Sundowner's Syndrome (also known as sundowning) is a condition that occurs in the late afternoon or early evening when the sun goes down — generally between 3 p.m. and 8 p.m. It is not a separate disease but is one of the symptoms of dementia or Alzheimer’s disease. According to the Alzheimer’s Association, the Sundowner's Syndrome involves confusion, disorientation, agitation, anger, depression, restlessness, paranoia and mood swings. Some of the behaviors may include wandering, rocking, crying, pacing, hiding things and acting out aggressively.
It is one of the misunderstood symptoms of dementia and can add to the difficulty of effectively managing other symptoms. It is not clear why Sundowner's Syndrome becomes prevalent around sunset. But the syndrome certainly is real and needs to be managed to provide relief to the individual.
The exact causes of the syndrome are not known. For a long time, it was thought lack of light led to disorientation, stress, or even boredom. Recent research indicates it can be a reaction to medication, fatigue after the day’s stimulation, hunger, and other physical reasons.
The options to manage Sundowner's Syndrome are dependent on the individual. Actions to relieve symptoms in one person may aggravate them in another. No one answer works for all persons. The family caregiver should be alert for the signs, and employ a wide range of strategies to cope with the symptoms.
Author Amira Choukair Tame ("ABC’s of Activities for Alzheimer’s: Therapeutic Activities That Work for Persons with Dementia") believes the symptoms associated with Sundowner's Syndrome become more prevalent as the disease progresses and persons lose control over their bodies. The evening is a time when Alzheimer’s patients become self-reflective and ponder their dimming future. The family caregiver can help make such moments more comfortable by providing support and empathy.