Dementia Sundowning: Symptoms, Stages, Causes, and How to Manage It
Sundowning is a common dementia-related pattern where confusion, agitation, anxiety, pacing, mood changes, or restlessness become worse in the late afternoon, evening, or nighttime. It is most often seen in moderate to severe dementia and may be triggered by fatigue, poor sleep, dim lighting, overstimulation, changes in routine, or caregiver stress. Helpful management strategies include keeping a consistent daily routine, scheduling difficult tasks earlier in the day, encouraging balanced rest, improving evening lighting, reducing noise, using calming activities, tracking triggers in a journal, and speaking with a doctor if symptoms remain severe. Sudden or dramatic changes should not be assumed to be sundowning because they may signal delirium or another medical issue that needs prompt medical attention.