10 Sleep Tips for Sundowner’s Syndrome

Sleep Tips for Sundowner's Syndrome

Sundowner’s Syndrome is often seen among people in mid to late stages of Alzheimer’s disease and related forms of dementia. Characterized by confusion and disorientation around sunset, sundowning can create a cycle of stress and disruptive behaviors leading to less sleep for both caregivers and people living with the disease.

Sundowning Syndrome and Dementia

While the cause of sundowning is largely unknown, researchers agree that the timing of the symptoms is not coincidental. Some medical professionals believe sundowning is an expression of stress and sensory overload experienced throughout the day, others believe it’s a hormonal imbalance, and still, others believe it’s the manifestation of exhaustion. No matter the cause, there’s no question that Sundowner’s Syndrome can cause stress for both patient and caregiver, leading to distress, lack of rest, and poor sleep habits.

A sundowning episode can look different for each person but usually, symptoms appear in the early evening and can last through the night, receding in the morning. Affecting nearly 20% of people with Alzheimer’s disease, sundowning appears to be triggered by a change in lighting.

When the sun starts setting, people with sundowning may start exhibiting these behaviors:

  • Agitation
  • Irritation
  • Disorientation
  • Paranoia or increased suspicion
  • Delusions or hallucinations
  • Anger
  • Restlessness

10 Tips to Cope with Sundowning

If a loved one is exhibiting these signs, these 10 things may help you decrease the intensity of the episode and potentially reduce the frequency of episodes.

  1. Have a daily schedule that includes a bedtime routine. Simple cues like taking a bath, drinking a cup of tea, or reading a book can signal that it’s time to start calming down for bedtime.
  2. Stay active during the day. During daylight hours, be sure your loved one is getting some form of stimulation or exercise to help them feel more relaxed during the night.
  3. Start a daily journal to identify potential patterns of activity and sundowning. For example, if you see that a walk before bed is making symptoms worse, consider moving the walk to earlier in the day. 
  4. Try to avoid napping at least 4 hours before bedtime. This will help your loved one actually feel tired when it’s time for bed.
  5. When the sun starts setting, draw the curtains and turn on lights. Shadows and darkness can increase symptoms of sundowning.
  6. Do not argue with a loved one if they are experiencing hallucinations and delusions. Live in their reality. Arguing will only lead to anger.
  7. Eliminate caffeine or alcohol, especially later in the day. Keeping a steady level of energy, especially before bedtime is important in calming symptoms of sundowning. Caffeine can cause bursts of energy and alcohol can contribute to feelings of disorientation and confusion.
  8. Reduce noise, clutter, and people in the room. Find a quiet and calm place for your loved one to relax before bedtime and prepare for a good night’s sleep.
  9. Avoid sudden movements or unexpected touching. If your loved one is feeling threatened or scared, these unanticipated events can worsen symptoms.
  10. Seek medical attention. Sundowning has been linked to infections, particularly urinary tract infections. Treating these infections may also help treat symptoms of sundowning.

Learn more about Sundowner’s Syndrome and get tips for coping with a sundowning episode.

Does your loved one exhibit signs of sundowning? What have you done to alleviate its symptoms? Share your successes in the comments below.

About the author

Alissa has been working in marketing and the senior living industry for over 7 years. She graduated from the University of Illinois with a B.S. in advertising and has worked all over the world as a freelance communications strategist and writer. Currently living in Okinawa, Japan, Alissa loves to travel, read, cook, and spend time with her two children and golden retriever.

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