Sundowners and Sleep: Tips for Finding Balance


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 Sundowner Syndrome 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.


  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.

Intense and visceral frustration for family members and caregivers is not uncommon when dealing with loved ones experiencing episodes of sundowners. Outbursts and strange demands are not unusual and not always under their control, requiring extreme patience on the part of family members and caregivers in order to make it through these episodes. Like pets and kids, you will need to experiment in order to discern the right pattern and methods for your family. Following these tips above may make your life easier by bringing rhythm to your loved one’s life, thus positively impacting your life.


Update: January 2018