
7. Keep a regular routine
Stick to a regular schedule during the day to reduce confusion or agitation. Begin by waking up at around the same time every day and getting some sunlight — this helps reset a person’s body clock.
Plan meals and other activities at regular intervals. Try to schedule activities that require more energy — such as bathing or doctor’s appointments — earlier in the day. Then, set bedtime for the same hour each evening.
8. Get a doctor’s input
If home remedies like those listed above don’t relieve a person’s symptoms, a thorough medical examination may identify underlying causes. For instance, pain, sleep disorders, or medication side effects can contribute.
A doctor may be able to recommend simple methods, such as adjusting medication timing, to minimize these issues. In other cases, they may prescribe a new medication.
Some studies suggest the hormone melatonin, which helps regulate sleep-wake cycles, could work with few side effects. Other medications like cholinesterase inhibitors and antipsychotics may relieve sundown syndrome, but more research is needed.
Learn 7 tips for Alzheimer’s caregivers.
Managing sundown syndrome may require a multifaceted approach. It could help to listen to a person when they become agitated, encourage regular walking, or schedule more intensive activities earlier in the day so a person can wind down in the afternoon and evening.
Talk with your loved one’s doctor if more conservative approaches don’t relieve their symptoms. Their doctor may be able to recommend additional measures to take or medications that may help manage sundown syndrome.