The National Institute on Aging defines sundowning as the restlessness, agitation, irritability or confusion experienced by some people with Alzheimer’s disease that begins or worsens as daylight begins to fade. This is often around the time of day that tired caregivers need a break. The situation may continue into the night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.
Deeper Dive
You may have heard of the term “sundowning” when reporting on patients with Alzheimer’s disease or other dementias. Becoming more familiar with the concept can add additional understanding, context and depth to your stories.The Alzheimer’s Foundation of America points out that most sundowning behavior starts appearing in mid-stage dementia and slowly worsens as the disease progresses. Up to 20% of people with moderate to moderately severe dementia experience sundowning.
It’s not clear what causes sundowning, but researchers think it may have something to do with how the disease affects the biological clock of a person with Alzheimer’s. It may interfere with normal sleep/wake cycles, leading to disturbances and confusion. Other hypotheses for the cause include pain, hunger, depression and boredom.
Sundowning seems to get worse if a person’s surroundings are noisy, cluttered or there are too many people around. Sometimes shadows cast by the setting sun can cause confusion too. Additionally, if the person is overstimulated or overtired, it can increase late afternoon and early-evening restlessness. Coffee, caffeinated sodas and alcohol all seem to make the situation worse. Too much going on in a given day can also lead to the person becoming overtired and irritable.