At least 40 million Americans each year suffer from chronic, long-term sleep disorders, and an additional 20 million experience occasional sleeping problems. Sleeping problems occur in almost all people with mental disorders, including those with depression and Alzheimer’s. Sleep affects our daily functioning and our physical and mental health in many ways that we are just beginning to understand. Many people who care for those with Sundowners believe that difficulty sleeping is central to the problem.

The term Sundowners describes a pattern of increased behavior problems with onset usually in the late afternoon and early evening. It can be most frequent in those people that have Alzheimer’s or perhaps dementia. This syndrome is also sometimes seen in older people who are in recovery from surgery in a hospital setting. Persons may exhibit increased confusion, agitation, wandering, hallucinations and general disorientation. For those living with or caring for someone exhibiting “sundowning” symptoms it can be quite startling and often intensely frustrating.

Although the following care tips may sound extreme, it has been shared that once a routine is set, life becomes a lot easier when caring for someone with Sundowners. Not all of these ideas will work for everyone; through experimentation you may find the right formula for your situation.

Care Tips for Sundowners Syndrome

  1. Allow for light exposure in the early morning to help set an internal clock.
  2. Daytime napping should be discouraged to help regulate the sleep cycle.
  3. Encourage exercise throughout the day to expend excess energy.
  4. Limit caffeine intake, particularly in the afternoon.
  5. Plan activities during the day so there is sufficient time to transition into the evening.
  6. Create a private space for relaxing.
  7. When you sense agitation coming on, try a five-minute hand massage or just hand holding for a few minutes. It is good to get in front of this and not wait until it progresses.
  8. Music or other sounds like ocean waves or singing birds can be calming.
  9. Interaction with a pet has also been known to calm agitation.
  10. Consider purchasing a bedside commode. Leaving his or her bed to use the restroom can start the cycle all over again, making it hard to get back to sleep.
  11. Take precautions to provide a safe space for him or her at night so that you can get a solid night’s rest, even if your loved one needs to stay awake and wander.
  12. Maintain a comfortable temperature in the bedroom; extreme temperatures may disrupt sleep or prevent one from falling asleep.
  13. Talk to your doctor about the many medications on the market that support those with Sundowners.


  1. cedrict

    These are some very good tips for caregivers. It’s important that you keep the person from sleeping a lot during the day, especially after lunch time. Taking brisk walks in the late afternoon could help with using up reserved energy and let them sleep during the night.

  2. Ella

    Thank you for explaining Sundowners Syndrome and noting the symptoms and care tips. I want to let you know how much I appreciate your explanations of the disorders of Alzheimer’s and dementia, your easy to understand format and terminology is a blessing for caregivers. I would like to share that I have found that certain medications or an over-medicating can bring on the same symptoms of Sundowners. It’s important to pay close attention when a loved one is prescribed something new or there’s a change in dose, especially with medications for Alzheimer’s and dementia. You don’t want to bring on these concerns if they’re not being experienced, they can be upsetting to witness and a challenge to fix and make better. I have noticed disorientation and hallucinating occurring more so after my brother’s afternoon nap, almost like his dreaming is real. Listening to his story telling and to avoid agitation I just go with it and move onto another subject, my goal being to bring him out of the moment gently. It seems to work. Trial and error. God Bless All Caregivers!

  3. margaret

    I have been taking care of my husband for 5 years now and now he has sundowners..I was thinking of finding a home for him or have a full time nurse. It is so hard to decide what I sure do.

  4. carole shannon

    I need some advice. Im caring for my 90 yr old sister in law who has dementia and now sundowners. What types of things can I do to alert me to when she walks up and starts to stir. She has fallen 2 in 2 wks. I tried bells on her walker but sometimes she stirs without it and Ive tried bubble wrap by her bed for when she stands but couldnt hear it on the carpet

    • Barbara larson

      My hubby has dementia, I have an alarm he sleeps on, it’s at his shoulders when he gets up it alarms. Have an alarm for a car coming on my property. The same alarm at doorways so I know he’s leaving the room. Inexpensive gadgets. About $20. Each.

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