What is Sundowning?
Sometimes individuals living with dementia will display changes in behaviour at certain times of day. This usually occurs in the evening and, as a result, is known as ‘sundowning’.
It is not an illness of any kind, but rather a set of symptoms or behaviours that you may notice which could help you to better understand yourself or a loved one. Behaviours may include anything from pacing and distressed behaviours, to anxiety or hallucinations. As a result of these behaviours, individuals may find it much harder to sleep or may be more difficult to support than they would be at other times of the day. Understanding that this is a normal and widely experienced phenomenon can help you begin to recognise and manage any issues that arise from it.
What Causes Sundowning?
The exact cause of sundowning is unknown, although there have been many studies into its prevalence and the factors that may contribute to it. One common belief is that exposure to blue light as the evening draws in, combined with increased light sensitivity and associations with this time of day, may be a central factor.
This is something that changes over the course of the year and may help to explain inconsistencies in the timing of behaviours. However, there are many other elements that are also believed to contribute to sundowning, or exacerbate behaviours that may mimic sundowning symptoms.
- Possible causes could include:
- Tiredness, whether mental or physical, from the day’s activities.
- Hunger or pain resulting from unmet needs.
- Disturbances in the internal ‘body clock’ due to damage in the brain or being in a new environment.
- Mood or mental health disorders.
- Sensory impairments taking their toll over the course of the day.
- Dreaming while asleep that causes confusion about reality upon waking.
- Side effects of medication.
How to Reduce Sundowning?
With a lack of solid evidence to suggest exactly why sundowning occurs, it is difficult to recommend a specific remedy to prevent it. However, we can provide some tips based on the potential causes listed above and the belief that blue light may be a significant influence.
- One of the biggest suggestions is to spend some time identifying individual triggers, as sundowning can be a very personal experience.
- Turn on evening lights before the sun goes down to create a more seamless transition from day to night.
- Engage the individual in an activity or adjust routines in a way that provides distraction.
- Encourage a regular routine that provides comfort and stability.
- Reduce intense stimulation in the evenings, especially activities involving screens.
- Introduce soothing activities such as listening to calming music, reading, or having a quiet conversation.
- Ensure that basic needs such as food, hydration, and comfort have been met.
These small adjustments can help create a calmer evening environment and may reduce some of the behaviours associated with sundowning.
Conclusion
Sundowning can be challenging for both individuals living with dementia and those supporting them. However, recognising that it is a common experience can help reduce frustration and uncertainty when these behaviours occur. By observing patterns, identifying possible triggers, and creating a calm and supportive evening environment, it may be possible to lessen the impact of sundowning. Patience, consistency, and understanding are key in helping individuals feel safe, comfortable, and supported during these times.