Late-day confusion in people with dementia - Mayo Clinic

COVID-19 Advice updates and vaccine options

Find out about COVID-19, COVID-19 vaccines, and Mayo Clinic patient and visitor updates. Skip to site navigation Skip to Content This content does not have an English version. This content does not have an Arabic version.

Appointments at Mayo Clinic

Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Request Appointment

Sundowning Late-day confusion

Products and services

I ve heard that sundowning may happen with dementia What is sundowning and how is it treated

Answer From Jonathan Graff-Radford, M.D. The term "sundowning" refers to a state of confusion occurring in the late afternoon and lasting into the night. Sundowning can cause different behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering. Sundowning isn't a disease. It's a group of symptoms that occur at a specific time of the day. These symptoms may affect people with Alzheimer's disease and other types of dementia. The exact cause of this behavior is unknown.

Factors that may aggravate late-day confusion

Fatigue Spending a day in an unfamiliar place Low lighting Increased shadows Disruption of the body's "internal clock" Difficulty separating reality from dreams Being hungry or thirsty Presence of an infection such as a urinary tract infection Being bored or in pain Depression

Tips for reducing sundowning

Keep a predictable routine for bedtime, waking, meals and activities. Plan for activities and exposure to light during the day to encourage nighttime sleepiness. Limit daytime napping. Limit caffeine and sugar to morning hours. Turn on a night light to reduce agitation that occurs when surroundings are dark or unfamiliar. In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting. In a strange or unfamiliar setting, bring familiar items - such as photographs - to create a more relaxed, familiar setting. Play familiar, gentle music in the evening or relaxing sounds of nature, such as the sound of waves. Some research suggests that a low dose of melatonin - a naturally occurring hormone that induces sleepiness - alone or in combination with exposure to bright light during the day may help ease sundowning. It's possible that a medication side effect, pain, depression or other medical condition could be contributing to sundowning. Talk with your loved one's health care provider if you suspect that an underlying condition, such as a urinary tract infection or sleep apnea, might be worsening sundowning behavior, especially if sundowning develops quickly. With Jonathan Graff-Radford, M.D. There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. ErrorEmail field is required ErrorInclude a valid email address Learn more about Mayo Clinic’s use of data. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Subscribe!

Thank you for subscribing

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes Retry

Alzheimer's prevention: Does it exist?Alzheimer's nose spray: New Alzheimer's treatment? ShareTweet May 27, 2022 Show references Todd WD. Potential pathways for circadian dysfunction and sundowning-related behavioral aggression in Alzheimer's disease and related dementia. Frontiers in Neuroscience. 2020; doi:10.3389/fnins.2020.00910. Sleep issues and sundowning. Alzheimer's Association. http://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.asp. Accessed April 4, 2022. Managing personality and behavior changes in Alzheimer's. National Institute on Aging. https://www.nia.nih.gov/health/managing-personality-and-behavior-changes-alzheimers. Accessed April 4, 2022. Francis J. Delirium and confusional states: Prevention, treatment, and prognosis. http://www.uptodate.com/home. Accessed April 4, 2022. Graff-Radford J (expert opinion). Mayo Clinic. April 7, 2022. Tips for coping with sundowning. National Institute on Aging. https://www.nia.nih.gov/health/tips-coping-sundowning. Accessed April 4, 2022. See more Expert Answers

Products and Services

Book: Mayo Clinic on Alzheimer's DiseaseAssortment of Products for Independent Living from Mayo Clinic StoreBook: Day to Day: Living With DementiaGive today to find Alzheimer's cures for tomorrow

Alzheimer's sleep problemsAlzheimer's: New treatmentsAlzheimer's 101Alzheimer's and daily tasksUnderstanding the difference between dementia typesAlzheimer's diseaseAlzheimer's disease: Can exercise prevent memory loss?Alzheimer's drugsAlzheimer's genesAlzheimer's nose spray: New Alzheimer's treatment?Alzheimer's prevention: Does it exist?Alzheimer's stagesAlzheimer's and holidaysAntidepressant withdrawal: Is there such a thing?Antidepressants and alcohol: What's the concern?Antidepressants and weight gain: What causes it?Antidepressants: Can they stop working?Antidepressants: Side effectsAntidepressants: Selecting one that's right for youAntidepressants: Which cause the fewest sexual side effects?Anxiety disordersAtypical antidepressantsCan music help someone with Alzheimer's?Caregiver stressClinical depression: What does that mean?Corticobasal degeneration (corticobasal syndrome)CT scanDepression and anxiety: Can I have both?Depression, anxiety and exerciseWhat is depression? A Mayo Clinic expert explains.Depression: Diagnosis is keyDepression in women: Understanding the gender gapDepression (major depressive disorder)Depression: Provide support, encouragementDepression: Supporting a family member or friendDiagnosing Alzheimer'sIntermittent fastingIs the definition of Alzheimer's disease changing?Male depression: Understanding the issuesMAOIs and diet: Is it necessary to restrict tyramine?Marijuana and depressionMayo Clinic Minute: 3 tips to reduce your risk of Alzheimer's diseaseMayo Clinic Minute: Alzheimer's disease risk and lifestyleMayo Clinic Minute New definition of Alzheimer's changesMayo Clinic Minute: Women and Alzheimer's DiseaseMediterranean diet recipesMemory loss: When to seek helpMonoamine oxidase inhibitors (MAOIs)MRINatural remedies for depression: Are they effective?Nervous breakdown: What does it mean?New Alzheimers ResearchPain and depression: Is there a link?Phantosmia: What causes olfactory hallucinations?Positron emission tomography scanPosterior cortical atrophySeeing inside the heart with MRISelective serotonin reuptake inhibitors (SSRIs)Serotonin and norepinephrine reuptake inhibitors (SNRIs)Brain anatomyTreatment-resistant depressionTricyclic antidepressants and tetracyclic antidepressantsVideo: Alzheimer's drug shows early promiseMRIVitamin B-12 and depressionYoung-onset Alzheimer'sShow more related content

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Mayo Clinic on Incontinence - Mayo Clinic PressMayo Clinic on IncontinenceNEW – The Essential Diabetes Book - Mayo Clinic PressNEW – The Essential Diabetes BookNEW – Mayo Clinic on Hearing and Balance - Mayo Clinic PressNEW – Mayo Clinic on Hearing and BalanceFREE Mayo Clinic Diet Assessment - Mayo Clinic PressFREE Mayo Clinic Diet AssessmentMayo Clinic Health Letter - FREE book - Mayo Clinic PressMayo Clinic Health Letter - FREE book

Mayo Clinic Footer

Legal Conditions and Terms

Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Terms and Conditions Privacy Policy Notice of Privacy Practices Notice of Nondiscrimination Manage Cookies

Advertising

Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not endorse any of the third party products and services advertised.Advertising and sponsorship policyAdvertising and sponsorship opportunities

Reprint Permissions

A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

TREND NOW

Late day confusion in people with dementia Mayo Clinic