Sundowning Dementia {causes and effects}

Sundowning Dementia {causes and effects}

You wouldn’t think that Dementia could be exacerbated by a certain time of day, but apparently, it can. I couldn’t help thinking about the time I read that police are far busier when there is a full moon as it apparently alters the behavior in some people. However, this falls into a far different category. It’s well documented that Sundowning Dementia causes and effects is the real deal and can have a very adverse effect on some seniors.


In its most basic terms, sundowning is a state of unrest and confusion that normally takes place in the later hours of the afternoon. Often it will carry on into the night. The confusion and anxiety may last just a few hours or continue on throughout the night.

Sundowning Dementia {causes and effects}
Keeping a senior relaxed throughout the day can help diminish sundowning.

It’s not really considered a disease, but rather a conglomeration of symptoms that tend to happen at a certain time of the day and often affects those people with dementia, such as Alzheimer’s Disease. Although is a very real issue, nobody knows the exact cause of sundowning.

The strange thing is, sundowning seems to occur more often in the middle stages of Alzheimer’s Disease and as the Disease reaches the later stages, the sundowning effect begins to subside.

According to Wikipedia:
Research shows that 20-45% of Alzheimer’s patients will experience some sort of sundowning confusion.

Although the exact cause cannot be pinpointed many experts agree on some contributing factors. For instance, a senior may be mentally or physically tired out after a long day, or possibly its caused by the shifting of the internal clock that occurs when daylight turns to darkness.

sundowning dementia {cause and effect}
Exposure to lots of light during the day will help minimize the sundowner effect.


  • Fatigue: If it’s been an especially long and trying day for the senior with dementia, they are more susceptible to the effects of Sundowners.
  • Muted Lighting: Subdued lighting can be a trigger of sundowners.
  • More Shadows: Shadows appear in the muted lighting as opposed to the brightness of the middle of the day.
  • Internal Clock Trigger: The increasing darkness tends to disrupt a person’s internal clock.
  • Differentiating Between Dreams and Reality: This really adds to the confusion the senior feels as they are not sure if it’s really happening or if they are in a dream-like state.
  • Infections of the Urinary Tract: This could well be one of the early warning signs. Caregivers should be aware of the possibility of the infection resulting in Sundowners.


Melatonin in a low dose seems to be one of the very few supplement treatments that can help prevent reducing the impact of Sundowners. It’s a naturally occurring hormone that will help cause sleepiness. Melatonin appears to be more effective in combating Sundowners when it’s combined with plenty of bright light during the day.

sundowning dementia {cause and effect}
Darkness can perpetuate sundowning. A nightlight is worth trying.

These Tips Might Also Help

  • Predictable Routines: A confusing schedule of events during the day can add to the sundowner effect. Sticking with a routine for sleeping, waking, eating, and other activities will help reduce the impact.
  • Light Exposure and Activities: Activities done during the day with plenty of light can often cause sleepiness.
  • Fewer Naps: Napping should be very limited in order to ensure the senior is tired at night and can fall asleep quickly.
  • Coffee and Sweets: These should be limited to the early morning hours as both tend to keep people awake at night. The whole idea is for the seniors to be tired so they can have a good night’s sleep.
  • Night Lights: These lights are very helpful to reduce the agitation that comes with the darkness.
  • Avoid Stimulation: There are many activities, including television and the resulting background noise that can be upsetting and these should be avoided in the evening.
  • Maintain a Familiar Setting: If there is an occasion to travel from home, be sure to bring items along that will help the seniors feel they are in a familiar setting.
  • Nature Sounds: Instead of television, try playing some relaxing nature sounds. Ocean waves tend to work well. Gentle, relaxing music is another alternative.
  • Talk to a Doctor: It’s important to make sure that there is no underlying condition causing the sundowning effect. A warning sign to look out for is sundowners developing quickly as opposed to slowly over time.
sundowning dementia {cause and effect}
Be sure to bring familiar objects if you are sleeping away from home.


Sundowners can happen in an assisted living facility just as easily as it can happen at home. It’s quite possible for a senior to enter a facility with no sign of sundowners syndrome, but it occurs at a later date away from their home.

It’s believed that sundowners can be triggered when a senior with Dementia leaves the relative quiet of their home and finds themselves in the middle of a whirlwind of activity that is found in many senior facilities.

If you are a caregiver and in need of advice or support, be sure to check out

This most often occurs when the staff is changing shifts. In most facilities, there is also a noticeable lack of facility-structured social activities after the late afternoon. Most of the activities including exercise, day trips, or crafts occur after breakfast and wind up in the early afternoon.

Check out this Amazon E-book The Ultimate Guide to Sundowner’s

Seniors can react to the flurry of shift change activity in any number of ways. They may have the urge to go home and check on their kids as this and other actions were something they did in their past. This type of confusion is quite common with those who suffer from Alzheimer’s.

It would be very helpful if seniors were kept busy with some sort of activity during the times of day when there is a lot going on with staff changing shifts or any other late afternoon happenings that might agitate a senior with Alzheimer’s.

sundowning dementia {cause and effect}
Be sure to discuss the sudden onset of Sundown syndrome with the senior’s doctor.


Keeping a senior’s activities structured and on some sort of fixed schedule while living in their home will help reduce the onset of Sundowning. Eating, sleeping, waking, and any other activities should be done at approximately the same time each day

Plenty of light and the use of low doses of Melatonin can also be very helpful.

The evening ritual should be relaxed and any stimulants like caffeine, sugar and even television should be avoided in the late afternoons and evenings. The whole idea is for the seniors to be tired and ready for a good night’s sleep. This will go a long way toward reducing Sundowning Dementia.

Try nature sounds or light, relaxing music and see if it helps the senior relax and drift off to sleep. A night light will also reduce the darkness that often sets off sundowning.

Hopefully, these Sundowning Dementia causes and effects tips will in some ways help you understand how to be aware of the syndrome and what to do in order to minimize the risk.

Would you like to share your thoughts on this topic? Feel free to leave a comment at the bottom of this page.

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