Experts have raised alarms about a troubling sign of dementia that can manifest as the day turns into night. Often referred to as “sundowning,” this condition may cause changes in behavior and could extend throughout the nighttime hours.

Dementia is a syndrome characterized by a range of symptoms, marked by the progressive decline in cognitive abilities.

While memory loss is widely recognized as a symptom, dementia can also lead to challenges such as shifts in personality and difficulties with movement.

The Alzheimer’s Society notes that certain symptoms may become more apparent as the evening approaches. Known as “sundowning,” this can cause those affected to feel a sense of distress or agitation.

The organization explains: “You might observe changes in behavior during the late afternoon or as the day winds down. During these times, individuals may experience heightened distress, agitation, and even hallucinations or delusions.

“These symptoms may persist into the night, complicating their ability to sleep. This phenomenon is termed ‘sundowning,’ although it is not strictly tied to the sunset or the end of the day.

“Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages.”

What triggers sundowning

Various factors can precipitate sundowning episodes. The precise cause remains unclear.

The Alzheimer’s Society explains: “The reasons why sundowning happens are not well understood, but it is possible that a range of different causes makes it more likely.”

These may include:

• Fatigue, hunger, pain or other unaddressed physical requirements
• Insufficient daylight exposure throughout the day
• Excessive stimulation during daytime hours, such as from a loud or hectic environment
• Disruption to their body clock resulting from brain damage
• Altered hormone levels that fluctuate throughout the day
• Sensory difficulties, such as hearing or vision problems
• Exhaustion in others causing the person with dementia to become distressed
• Mental health issues, such as anxiety or depression
• Reduced care staff availability to support the individual (in a care home)
• Adverse effects of prescribed medications

The charity adds: “Some of these are related to the time of day, and others may happen at any time. Try to identify which of these problems might be affecting the person, as each problem may need a different treatment.”

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How to help someone experiencing sundowning

If you believe someone is experiencing sundowning you could consider the following:

• Sometimes, what appears to be “sundowning” could actually be the person attempting to communicate a need, such as needing the loo, feeling peckish or experiencing discomfort
• Indoor lighting that’s inconsistent and reflective surfaces can occasionally cause confusion by creating unsettling shadows or reflections. Draw the curtains or blinds once it begins to darken and cover the telly with a dust cover when it’s not in use
• Consider whether an event from the day has had an impact on them. If they seem restless, try to soothe them by diverting their attention, perhaps discussing a cherished memory or an event they enjoy reminiscing about
• If they continue to be agitated, it might be that they have a need that isn’t being fulfilled

If you suspect a loved one is showing signs of dementia, it is advisable to consult a GP.