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Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.
Sundowning can 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.
The causes of sundowning are not well understood. One possibility is that Alzheimer’s-related brain changes can affect a person’s “biological clock,” leading to confused sleep-wake cycles. This may result in agitation and other sundowning behaviors.
Other possible causes of sundowning include:
Look for signs of sundowning in the late afternoon and early evening. These signs may include increased confusion or anxiety and behaviors such as pacing, wandering, or yelling. If you can, try to find the cause of the person’s behavior.
If the person with Alzheimer’s becomes agitated, listen calmly to his or her concerns and frustrations. Try to reassure the person that everything is OK and distract him or her from stressful or upsetting events.
You can also try these tips:
Being too tired can increase late-afternoon and early-evening restlessness. Try to avoid this situation by helping the person:
Avoid things that seem to make sundowning worse:
If sundowning continues to be a problem, seek medical advice. A medical exam may identify the cause of sundowning, such as pain, a sleep disorder or other illness, or a medication side effect.
If medication is prescribed to help the person relax and sleep better at night, be sure to find out about possible side effects. Some medications can increase the chances of dizziness, falls, and confusion. Doctors recommend using them only for short periods of time.
Receive weekly tips and resources on Alzheimer’s disease and related dementias from NIA’s Alzheimers.gov
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer’s and related dementias from across the federal government.
Mayo Clinic
www.mayoclinic.org/patient-care-and-health-information
Family Caregiver Alliance
800-445-8106
info@caregiver.org
www.caregiver.org
National Respite Locator Service
www.archrespite.org/respitelocator
This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
Content reviewed: May 17, 2017
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An official website of the National Institutes of Health