Published on June 03, 2020

What is Sundowning?

June is Alzheimer’s and Brain Awareness month. While you likely know a little about Alzheimer’s and dementia, it has many effects on a person’s mind that you may have never heard of.

One of these effects is commonly known as “sundowning.” The term refers to confusion that typically occurs later in the day for patients with dementia such as Alzheimer’s disease.

Sundowning can cause a variety of behaviors relating to the confusion the person is experiencing. These may include:

  • General confusion
  • Anxiety
  • Aggression
  • Ignoring directions
  • Pacing
  • Wandering

These behaviors will typically occur during periods of transition between day in night. Although the name suggests evening, sundowning behaviors can also occur in the early morning hours.

While the cause of sundowning is largely unknown, there are some factors that are thought to aggravate it such as:

  • Fatigue
  • Low lighting
  • Increased shadows
  • Disruption of the patient’s “internal clock”
  • Infections such as urinary tract infections

Changes in a person’s environment or modification to their routine can also be a factor that exacerbates sundowning.

Sundowning behaviors can be difficult for caregivers to manage but there are things we can do to help alleviate them for loved ones. Make sure the environment is well lit and keep distractions and excess noise to a minimum. Help make sure they are receiving enough rest and good nutrition. Maintaining a predictable routine for the person can also help. You should also be mindful of any signs of infection or sudden changes that warrant medical attention as these can trigger or worsen sundowning behaviors.

You can also observe and make notes about certain things that may be especially triggering for your loved one. Once you observe these patterns, you can try and help them avoid or limit their personal triggers and minimize sundowning behaviors.

Most importantly, try to practice patience. Seeing these behaviors in your loved one can be hard but staying calm will help comfort them. You can ask them if they need something, remind them of what time it is, avoid arguing, reassure them that everything is OK, allow them to get up and move around if they need to, and keep them safe with night-lights, door and window locks, and baby gates to block stair.

About Kyle Dunlap

Kyle Dunlap, MSN, RN is the Director, Ambulatory Nursing for Fisher-Titus. Fisher-Titus offers several levels of senior health care including home health, assisted living at the Carriage House, and skilled nursing at Norwalk Memorial Home. For more information, visit