What is sundown syndrome: Part 1

This syndrome affects people with Alzheimer’s and dementia.

While in a recent meeting with another Michigan State University Extension staff member mentioned the term “sundown syndrome.” That was a term I had never heard, so I asked her about it. She told me that sundown syndrome occurs in adults who suffer from Alzheimer’s and other forms of dementia. It isn’t a disease itself, but it’s a set of symptoms that people might experience at a specific time of day. Sundown syndrome occurs at the end of the day and into the night, hence the name. Older adults who don’t have dementia can still suffer from this syndrome.


Sundowning can cause a number of behaviors in a person, including confusion, anxiety, aggression or ignoring directions. Individuals may get particularly agitated, yell, and hear or see things that are not there. Mood swings, pacing or wandering are also commom. Sundowning can worsen as the night goes on but usually improves by morning.

Sundowning may be more likely to occur if a person is overly tired, hungry, thirsty, depressed, in pain, bored or having problems with sleep.


The exact cause of sundowning and the accompanying behaviors is unknown. What is known is that certain factors might aggravate late-day confusion, including fatigue, low lighting, increased shadows, difficulty separating reality from dreams and disruption of the body’s internal clock. The internal clock is the area of the brain that signals when we’re awake and asleep. This internal clock fails to work in people with dementia.

How to help

If you are caring for a person who suffers from sundown syndrome, there are things you can do to help. Look for patterns in the person or in his or her surroundings. There might be things there that trigger the symptoms. If so, do your best to limit those triggers. Creating predictable routines can also help. Plan activities and exposure to light during the daylight hours. To ensure a better nights sleep, limit the amount of time the person naps during the day. If a nap is absolutely necessary, try to time it earlier in the day and for a short period of time.

Other things that might help include limiting caffeine and sugar later in the day and use nightlights in dark areas. Keep background noise to a minimum in the evening. Reduce stimulating activities in the evening, such as TV watching, which can sometimes be upsetting. If the person is in an unfamiliar place it might help to have familiar items around, such as photos, to create a more relaxed setting. Just as soothing music can help any of us if we’re under stress, it can also aid in calming a person who suffers from sundown syndrome.

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