Evening Confusion? 8 Sundowning Signs in Dementia

Written by Nguyenjessica

Published on July 3 2025

Sundowning causes confusion and behavioral changes in dementia patients during late afternoon or evening. Learn to recognize and manage it.

Evening Confusion? 8 Sundowning Signs in Dementia

Key Points

Sundowning is a common symptom of dementia, especially in Alzheimer’s disease.

It typically occurs in the late afternoon or evening hours.

Symptoms include agitation, confusion, pacing, yelling, and sleep issues.

Identifying triggers like fatigue, lighting, or overstimulation helps.

Simple routines, calming environments, and light therapy can ease symptoms.

What exactly is 40hz therapy?

have a look

Table of content

What Is Sundowning?

Why It Happens in Dementia?

8 Common Signs of Sundowning

Real-Life Example: Grandma Mary at 6 PM

How You Can Help

What Is Sundowning?

Sundowning, or "late-day confusion," is a pattern of behavior changes that tend to happen in the late afternoon, evening, or even nighttime. People with dementia may become more agitated, confused, or anxious as the day wears on — just when caregivers are also getting tired.

It doesn’t affect everyone with dementia, but it’s very common in moderate to late stages of Alzheimer’s.

Why It Happens in Dementia?

Experts aren't 100% sure why sundowning occurs, but several factors seem to play a role:

Changes in the body’s internal clock
Exhaustion or sensory overload
Hunger, pain, or discomfort that’s harder to express
Shadows and lower lighting that increase confusion
Lack of social cues in the evening

Imagine your brain has a rhythm — when dementia throws that rhythm off, evenings become more unpredictable.

8 Common Signs of Sundowning

Here’s what to watch for as the sun sets:

Restlessness or pacing
– Walking back and forth with no clear purpose.
Increased confusion
– Not recognizing familiar people or places.
Irritability or anger
– Short fuse, often without obvious cause.
Yelling or calling out
– Loud expressions of discomfort or fear.
Paranoia or suspicion
– Thinking others are stealing or hiding things.
Wandering or trying to "go home"
– Even if they’re already at home.
Sleep disturbances
– Trouble falling or staying asleep at night.
Hallucinations or seeing things
– Visual confusion made worse by dim light.

If these symptoms appear mostly during late-day hours, sundowning might be the reason.

Real-Life Example: Grandma Mary at 6 PM

At 10 AM, Grandma Mary is sweet and smiling.

At 6 PM, she’s pacing the hallway, shouting for her mother (who passed away 30 years ago), and accusing the neighbor of stealing her purse.

Her daughter, Anna, used to think it was just bad moods — until a doctor explained it was sundowning.

That knowledge helped Anna adjust her caregiving routine — and it changed everything.

ZenWave Z1 - Precision 40Hz Gamma Sound & Light Wave Generator - ZenWave Precision 40Hz

Video-ZenWave Z1 - Precision 40Hz Gamma Sound & Light Wave Generator

ZenWave Z1 - Precision 40Hz Gamma Sound & Light Wave Generator

$149.99

How You Can Help?

Here are some tips that make a big difference:

🕒 Keep a routine: Try to do meals, activities, and bedtime at the same time every day.
🌞 Use natural light: Open blinds during the day. Try light therapy in the late afternoon.
📺 Reduce noise and clutter: A calm, quiet space helps avoid overstimulation.
🍽️ Offer a light dinner: Heavy meals can cause discomfort and worsen symptoms.
💤 Encourage a nap, but not too late: Early afternoon naps are fine, but not in the evening.
💬 Offer reassurance: Calmly remind them that they are safe and loved.
👣 Avoid evening outings: Stay home in the evening to reduce disorientation.
🌼 Try aromatherapy: Scents like lavender can calm the nervous system.