Education and Care

Behavioral Challenges:  
Coping With...Sundowning

Sundowning is a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening. Most sundowning emerges in mid-stage dementia and slowly worsens as the disease progresses. What causes it? Dementia may damage the body's internal clock, causing a disruption of sleep-wake cycles. Secondly, individuals with dementia become fatigued by their inability to process information; the more hours spent on this process, the more exhausted—and irritable—they may become.


  • Plan activities or outings in the morning.

  • Do only simple, calming activities in the afternoon.

  • Keep individuals awake during the day.

  • tilize bright light therapy. Increase indoor lighting before dusk. Some research suggests light therapy may reset the body's circadian rhythm, or inner biological clock. 

  • Ensure that the individual is not suffering from hunger, thirst, pain or fear.

  • Correct potential causes with basic interventions such as hydration and snacks.

  • Remove excess stimuli and clutter.

  • Watch for sundowning in early-stage dementia or rapidly worsening symptoms, both of which may suggest delirium.

  • Be twice as patient and kind during these hours.

  • Consult with a doctor about other non-drug interventions.
  • For more information, connect with the Alzheimer’s Foundation of America’s licensed social workers. Click here or call 866.232.8484. Real People. Real Care.

    Alzheimer's Foundation of America  866.232.8484