
Alzheimer’s is one of the most common neurodegenerative diseases in the world, affecting millions of people every year.
While memory loss and confusion are the most well-known symptoms, there’s a lesser-discussed symptom that often appears at night: sundown syndrome, also known as “sundowning”.
What is Sundown Syndrome?
Sundown syndrome is a condition that affects some people with Alzheimer’s, causing increased confusion, anxiety, and agitation in the late afternoon and evening hours. This phenomenon can be particularly challenging for both patients and caregivers, as it disrupts sleep and overall quality of life.

Causes of Sundowning
The exact cause of sundowning is still unknown, but it’s believed to be linked to:
Disruptions in the body’s internal clock: Alzheimer’s patients may struggle to distinguish between day and night, throwing off their sleep-wake cycle.
Fatigue: Tiredness built up throughout the day can intensify confusion and anxiety.
Lack of natural light: As daylight fades, symptoms can worsen.
Symptoms of Sundown Syndrome
Symptoms can vary from person to person, but often include:
- Agitation and irritability
- Anxiety
- Increased confusion
- Trouble sleeping
- Aggressive or unpredictable behavior
- Strategies for Managing Sundown Syndrome
While there’s no cure for sundown syndrome, several approaches may help reduce its effects:
Stick to a consistent daily routine: Regular schedules for meals, activities, and bedtime can help ease confusion.
Increase exposure to natural light: Make sure the person gets enough daylight, especially in the morning.
Create a calm environment: Reducing noise and distractions in the late afternoon and evening can help soothe agitation.
Avoid caffeine and sugar: Limiting these stimulants may help improve sleep.
Relaxation techniques: Deep breathing, soft music, and gentle massage may help reduce anxiety.

The Importance of Early Recognition
Recognizing and addressing signs of sundowning early can make a significant difference for both patients and caregivers. If you suspect a loved one is experiencing these symptoms, it’s important to seek help from a healthcare professional for a proper diagnosis and a tailored care plan.
Conclusion
Sundown syndrome is a lesser-known but impactful symptom of Alzheimer’s that can take a heavy toll on quality of life. With effective coping strategies and professional guidance, it’s possible to better manage these episodes and create a safer, more comfortable environment for those affected. Awareness and understanding of sundowning are essential steps toward providing stronger support and care.