Sundowning: Late-Day Confusion for People with Dementia

Over the holidays, my brother and I tried to visit our mother on a daily basis.  My brother mentioned that he preferred to visit in the morning, because her behaviour changes significantly after the sun goes down.

This neurological phenomenon is known as Sundowning or Sundown Syndrome, which I witnessed firsthand while working at an assisted living facility.

Sundowning is an ailment of Alzheimer's Disease and other forms of dementia, and is most prevalent in the elderly, that causes symptoms of confusion after "sundown."

Dementia sufferers purport periods of extreme anxiety, increased confusion, delusions or paranoia during mid-afternoon to early evening, although specific behavioural changes are unique to the individual.

Interestingly, the specific causes of sundowning is considered somewhat of a medical mystery and has not been empirically proven to date. There are several theories on the exact cause, but some evidence suggests that disruption to the circadian rhythm can directly impact sundowning behaviours. 

Some doctors believe it’s an accumulation of the sensory stimulation from the day which begins to overwhelm and cause stress, while others speculate that Sundown Syndrome is caused by hormonal imbalances that occur at night. 

According to the Alzheimer Society of Canada, it is thought that sundowning can be a problem for as many as 66% of people with Alzheimer’s disease or other dementias.

These changes in behaviour can be very difficult and frustrating for caregivers. The good news is that there are several ways of coping with the confusion and irritability 

Here are some tips to help come with caring for your loved one after sunset.