Definition: Sundowning, also known as sundown syndrome, is a phenomenon characterized by a set of behavioral and psychological symptoms that occur in the late afternoon or evening, typically among individuals with Alzheimer’s disease or other forms of dementia.


1. Agitation: Restlessness, pacing, and displays of increased anxiety or irritability.

2. Confusion: Disorientation, memory problems, and difficulty in recognizing familiar people or places.

3. Mood changes: Rapid mood swings, increased sadness, anger, or frustration.

4. Hallucinations: Seeing or hearing things that aren’t there, often leading to intensified fear or confusion.

5. Delusions: Holding false beliefs, sometimes leading to paranoia, suspicion, or accusing others of theft or other misdeeds.

6. Disrupted sleep patterns: Insomnia, difficulty falling asleep, or frequent waking up during the night.

7. Restlessness: A constant need to move around, fidget, or exhibit agitated behaviors.

8. Increased sensitivity: Heightened sensitivity to noise, light, touch, or other stimuli.

Possible Triggers

1. Fatigue: Physical or mental exhaustion can worsen sundowning symptoms.

2. Low lighting: Dim or inadequate lighting conditions can contribute to confusion and disorientation.

3. Disruption of routine: Changes in daily schedule or environment can lead to increased anxiety or agitation.

4. Hunger or thirst: Dehydration or hunger may intensify sundowning symptoms.

5. End-of-day confusion: A natural phenomenon where sensory stimulation overload and fatigue occur as the day progresses.

It’s important to note that while the exact causes of sundowning are still unclear, it is believed to involve a combination of factors including disruptions in the internal body clock, exhaustion, and increased vulnerability to environmental stimuli.