Independent Living

What is Sundown Syndrome and How Can You Help?

Posted by Frank Herold on December 7, 2020

Sundown syndrome, also known as late-day confusion, is a state of confusion that occurs late in the afternoon and often continues into the night. It consists of a range of behaviors, including increased confusion, disorientation, and anxiety. 

Sundown syndrome is not a disease, however, it is a common pattern of behavior that happens during a particular time each day. It is especially prevalent in those who have been diagnosed with a form of dementia. 

Related Blog: How and When to Talk to Mom About Her Memory Loss

Based on the data from the Alzheimer's Association, as many as 20% of patients diagnosed with Alzheimer's disease may experience a sundown syndrome. However, sundowning sometimes occurs in healthy older adults, particularly after surgery or hospital stays.

Signs and Symptoms of Sundown Syndrome

The symptoms of sundown syndrome typically develop late in the afternoon, as daylight starts to fade. Sometimes one or more symptoms appear together, or symptoms may last for an hour or two in the evening. Signs and symptoms range in severity. These symptoms include:

  • Anger or aggression
  • Emotional outbursts
  • Anxiety or depression
  • Restlessness
  • Trouble sleeping
  • Energy surges
  • Disorientation
  • Fear
  • Pacing or wandering

Factors That Can Aggravate Sundown Syndrome

The cause of late-day confusion is unknown, and it can happen without any identifiable "triggers." However, there are several factors that can intensify sundown syndrome, such as:

  • Sensory deprivation or overload (e.g. too little or too much light)
  • Unfamiliar environment or changes in a regular daily schedule
  • Unmet physical needs (e.g. hunger, pain, fatigue)
  • Limited mobility or social isolation
  • Increased stress levels
  • Decreased sense of security/feeling of safety
  • Unfamiliar environment or unexpected change
  • Disrupted circadian rhythm, sleep deprivation

Tips for Managing Sundown Syndrome

Caregivers may find it impossible to do away with all sundown syndrome behaviors, but the following tips can help manage the behaviors:

  1. Observe and minimize triggers. Remember that afternoon transitions and activities that you consider normal can be anxiety-producing for your loved ones.
  2. Maintain an established routine, which reduces uncertainty.  The individual is less likely to get days and nights mixed up if they have a schedule for the morning, daily activities, meals, and bedtime.
  3. Plan a reasonable amount of exercise and daytime activities to encourage nighttime drowsiness.
  4. Limit daytime napping to increase sleepiness at night.
  5. Avoid stimulants such as caffeine, nicotine, and sugar, which can affect the ability to sleep.
  6. Discourage watching television during nighttime periods of wakefulness.
  7. Ensure that there is enough exposure to natural light during the day. This will help keep the body's internal clock operating properly.
  8. Reduce emotional stress by simplifying the physical environment, removing clutter and using calming colors.
  9. Play calming music or sounds of nature in the evenings to create a soothing atmosphere.

Managing sundown syndrome requires careful observation, creativity, flexibility, and empathy. If you’re unsure about next steps with a loved one who may be experiencing these symptoms, contact us today to speak with a member of our team about how the expert caretakers at Jacaranda Trace and Cadbury Park can help.

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Tags: Memory care, alzheimers, dementia, memory care venice, caring for patients with alzheimers, father with alzheimers, relative with alzheimer's