Defining Sundowning Syndrome

By Lois Thomson

Sundowning is a syndrome that refers to a set of behaviors and feelings that people who have dementia or Alzheimer's experience when the sun sets. While it can actually occur at any time, it usually starts or gets worse at "sundown."

Sundowning affects up to two-thirds of patients with dementia, and it may be a sign that the disease is progressing. Factors that can aggravate sundowning include mental and physical exhaustion; new or confusing environments; increased stress; or environmental factors, such as insufficient exposure to sunlight, noise, and overstimulation.

Those who struggle with sundowning may exhibit behaviors like pacing, rocking in a chair, wandering aimlessly, shadowing a caregiver wherever he/she goes, crying, insomnia, or even yelling or violence. They may also have feelings of sadness, anxiety, fear, agitation, or irritability.

The following can help lessen the impact of sundowning:

• Get enough rest at night

• Limit caffeine to the morning hours

• Avoid drinking excessive alcohol

• Get as much sunlight as possible by taking walks outside or sitting by a window

• Exercise

• If a nap is necessary, make it short and early in the day

• Participate in some activities throughout the day, but not too many