Published: October 20, 2025
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If you’re caring for someone with dementia, you might notice that evenings and late nights feel especially difficult. Your loved one may become more confused, restless, or agitated as the day goes on. This shift is known as sundowning, and it’s a common experience for many families.
While it can be unsettling, sundowning isn’t a sign that your loved one is declining more quickly. It’s simply one of the ways Alzheimer’s disease and other forms of dementia can affect the brain and body. With a few gentle strategies, you can ease these moments and bring more peace to your evenings together.
What is sundowning?
Sundowning, sometimes called sundowner’s syndrome, isn’t a disease on its own. Instead, it’s a set of dementia-related symptoms that often start in the late afternoon and continue through the night. Research from the National Institutes of Health suggests that as many as two out of three people living with dementia experience sundowning at some point. It can affect anyone, regardless of age, gender, or specific diagnosis.
While the signs can vary from person to person, you may notice:
- Anxiety or nervousness
- Difficulty following directions
- Increased confusion or disorientation
- Irritability or sudden anger
- Restlessness, pacing, or wandering
- Shadows or hallucinations that feel real
- Trouble sleeping
These changes may not happen every day, and they can feel unpredictable at times. Still, many caregivers notice a pattern that appears most often between 5 p.m. and 11 p.m. Symptoms can feel especially intense during fall and winter, when darkness sets in earlier.
Why does sundowning happen?
We don’t know exactly why sundowning happens, but there are several factors that may contribute:
- Changes in the brain: Dementia affects the body’s internal clock, making it harder to keep track of time and routines. Your loved one may feel sleepy during the day and be more active at night.
- Dreams or disrupted sleep: Vivid dreams or waking in the night can make it difficult to separate reality from imagination.
- End-of-day fatigue: As the day wears on, your loved one may have less energy to cope with stress and confusion.
- Lighting changes: Dimming light in the evening can create shadows that are frightening or confusing to your loved one.
- Overstimulation: Too much noise, activity, or disruption in routine can be overwhelming.
- Unmet needs: Hunger, thirst, pain, or needing to use the bathroom can increase distress.
Eight ways caregivers can ease sundowning
When sundowning sets in, it can add extra strain to an already long day. You may find yourself drained, discouraged, or longing for peace. While you can’t always stop sundowning from happening, you can take small, intentional steps to bring more calm and comfort to these hours.
1. Watch for triggers
It may be helpful to keep a journal of when sundowning behaviors appear and what might have caused them. Over time, you may notice certain triggers — like particular foods, background noise, or changes in routine — that make symptoms worse.
2. Keep a routine
Consistency creates a sense of safety. Try to keep meals, naps, and activities on a predictable schedule each day, so your loved one knows what to expect.
3. Adjust the environment
As daylight fades, turn on soft lights to reduce shadows and keep the space well-lit. Draw curtains, limit visitors, reduce background noise, and use soothing scents like lavender to create a calm, quiet setting.
4. Plan mornings wisely
When your loved one has the most energy, schedule important tasks such as medical appointments, baths, or light exercise. Save afternoons and evenings for quieter, relaxing activities, like listening to music or looking at photo albums.
5. Get fresh air and sunlight
Natural light and fresh air during the morning and afternoon can help reset your loved one’s internal clock (circadian rhythm). Even a short walk outside may reduce restlessness later.
6. Prioritize rest
Encourage short naps earlier in the day and allow time for rest after activities. Try to avoid long naps in the late afternoon, which can make falling asleep at night more difficult.
7. Offer reassurance
Your presence matters more than anything. Hold your loved one’s hand, sit close, and speak with a steady voice. If agitation rises, don’t argue or correct. Use gentle redirection to bring them back to a sense of calm.
8. Ask for help when you need it
If sundowning becomes too much to handle alone, lean on your healthcare or hospice team. They can check for underlying issues — such as pain or infection — and may suggest medications or therapies to improve rest.
Support for the hardest hours
Caring for someone with dementia is never easy, and sundowning can bring extra strain. At Traditions Health, our home health, palliative care, and hospice teams provide guidance and support to bring more peace to your evenings.
Are you ready to speak with a Traditions Health representative about receiving care? Click the button below, complete the Request Care form, and a representative will contact you.
