Sadness, agitation, fear, as well as other mood and behavior changes that occur just before dark are called Sundowner's Syndrome, or sundowning. Caregivers might notice that their parent who has Alzheimer's disease or dementia becomes more agitated at twilight.

People with Sundowner's Syndrome may also "shadow" you, following you around and doing everything you do. They might ask you questions over and over or interrupt you when you're speaking to someone else. They may lose their full language abilities, and abstract thoughts may become especially difficult for them to comprehend.

Sundowner's Syndrome Behaviors and Emotional Issues

  • Anger
  • Agitation and outbursts
  • Anxiety
  • Pacing
  • Fear
  • Depression
  • Stubbornness
  • Restlessness
  • Rocking
  • Hallucinations
  • Hiding things
  • Paranoia
  • Violence
  • Wandering
  • Crying

Causes of Sundowning

Doctors and researchers aren't sure what causes sundowning, but the theory is that the symptoms have something to do with the onset of darkness.

Some medical professionals believe that the syndrome is an accumulation of all of the sensory stimulation from the day that starts to overwhelm and cause stress. Others speculate that it is caused by hormonal imbalances that occur at night. Another theory suggests that the onset of symptoms at night is simply due to fatigue; while some believe it has to do with the anxiety caused by the inability to see as well in the dark.

How to Handle Sundowner's Syndrome

  • Approach the person in a calm manner. Don't yell, raise your voice, or touch them in an expected way. Avoid arguing or asking for explanations to statements that don't make sense.
  • Draw the curtains. That way, they can't see the sky's change from light to dark. When drawing the curtains, turn on inside lights as it grows dark outside, to keep the environment light and calming.
  • Provide a peaceful setting. Guide the person to an area away from family activity and other distractions. Try to prevent excessive noise during sunset.
  • Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
  • During the evening, when the sun is setting is another good time to plan activities. Arts and crafts, and even pet therapy also have a calming effect.
  • Have a routine. Maintaining a routine tends to alleviate the severe anxiety experienced by those sundowning. Even simple tasks like putting on pajamas can be helpful.
  • Use music. Sometimes soothing music will help to calm and relax a person with Alzheimer's or dementia.
  • Ensure safety. Install locks and safety devices as necessary. Take precautions to provide a safe space for him or her at night so that you can get a solid night's rest, even if he or she needs to stay awake and wander.
  • Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it's most comfortable.
  • Use a nightlight. Keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.
  • When the person's becomes agitated or fearful, reassure him or her that everything is all right and everyone is safe.
  • Monitor diet. Restrict sweets and caffeine consumption to the morning hours. Serve dinner early.
  • Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. Your doctor may also be able to prescribe medication to help the person relax at night.

Whether or not you fully understand Sundowners Syndrome, the look of terror and bad behaviors that accompany this time of day are extremely taxing and stressful. Doing everything you can to eliminate the affects of sundowning will make for a more pleasant evening for everyone in the home.

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