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Sundowning: How Seasons Changing Affects People With Dementia

Senior man in a wheelchair with his caretaker, outside

When evening approaches, most people begin to wind down. For individuals living with dementia, however, this time of day can bring a very different experience. 

Sundowning — also known as sundowner’s syndrome — is not a disease itself, but a group of symptoms that commonly affect people with Alzheimer’s and other forms of dementia. It’s characterized by increased confusion, anxiety and agitation that typically begin in the late afternoon and can continue into the evening or night. While estimates vary, research suggests sundowning may affect a significant portion of people living with dementia, with prevalence ranging widely depending on the individual and stage of the condition. 

For families and caregivers, these changes can feel sudden and distressing. A loved one who was calm earlier in the day may become restless, fearful or disoriented as daylight fades. 

What Is Sundowning? 

Sundowning refers to a pattern of behavioral and mood changes that occur later in the day. Symptoms can include: 

  • Increased fatigue as the day progresses  
  • Heightened confusion or disorientation  
  • Mood swings, irritability or anxiety  
  • Difficulty recognizing familiar people or surroundings  
  • Hallucinations or paranoia  
  • Restlessness, pacing or wandering  
  • Trouble sleeping at night and daytime drowsiness  
  • Agitation, yelling or other aggressive behaviors  

These symptoms can vary from person to person, but they often follow a predictable late-day pattern. 

Why Does Sundowning Happen? 

There isn’t a single known cause of sundowning, but several contributing factors have been identified. Changes in the brain caused by dementia can disrupt the body’s circadian rhythm, or internal clock, making it harder to distinguish between day and night. Reduced exposure to natural light and lower levels of melatonin — the hormone that helps regulate sleep — may also play a role. 

Other factors can intensify symptoms, including: 

  • Fatigue from the day’s activities  
  • Changes in routine or unfamiliar environments  
  • Low lighting or increased shadows  
  • Noise or overstimulation  
  • Underlying health issues such as infections or sleep disorders  

Because triggers vary, understanding an individual’s patterns is key to managing symptoms effectively. 

Tips for Managing Sundowning 

While there is no cure for sundowning, there are practical steps that can help reduce symptoms and create a calmer evening experience: 

  • Keep a consistent routine. Predictability helps reduce confusion and anxiety.  
  • Encourage daytime activity and sunlight. Exposure to natural light supports a healthy sleep-wake cycle.  
  • Limit naps during the day. If needed, keep them short and earlier in the afternoon.  
  • Reduce stimulants. Avoid caffeine and excess sugar later in the day.  
  • Create a calm evening environment. Lower noise levels and avoid overstimulating TV or activity.  
  • Use soft lighting. Well-lit spaces can reduce shadows and confusion.  
  • Play soothing music or calming sounds. This can help ease restlessness.  
  • Watch for underlying health concerns. Conditions like urinary tract infections or sleep apnea can worsen symptoms.  

Some individuals may also benefit from light therapy or discussing sleep support options — such as melatonin — with a healthcare provider. 

Seasonal Changes and Sundowning 

As the seasons shift and daylight hours become shorter, sundowning symptoms may become more noticeable. Earlier sunsets and longer nights can further disrupt the body’s internal clock, especially for individuals who rely on routine. 

During fall and winter months, it may help to: 

  • Turn on lights earlier in the evening  
  • Spend time outdoors during daylight hours when possible  
  • Maintain a structured daily schedule  
  • Incorporate calming nighttime rituals, such as gentle music or hand massage  

Supporting the Caregiver 

Caring for someone experiencing sundowning can be physically and emotionally demanding — especially when sleep is disrupted. Taking care of your own well-being is essential. 

When possible: 

  • Ask for help from family members or trusted friends  
  • Take breaks during the day  
  • Prioritize rest, nutrition and physical activity  
  • Stay connected to hobbies or activities you enjoy  

Even small moments of rest can make a meaningful difference. 

The Role of Memory Care 

For many families, additional support can make all the difference. Memory care communities are designed to provide a safe, structured and supportive environment for individuals living with dementia while offering peace of mind for caregivers. 

At Cypress Village, our Heartfelt CONNECTIONS – A Memory Care Program® is a nationally recognized approach that focuses on each person’s remaining abilities, helping residents feel engaged, valued and understood. Our specially trained team understands the unique challenges of sundowning and uses proven techniques to reduce agitation, promote calm and maintain a sense of routine. 

Thoughtfully designed spaces, consistent daily rhythms and compassionate care all work together to support comfort and safety — day and night. 

For those navigating changes like sundowning, the right environment matters. Schedule a visit to see how our memory care program supports each day and brings greater peace of mind to every evening.