What it is
Sundowning is a pattern of increased confusion, agitation, anxiety, or restlessness that shows up in the late afternoon and evening, often as light starts to fade. It isn't a diagnosis on its own, it's a symptom pattern common in dementia, and its exact cause isn't fully understood. Fatigue, disrupted internal clocks, and the visual confusion of changing light all likely play a role.
Signs to watch for
Increased confusion or disorientation that's noticeably worse than earlier in the day.
Restlessness or pacing, wanting to "go home" even when already home.
Agitation or irritability that seems to come from nowhere as the day winds down.
Difficulty settling in the early evening, resisting the usual routine.
What helps
Keep afternoons and evenings predictable. A consistent routine reduces the disorientation that fuels sundowning.
Manage light early. Turning on lights before it gets dark, rather than after, can ease the transition and reduce shadows that add to confusion.
Limit afternoon caffeine and long naps. Both can make evening agitation worse.
Lower the stimulation, not the connection. A quieter environment helps, but your calm presence still matters more than silence.
What to avoid
Arguing or reasoning during the episode. Sundowning isn't a logic problem, and trying to talk someone out of it usually raises the agitation rather than lowering it.
Introducing something new in the evening. New visitors, new activities, or big changes to the routine are best saved for earlier in the day.
When sundowning starts
This pattern shows up often enough that it's worth planning for in advance, rather than reacting to it fresh every evening. The free guide covers sundowning alongside other behavior changes in more depth, including how routines shift as dementia progresses.
This is one piece of the full guide, "Diagnosed With Dementia: Now What?" Section 3 covers understanding the disease, including changes like sundowning, in full.