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What is “sundowning”?

Portrait of an angry old woman showing fist

Does your relative with dementia stay calm during the day but shift toward agitation as evening approaches? Are you noticing that in late afternoon they become anxious, confused, restless? Perhaps they pace the house or ask the same questions again and again. This frustrating pattern is called sundowning or sundown syndrome.

Sundowning is a group of behaviors that often appears in people living with Alzheimer’s disease or other forms of dementia. As daylight fades, your loved one may become suddenly irritable or distressed. They may want to get out of the house or “go home,” even though they are home. Their behavior is not intentional or willful, though it is plenty stressful for you!

Experts do not fully understand why sundowning happens, but several factors may play a role. After a full day, your relative’s brain and body may simply be tired. Dementia can also disrupt the brain’s internal clock that controls sleep and wake cycles, making evenings more difficult.

Aspects of the environment are also believed to be involved: dusk brings shadows and rooms may look unfamiliar. Noise, busy household activity, or a rushed evening routine can precipitate symptoms. Possibly, they are expressing a need to use the toilet or are hungry or in pain. A change in surroundings, such as with travel or moving, can also trigger sundowning behaviors.

To help make evenings calmer, focus on prevention and simple routines:

When your loved one is upset, pause to calm yourself. Your frustration will only add to their stress. Approach them calmly and offer reassurance. Don’t disagree. Instead, gently redirect their attention by asking a question or sharing a memory. With patience and steady routines, many families find that evenings become easier to manage.

Is a relative experiencing sundowning or other dementia-related behaviors?
Such behaviors can leave families feeling exhausted and unsure of what to do. As the Roanoke and Lynchburg experts in family caregiving, we at Gentle Shepherd Hospice can help you understand what’s triggering these changes and develop practical, tailored solutions that fit your loved one’s needs and daily routine. We’re here to help you create a calmer, more manageable path forward. Give us a call at 1-800-789-0586 (toll-free).

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