The doctor said that your parent’s attitude and personality might seem different as his or her dementia or Alzheimer’s diagnosis progresses. But up until now, it has just been the little things – forgetting to take medication, dropping words, sleeping more.
But this week, things have escalated. He’s not sleeping; her anxiety level seems up, and both are quickly agitated. After a quick visit to the doc, you learn they are “sundowning.”

Sundowning: What Is It?

A symptom of dementia, sundowning typically expresses itself as increased anxiety and agitation, and a disruption of a loved one’s former sleeping habits. Mom or dad may stay up until 3 a.m. and then not want to arise before noon. They may pace or be unable to sit with a task; a once mild-mannered parent may “fly off the handle.” Sundowning most often affects those with mid-stage dementia, and usually occurs mid to late day.

Tips for Managing Altered Behaviors

  • Limit caffeinated beverages to early in the day. If they are a committed coffee drinker, you might unobtrusively replace their usual cup of caffeinated Joe with decaf.
  • Serve the larger meal mid-day and limit the evening meals to lighter snacks and fewer liquids to help with midnight trips to the bathroom.
  • Use a natural lightbox in the room during the earlier hours of the day. Used for seasonal affective disorder (SAD), these light systems mimic sunlight and help the body balance its natural sleep/wake rhythm.
  • Encourage exercise. For those with mobility issues, chair programs, or using a stress ball is beneficial. If mom or dad refuses formal exercise, encourage “tidying up” or tasks like folding clothes or making the bed with assistance. Small naps are okay, but lengthy napping leads to restless sleep and a disorganized sleep cycle.
  • Relaxing activities in the evening help the body downregulate toward sleep. Be mindful of over-stimulating television shows. Using an essential oil diffuser with lavender has been shown to support relaxation and sleep.
  • Evening conversations are not the time to address sundowning. Emotion-filled or frustration may agitate your loved one further, lessening a successful sleep transition.
  • A consistent routine is one of the most effective ways to minimize agitation with a mind that is now struggling with maintaining organization. Avoid surprises – new foods, activities, or people.  Without slow integration, sudden change is highly confusing and can be frightening to your loved one.

Caring for You

Sundowning is hugely challenging for the primary caregiver who is trying hard to maintain their own life rhythm. It is crucial to create your own self-care routine – talk to a peer, take a pause, give yourself a 10-minute time out to recuperate. And, remember: Self-compassion is the key to self-care and, in turn, the ability to care for others.