Sundowning: What It Is and How to Navigate It

If you care for someone with Alzheimer’s or another form of dementia, you may have noticed a pattern: the closer it gets to evening, the harder things seem to get. Confusion increases, moods shift, restlessness shows up, and bedtime feels anything but calm.

This common experience has a name—sundowning—and while it can be exhausting, understanding it can make a huge difference.

Let’s talk about what sundowning is, why it happens, and practical ways to make evenings a little easier for both you and your loved one.

What Is Sundowning?

Sundowning refers to a group of behaviors that tend to appear in the late afternoon or evening in people living with dementia.

It can look like:

• Increased confusion or disorientation

• Anxiety or fear

• Irritability or agitation

• Restlessness or pacing

• Trouble sleeping

• Repeating questions or behaviors

Not everyone with dementia experiences sundowning, and it doesn’t look the same for everyone. Some people have mild changes in mood, while others may become very distressed as the day winds down.

The important thing to remember? Sundowning is not intentional behavior. It’s a symptom of how dementia affects the brain—not a reflection of your loved one’s feelings toward you.

Why Does Sundowning Happen?

There isn’t one single cause of sundowning. Instead, it’s usually a combination of physical, emotional, and environmental factors.

As the brain changes with dementia, it can disrupt the body’s internal clock. That natural rhythm that tells us when to feel awake or sleepy becomes harder to follow. By the end of the day, your loved one may also be:

• Physically tired

• Mentally overstimulated

• Hungry or thirsty

• Uncomfortable or in pain

All of that can add up to confusion and frustration.

Additionally, the evening often brings changes in lighting and routine that can feel unsettling:

• Dim light creates shadows that may look confusing or scary

• Noise from TV or household activity can feel overwhelming

• A busy day can catch up emotionally all at once

For someone with dementia, these small changes can feel much bigger.

How to Navigate Sundowning

Every person is different, so you may need to experiment a little to see what works best. But these ideas are a gentle, realistic place to start.

Create a Predictable Evening Routine

People living with dementia often feel safer and calmer when life feels familiar. A consistent evening routine can make a big difference. Try serving dinner around the same time each night, following the same steps before bed, and sticking to calm, simple activities in the evening. Over time, these predictable patterns help signal to the brain that the day is winding down—and that it’s okay to relax.

Manage Lighting and Environment

Lighting plays a surprisingly big role in sundowning. As daylight fades, shadows and dim rooms can increase confusion and anxiety. Turning on lights before the sun starts to set, using night-lights in hallways and bathrooms, and closing curtains to reduce glare or confusing reflections can all help. Keeping the environment bright, quiet, and calm often prevents agitation before it even has a chance to begin.

Meet Basic Needs Early

Sometimes restlessness in the evening is really just a basic need that hasn’t been met yet. Hunger, thirst, or discomfort can all trigger anxiety. Offering a light snack or drink in the late afternoon, encouraging a bathroom break before evening confusion sets in, and avoiding caffeine or sugary foods later in the day can make a big difference. Taking care of these simple needs ahead of time can prevent a lot of challenges later on.

Encourage Daytime Activity

A calmer night often starts with a more active day. Gentle movement like short walks, chair exercises, or even helping with small household tasks, can help burn off restless energy. Spending time outside in natural sunlight is especially helpful for regulating sleep and mood. Even simple daytime hobbies, social interaction, or dementia-friendly activities can help the body and brain feel more settled when evening arrives.

Keep Evenings Calm and Low-Stimulation

As the day winds down, the environment should too. Loud TVs, busy rooms, or too much activity can easily feel overwhelming. Lowering the volume, choosing soothing music, and sticking to quiet, comforting activities can help create a peaceful transition into night. Think of evenings as a “soft landing” rather than just another busy part of the day.

Use Reassurance Instead of Reasoning

When confusion increases, logic usually doesn’t help—and can sometimes make things worse. Instead of correcting or arguing, gentle reassurance is often more effective. Simple, comforting phrases like “You’re safe,” “I’m right here with you,” or “Everything is okay” can help calm fears. A calm tone of voice and a gentle touch usually work far better than long explanations.

Track Patterns and Triggers

Sundowning often follows patterns, even if they aren’t obvious at first. Keeping simple notes about what time symptoms start, what happened earlier in the day, and what seems to help or make things worse can be very useful. Over time, these observations allow you to adjust routines, avoid triggers, and plan ahead for the most challenging moments.

Keep Tabs on Health and Medication Factors

If sundowning becomes severe, lasts for long stretches, or suddenly gets worse, it’s worth checking in with a doctor. Sometimes sundowning is made worse by things like:

• Medication side effects

• Infections (like a UTI)

• Poor sleep the night before

• Vision or hearing problems

• Untreated pain

That’s why it’s always a good idea to mention new or worsening behaviors to a healthcare provider.

Caring for the Caregiver: Tips

Sundowning doesn’t just affect the person with dementia—it affects you, too. Evenings can feel long, emotional, and exhausting. Caring for yourself is just as important as caring for your loved one.

• Protect your energy throughout the day. Try to pace yourself so you’re not completely drained by late afternoon. Take small breaks when you can, rest when your loved one rests, and save a little emotional “battery life” for the evening hours.

• Have a simple plan for tough nights. Keep calming activities ready, have a few go-to distractions in mind, and know who you can call if you need backup. A little preparation ahead of time can make difficult moments feel much more manageable.

• Lower your expectations. Some evenings will be peaceful, and others will be hard—and that’s normal. Your goal isn’t perfection; it’s safety and comfort. Remind yourself that you don’t have to fix everything and that doing your best is enough.

• Don’t take behaviors personally. Agitation, anger, or confusion during sundowning is part of the disease, not a reflection of your relationship. Even when words are hurtful, try to remember: it’s the illness talking, not your loved one.

• Build in support for yourself. You don’t have to carry this alone. Joining a caregiver support group, talking with a counselor, or leaning on friends and family can make evenings feel far less overwhelming. Reaching out for help is a sign of strength, not weakness.

The Bottom Line

Sundowning is a challenging part of dementia caregiving, but it’s also something you can learn to navigate with the right tools.

And remember, support matters, too. If you need more resources, practical guidance, or simply a caring support network that understands what you’re going through, CRC OC is here to help. You don’t have to navigate the challenges of caregiving on your own—sometimes the most important step is reaching out.