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Caregiver Center

Sundowning

Quick answer

Confusion and restlessness that increase in the late afternoon and evening.

Author:
Illinois Dementia Guide editorial team
Medically reviewed by:
Amarish Dave, DO, Board Certified Neurologist
Published:
August 2026
Last medically reviewed:
August 2026
Geographic relevance:
Illinois, United States

What may be causing this

  • Fatigue accumulated through the day
  • Low light and shadows
  • Hunger or low fluid intake
  • Disrupted sleep-wake rhythm
  • Too much late-day activity or visitors

What to try first

  • Turn lights on before dusk and close blinds to remove shadows
  • Serve a light snack in mid-afternoon
  • Move demanding tasks to the morning
  • Play familiar quiet music
  • Build a predictable, unhurried evening routine

What usually makes it worse

  • Late-day appointments and outings
  • Caffeine after midday
  • Long afternoon naps
  • New environments in the evening

Simple things you can do today

  • Increase morning daylight exposure and a short morning walk
  • Set a consistent dinner and bedtime
  • Prepare the evening environment before 4 p.m.

When to call the doctor

  • Sudden onset over a day or two
  • Pain, fever, or urinary symptoms
  • Evening confusion is affecting safety or sleep for the household

When it may be an emergency

  • Threats or acts of violence toward self or others
  • Sudden confusion, weakness, slurred speech, or facial droop
  • A fall with head injury, especially on a blood thinner

Related resources

Medically reviewed. Last reviewed August 2026. This page is educational information, not individualized medical advice.

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