Sundown Syndrome and Alzheimer’s Disease

An Alzheimer’s disease caregiver will tell you coping with sundown syndrome is difficult when providing care to an Alzheimer’s patient.  Described as a state of confusion and agitation, sundown syndrome usually occurs in Alzheimer’s disease patients around late afternoon or early evenings.

While the exact cause of sundown syndrome is not known, many speculate people suffering from Alzheimer’s disease and dementia have somehow had their biological clock altered because of a reduction in brain function.  With an altered internal clock, people with Alzheimer’s and dementia are suspected to have difficulty regulating behaviour and activity associated with different times of the day.

Several researchers have also theorized that sundown syndrome may be associated with a drop in blood pressure after a meal, hunger or changes in blood glucose levels may trigger periods of confusion and agitation.

In dealing with sundown syndrome, Alzheimer’s disease caregivers are often left determining what causes the periods of agitation and confusion.  Sundown syndrome triggers can vary greatly from Alzheimer’s patient to Alzheimer’s patient, leaving caregivers often at a loss at how to calm the patient.

When dealing with an Alzheimer’s disease patient prone to sundown syndrome, using full spectrum lighting to simulate sunlight may alleviate sundown symptoms.  Regulating snacks and diet may help if sundown syndrome is triggered by diet.

Some Alzheimer’s caregivers have indicated they have success with sundown syndrome if they play a person’s favourite music or move them to a quiet room.  Others have indicated using relaxation techniques and a gentle touch helps calm Alzheimer’s patients dealing with sundown syndrome.

It is important to recognize that Alzheimer’s patients experiencing sundown syndrome need reassurance and understanding of the Alzheimer’s caregiver.  Recognizing triggers and alleviating triggers known to cause sundown syndrome will make both the Alzheimer’s caregiver and Alzheimer’s patient cope with the situation at hand.

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  1. Evan Perrault says:

    Hi Barry,

    My name is Evan Perrault and I am a Health Communication Master’s student at Michigan State University. For one of my projects I am monitoring blogs, and am asking blog masters their opinions about the use of blogs to get their health messages out to the populations. I’ve been monitoring your blog about Alzheimer’s Disease for the past few weeks and was wondering if you would be willing to answer a few questions for me? The more information you can provide the fewer follow-up questions I’ll have to ask.

    1. How many years/months have you been operating this blog? And how many years/months have you been blogging in general?
    2. Why did you decide to start this blog? What is the principal reason/motivation?
    3. Do you feel as though your blog is meeting the need for which you designed it? How do you know? Do you wish it could reach more people? Are you happy with the audience you have?
    4. Blogs haven’t been around too long, but do you see the world of social media (like blogs, tweets, youtube…etc) as replacing traditional media (tv news, newspapers, etc)? Why or why not?
    5. What do you feel has been the biggest impact of your blog?

    Thank you so much for your time. I look forward to your thoughtful responses.

    Evan Perrault

  2. Iona Askew says:

    Oh my Goodness, reading your article is like a light being switched on in my head – I am caring for my elderly Dad with mid stage Alzheimers, and had never heard of Sundown Syndrome – suddenly a lot makes sense. We are struggling to keep dads mind as sharp as possible, and a colleague put me onto this amazing free bonus book all about dealing with Alzheimer’s, and it has helped guide us through the stages. It was very eawy to read and understand and has definately helped us with Dad, and his concentration spans. things like, learning how to retrace steps etc to remember where you left something, or getting Dad to remember that he has had his dinner.
    Seven Second Memory ebook

  3. i have abrother who i think has this sundown syndrome, he is great during the day and violant at nights irratated too,so when i go to the hospital i shall memtion this to them thank you .jean

  4. I am looking after my father and did not know about this syndrome. Now it is coming clear to me. It seems that I make a change myself during that time of day. I get ready about this time to “protect” myself because I know “it” is coming.

    Good to know,

  5. My husband has this syndrome and it is getting worse. Today he was getting into bed at 4.05 p.m. when I told him it was far too early, and he hadn’t had his tea, he got very wild with me, and yelled, and abused me. He does not usually do this. I am finding this situation so hard to deal with. He is 83 and during the day mainly sits and nods off, but once 4.00 p.m. comes he is a changed person. How do we deal with this. I have tried reasoning with him, but to no avail.

  6. lynthia brown says:

    My 93 year old Mother has in the last 3 weeks become very irrate form around 5ish on she doesn’t no where she is suppose to go to bed, very scared to sleep alone so now i sleep with her. she will get up and come to the room where i am watching tv or on the pc wanting to know if i will sleep with her. I tell her at dinner time that I am going to sleep with her, my husband had to have surgery and i spent the night with him in the hospital, had to come the next night because she had gotten so upset she cried when i came home although I had a lady stay with her the night I stayed at the hospital and she stays with her every day while i work. mother was very upset, the next day i left to go back to the hospital and when she found out i was leaving she acted like she was sick. half the time she thinks i’m her older sister who died in 1976 or her mother, i can deal with this but it’s the late afternoons when she doesn’t no where to go to bed or sleep by herself that is getting to me, any body got an answer for this.

  7. My 90 year old mom has dementia and has sundown syndrome that usually starts about 3pm. She becomes confused and agitated. She will start asking questions about who is going to stay with her and think she is somewhere else other than her home. We are giving her ativan after lunch which seems to lessen the spells.Usually it passes in about an hour.

  8. There’s lots of literature out there attempting to define Sundown Syndrome but as each person here knows, there is no step by step manual to help manage this condition. Sundowning is very individualized and for that reason very complex.It’s only thru trial and error do caregivers learn to manage and adjust. Most caregivers can sucessfully manage sundown syndrome through the art of distraction. Distraction techniques work intially in the early to moderate stages of Alziheimer’s however as the disease progresses so does the success of this art. One necessity however has remained constant…..the need for support. Stick together and stay strong!

  9. Thank you, I don’t feel so alone. Not sure how to reply just yet. All of your posts are helpfull. I would love to be closer(location) to my Father and be able to help out, but money and a new job are keeping me from seeing my Father during his final days. I was able to spend 2 weeks with Dad and his wife during his hospital stay. I have learned to find humor in my Father’s actions. Dad saw me the first day I arrived in his hospital room, and he was so excited to see me. Well the sad part, and the happy part, My Father greeted me the next day as is if I just arrived that day. He was so happy to see me, for the first time 3 days in a row.

    Is it okey to laugh, as long as we respect the person they were before?

  10. My father in law reasantly had sergery,so he had to stay in the hospital for second week now,he had some holusinathion episods but not bad,tonight we all had to rush to the hospital because he was out of it,he didnt know who we wore he was just saying some staff,and was trying to get up,can anyone help me understend if he has sundawn demential,and it happened with in a few days

    • Karen Harkins says:


  11. Karen Harkins says:

    I have recently found out my mom has Sundown Syndrome. I was told it was due to early stages of Alzheimers disease and there wasnt much we could do to for her. She is 78 yrs old and has other health issues so not knowing any better, I believed it. After looking it up on web md and, I have found out there are things we can do to help her. If you have a loved one who has been diagnosed with this, please look into it. It cant be cured, but there are things to do that may help. I am not a doctor or nurse, so please read up on it it yourself. dont take my word for it. I am going to try everything suggested, God willing it will help. But if it doesnt, at least Ill know I tried everything to make her more comfortable. She has ALWAYS been the one to take care of everything and everyone. now its my turn.

  12. My 94 year old mother in law started I guess about a year ago with blaming different things on other people. Things like everyone was stealing from her but she was miss placing things and stating that we were trying to trick her. She had gotten sick and ended up in the hospital and we removed some of her valuables from her home but before we had the chance to return them, she had turned her family into the police for stealing them. We got that cleared up and she understood that no one was trying to steal her things. She was mad at us for making her look bad in front of the police. She never wanted to leave her house to live with anyone and she wanted no help because she could take care of herself (so she said). Hard headed lady too. July fourth we got a call from the police that she was seeing children in her house and they wouldn’t leave. After staying with her for six hours and finally getting her to sleep, my husband and I finally went home. I called the next day to see how she was doing but she never even remembered us being there. Telling us we were liars and were tricking her again. A week ago, we got another call from the police telling us that they got a call from her again were she had fallen out of bed and hit her head and was bleeding. So off we went again to her house and had her transported to the hospital. When asked what happened, she stated that there were men in her dining room playing poker and when she tried to get out of the bed, she got rapped in her blankets and fell and busted her head open. She had not slept in two days. Ten hours at the hospital, we were dying but she was still going strong. She was so out of it that it would be funny if it wasn’t so sad. She is doing better now but she will have to go to a home for Alzheimer’s patients because her youngest is seventy and can’t handle her. It’s so sad to watch a loved one go through this.

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