June 16, 2023
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5 Signs of Sundowning in Seniors: What You Need to Know

Sundowning is more common in seniors than we think. 

Sometimes our elders can be melancholic, especially when they feel like time is getting to them. 

But there are also times when elders become restless and confused as the evening comes. 

And it can be a bit challenging to understand what’s happening to them. 

So today, we’re talking about sundowning and what you need to know. 

Let’s get started. 

What is sundowning?

Sundowning, also known as sundown syndrome or sundowning syndrome, refers to a pattern of behavioral changes that commonly occur in older adults. 

It is characterized by worsening symptoms, particularly agitation, confusion, and restlessness, during the late afternoon or evening hours. 

Sometimes these behaviors continue into the night. 

Sundowning is relatively common in seniors, particularly those living with Alzheimer's disease or other forms of dementia. 

While not every senior with dementia experiences sundowning, studies suggest that it affects a significant portion of individuals with cognitive impairment. 

Estimates vary, but it is believed that between 20% and 45% of people with dementia may experience sundowning symptoms at some point.


Sundowning can occur in seniors without dementia as well, although it is more prevalent in individuals with cognitive decline. 

The exact prevalence of sundowning may vary among different populations and settings, but its impact on seniors and their caregivers can be significant.

Sundowning tends to become more pronounced as dementia progresses and can occur at various stages of the disease. 

The symptoms often worsen in the late afternoon or evening, making the evenings a particularly challenging time for seniors and their caregivers.

That’s why is essential for caregivers, family members, and healthcare professionals to be aware of its potential occurrence. 

What are the causes of sundowning?

There’s little research as to what causes sundowning in seniors. However, certain factors trigger this in seniors. 

A huge disruption in their circadian rhythms is said to cause sundowning in seniors. 

Changes in our elders’ sleep-wake cycles can cast a shadow of confusion and behavioral changes as evening falls. 

The tiredness and exhaustion that accumulate throughout the day can make sundowning more prominent and disruptive. 

Read more about better sleep for seniors here.

Heightened sensitivity to sensory stimuli and fluctuations in hormones may also contribute to this complex puzzle. 

As evening approaches, the lack of clear environmental cues can cause disorientation, while restlessness and discomfort become more intense. 

Changes in routine and unfamiliar surroundings can act as powerful triggers, further exacerbating sundowning. 

By acknowledging these potential causes, we can approach sundowning with compassion and understanding. 

Equipped with effective strategies, we can work towards managing and alleviating the unpredictable and burdensome effects of sundowning.

5 Symptoms of Sundowning in Seniors

What does sundowning look like? It may show in different ways. But the most common symptoms are the following. 

Agitation and Restlessness

Seniors experiencing sundowning may become increasingly agitated, restless, or fidgety during the late afternoon or evening hours. 

They may pace back and forth, exhibit signs of anxiety or irritability, or have difficulty sitting still.

Confusion and Disorientation 

Sundowning often leads to heightened confusion and disorientation. 

Seniors may need help recognizing familiar people or surroundings, become easily disoriented in time and place, or have trouble following conversations or instructions.

Increased Memory Problems

Memory issues can worsen during sundowning episodes. Seniors may need help to recall recent events, forget names or details, or repeatedly ask the same questions.

Memory lapses may cause frustration and distress.

Mood Changes

Sundowning can trigger sudden and significant mood swings in seniors. They may display sudden shifts from calm to agitation, sadness, or anger.

Emotional volatility during the evening hours is a common hallmark of sundowning.

Sleep Disturbances

Seniors experiencing sundowning often have disrupted sleep patterns. They may struggle to fall asleep or stay asleep throughout the night. 

Sleep disturbances can exacerbate daytime fatigue and contribute to increased restlessness and confusion.

How to manage sundowning for seniors 

sundowning routines

Managing sundowning in seniors involves creating a calm and structured environment to help reduce anxiety and confusion. 

Some strategies that may be helpful include:

1. Establish a routine: Maintain a consistent daily schedule to provide structure and familiarity.

2. Promoting relaxation: Encourage relaxation techniques such as listening to calming music, engaging in light exercises, or practicing deep breathing exercises.

3. Minimizing stimulation: Create a quiet and peaceful environment by reducing noise, dimming lights, and limiting the number of visitors during the evening hours.

4. Encouraging exposure to natural light: Ensure that the person receives sufficient exposure during the daytime, as it helps regulate the sleep-wake cycle.

5. Monitoring diet and medications: Avoid caffeine and large meals in the evening, as they can disrupt sleep. Consult a healthcare professional to review medications contributing to agitation or sleep disturbances.

6. Providing reassurance and comfort: Offer reassurance, comfort, and companionship to help alleviate anxiety and confusion.

At the end of the day, what matters most is providing comfort for your senior loved ones.

And remember, if it gets too much for you, it's also good to ask for help.

Read more about geriatric care management here.

Final Thoughts 

Sundowning, a complex aspect of dementia, presents certain challenges for seniors and caregivers. 

While it can be challenging for us as caregivers, it’s always important to approach it with love and care. 

The best we could do is to give our support and provide a calm and supportive environment around them. 

That's all for today.

Take care, keep mom safe at home and have a great day!


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