Sundowning is a state of confusion that often appears in the late afternoon or evening, most often seen in parents or grandparents living with dementia. You may notice symptoms such as agitation, pacing, irritability, or disrupted sleep.
While sundowning can feel overwhelming, families often find relief with steady routines, softer lighting, calming activities, and safe, familiar spaces.
This guide explains what sundowning looks like, why it happens, and how you can manage it at home — along with when it may be time to seek professional support.
What Is Sundowning?
Sundowning is a state of confusion that tends to appear in the late afternoon or evening.
It isn’t a disease on its own. Think of it the way you think of memory loss or trouble finding words: another way dementia, especially Alzheimer’s, can show itself.
Families may hear doctors call it sundowning, while many caregivers simply say sundowners, both mean the same thing.
The signs can look different from one person to another. Families often notice things like:
- pacing or wandering
- refusing meals
- shouting or calling out
- restlessness that makes it hard to sit still
You might see this shift in the late afternoon or evening. A parent or grandparent who seemed calm all morning may begin pacing, refusing dinner, or calling out as the sun goes down.
Research shows sundowning is common in dementia, though the numbers vary.
Some studies report rates as low as 2.5%, while others find it in as many as two-thirds of people living with Alzheimer’s at home.
The Alzheimer’s Association estimates about 1 in 5 people with Alzheimer’s disease experience sundowning.
What Are the Symptoms of Sundowning?
Sundowning doesn’t look the same for every parent or grandparent. Some dementia behaviors are very common, while others only show up in certain situations. The mix often depends on the type of dementia, the stage of disease, and even the person’s own personality.
Common Symptoms
These are the changes families most often notice in the late afternoon or evening:
- confusion or disorientation, such as not recognizing where they are or what time it is
- anxiety and restlessness, shown through pacing, fidgeting, or an inability to sit still
- irritability or sudden anger, snapping at small things or raising their voice
- wandering, often paired with asking to “go home” even if they’re already there
- trouble with sleep, including resisting bedtime, waking often through the night, or insomnia
Less Common or More Unique Symptoms
Some behaviors are less common, but can be especially upsetting for families when they appear:
- hallucinations, such as seeing shapes in the shadows or hearing voices that aren’t there
- paranoia, believing someone is trying to harm them or steal from them
- shadowing, following you closely from room to room and becoming upset if left alone
- repetitive actions, such as asking the same question over and over or repeating the same gesture
What Influences Sundowning Symptoms
Not every parent or grandparent with dementia experiences sundowning the same way. Several factors can shape the symptoms:
- Type of dementia: Alzheimer’s often shows confusion and agitation, while Lewy body dementia may bring more visual hallucinations
- Individual personality: someone who was naturally anxious may show more agitation, while a quieter person may withdraw
- Underlying triggers: low light can lead to visual confusion, while too much noise or activity may cause irritation or lashing out
- Stage of dementia: sundowning tends to show up in the middle to later stages, and the symptoms may shift as the disease progresses
What Causes Sundowning?
Sundowning happens because changes in the brain disrupt the body’s internal clock. Normally, this clock helps us know when to be awake and when to rest. In dementia — especially Alzheimer’s disease — that rhythm doesn’t work as well anymore, which is why evenings can bring more confusion, worry, or restlessness.
Sundowning is most often linked to dementia, but it isn’t limited to it.
Can you have sundowning without dementia?
Yes, older adults without a dementia diagnosis can also experience sundowning. Age-related changes in the brain, sleep disturbances, and certain health conditions may trigger similar late-day confusion or agitation.
Certain factors can make sundowning worse, and they’re often the same triggers families notice at home:
- fatigue after a full day
- low lighting or more shadows in the evening
- hunger, thirst, or physical discomfort
- too much noise or activity
- being in a place that feels unfamiliar
Here’s how those triggers often show up in daily life:
| What sets it off | What you might see |
| Tired at the end of the day | Less patience, more irritability, snapping at small things |
| Dim light and shadows | Confusion about where they are, trouble recognizing familiar rooms |
| Hunger or thirst | Restlessness, refusing meals, asking repeatedly for food or water |
| Too much noise or activity | Agitation, covering ears, lashing out |
| Unfamiliar place | Pacing, wandering, asking to “go home” even if already there |
Stress by itself doesn’t cause dementia. What long-term stress can do is affect brain health in ways that may raise the risk over time. High levels of stress hormones can wear down areas of the brain that manage memory and focus.
For someone already living with dementia, stress often makes behaviors like confusion, agitation, or restlessness worse. Caregivers feel the strain too, and that tension can add to the challenges of sundowning in the evening.
How Do You Manage Sundowning?
You can’t always prevent sundowning, but you can take steps to make evenings calmer for your parent or grandparent. Small changes in the daily routine and home environment often make the biggest difference.
- Keep a steady routine: Follow the same wake-up times, meals, and bedtime every day. A predictable rhythm lowers anxiety and helps evenings run more smoothly.
- Adjust lighting as the day fades: Switch on lights before the sun goes down to keep rooms bright and familiar. Good lighting reduces shadows that may cause confusion or fear.
- Plan calming activities in the afternoon: Choose quiet, low-stress activities such as listening to music, folding laundry, or looking at family photos. Skip noisy shows, errands, or crowded spaces late in the day.
- Create a safe and comfortable environment: Clear away clutter, secure doors if wandering is a concern, and keep comfort items nearby. A favorite sweater, blanket, or chair can bring a sense of calm.
- Offer light, steady nourishment: Give a small snack with protein in the late afternoon to prevent low energy. Limit caffeine and sugar after lunch to support better sleep at night.
- Balance rest with activity: Encourage short rest breaks earlier in the day to ease evening fatigue. Avoid long naps, which make it harder to fall asleep at night.
- Use music and reassurance: Play soft, familiar music to create a calm atmosphere. When your parent or grandparent feels unsettled, reassure them with a gentle voice instead of correcting or arguing.
When Should You Seek Help?
Most families manage sundowning at home with small adjustments, but there comes a point when outside support makes a difference. You don’t have to wait until you feel overwhelmed.
- Watch for safety concerns: Seek help if your parent or grandparent wanders outside, forgets how to get back, or puts themselves at risk by leaving the stove on or unlocking doors at night.
- Take aggression seriously: Ask for guidance if sundowning leads to yelling, hitting, or resistance that puts you or your parent at risk. Aggression often signals a need for more structured care.
- Recognize caregiver stress: Reach out when sundowning leaves you feeling exhausted, anxious, or unable to rest at night. Ongoing stress takes a toll on your health and makes caregiving harder.
- Consult a memory care professional: Talk with a doctor or memory care team when symptoms grow too intense to manage at home. Professionals can suggest medication adjustments, therapeutic activities, or a move to a safer setting if needed.
FAQ: What Is Sundowning?
1. What are the symptoms of sundowning?
Sundowning often brings confusion, anxiety, or restlessness in the late afternoon or evening. Families may also notice pacing, wandering, mood swings, sleep problems, or in some cases hallucinations and paranoia.
2. Can you have sundowning without dementia?
Yes. Sundowning is most common in dementia, but it can also appear in older adults without a diagnosis. Age-related cognitive changes, sleep disturbances, and certain health conditions may trigger late-day confusion or agitation.
3. What stage of dementia is sundowning?
Sundowning tends to show up in the middle to later stages of dementia. The exact timing depends on the type of dementia and the individual, and the symptoms may change as the disease progresses.
4. What do you do when a person is sundowning?
Keep the environment calm and predictable. Turn on lights before evening shadows appear, offer a light snack, and guide them into quiet activities. If your parent or grandparent grows unsettled, use reassurance instead of correction. Seek professional help if the behaviors become unsafe or overwhelming.
Sundowning Requires Understanding First
Sundowning can feel overwhelming, especially when evenings keep turning into the hardest part of the day. What helps most is remembering that these behaviors come from changes in the brain. Your mom or dad isn’t choosing to be restless or upset.
What you can do is lean on the simple things that bring calm: steady routines, softer lighting, quiet activities, and safe spaces. When the symptoms grow too heavy to manage, reaching out for help is the next right step — not a sign of failure.
Above all, give yourself grace. Sundowning isn’t about doing things wrong as a caregiver. It’s about learning how to adjust, one evening at a time, and knowing support is always within reach.
Memory Care at 12 Oaks Senior Living
At 12 Oaks communities, memory care is designed around dignity, safety, and calm daily rhythms. Our approach focuses on creating environments where residents feel secure and connected. We provide personalized care that adapts as needs change.
Families who choose 12 Oaks find reassurance in knowing their parent or grandparent is supported during every part of the day — including the challenging evening hours. Our teams provide not just care, but peace of mind, so families can return to their role as sons, daughters, or spouses.
If you’re beginning to explore options, we invite you to see our approach firsthand.
Schedule a tour and experience how 12 Oaks supports both residents and families every step of the way.