What Is Sundowning?
Sundowning, also calledsundown syndrome, is the increased anxiety andagitationthat some people withdementia(and occasionally some without dementia) often display in the later afternoon and evening hours. Sundowning behaviors include restlessness,falls,calling out, crying, pacing,wandering, fearfulness, mood swings,paranoia,hallucinationsand shadowing.
Challenging Behaviors Can Increase near the End of the Day.José Antonio Jiménez age fotostock/ Getty Images
Prevalance
The Alzheimer’s Association estimates that approximately 20% of people withAlzheimer’sexhibit sundowning behavior. However, some research has placed that number as high as 66%, specifically for people with dementia who are living at home.
In Which Stage of Dementia Does Sundowning Behavior Develop?
Sundowning behaviors, along with other challenging behaviors, most often develop in the middlestages of dementiaand increase as the disease progresses.
What Causes Sundowning?
There are several theories as to what triggers sundowning. These include the following:
Which Medications Cause Sundowning Symptoms?
Which Interventions Should Be Used to Help in Sundowning?
Approaches that are individualized to each person are the best way to respond to, prevent and minimize sundowning. Some specific non-drug approaches that may be helpful include the following:
Possible Medications
Some physicians have also prescribed medication to “take the edge off” these behaviors. Medications should always be a second resort after non-drug interventions have been attempted. Medications should not be given to alleviate the caregiver’s burden but rather should be focused on minimizing the distress of the person.
Can Too Many Medications Increase Dementia Symptoms?
Melatonin,acetylcholinesterase inhibitorsandantipsychotic medicationshave all shown some benefit for some people with sundowning behaviors in research studies.
SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alzheimer’s Association. Sleep Issues and Sundowning.https://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.aspAlzheimer Society Canada. October 11, 2012. Sundowning.http://www.alzheimer.ca/en/Living-with-dementia/Understanding-behaviour/SundowningKhachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: An update. 2011;8(4).http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246134/.National Institute on Aging. June 2013. Alzheimer’s Disease Education and Referral Center. Alzheimer’s Caregiving Tips: Sundowning. http://www.nia.nih.gov/sites/default/files/caregivingtips_sundowning-final_13jun24_0.pdf
Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alzheimer’s Association. Sleep Issues and Sundowning.https://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.aspAlzheimer Society Canada. October 11, 2012. Sundowning.http://www.alzheimer.ca/en/Living-with-dementia/Understanding-behaviour/SundowningKhachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: An update. 2011;8(4).http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246134/.National Institute on Aging. June 2013. Alzheimer’s Disease Education and Referral Center. Alzheimer’s Caregiving Tips: Sundowning. http://www.nia.nih.gov/sites/default/files/caregivingtips_sundowning-final_13jun24_0.pdf
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Alzheimer’s Association. Sleep Issues and Sundowning.https://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.aspAlzheimer Society Canada. October 11, 2012. Sundowning.http://www.alzheimer.ca/en/Living-with-dementia/Understanding-behaviour/SundowningKhachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: An update. 2011;8(4).http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246134/.National Institute on Aging. June 2013. Alzheimer’s Disease Education and Referral Center. Alzheimer’s Caregiving Tips: Sundowning. http://www.nia.nih.gov/sites/default/files/caregivingtips_sundowning-final_13jun24_0.pdf
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