Summer Sundowner’s Syndrome – Physical Therapy May Help

| Dr. Eva Norman

Sundowner's Syndrome

It’s summertime and while many of us are out enjoying the sunny days and nice weather, this isn’t the case for everyone. Those affected with Alzheimer’s can often suffer from something referred to as Sundowners. Sundowners is a condition in which individuals with Alzheimer’s Disease seem to have a change in personality, often suffering from symptoms of dementia worse than usual when evening sets in. While each person can have a different time that they’re affected; generally speaking in most cases it’s during the time when the sun begins to go down. Some may be affected at twilight while others  earlier or later. There are many theories of why they suffer from sundowners; however, there is no medical evidence or agreement of its cause. Basically, Sundowner Syndrome remains a mystery to the medical world.

One thing is obvious to most caregivers; sundowners syndrome is very real and often changes in severity with the change of seasons. Like some people who suffer from Seasonal Affect Disorder , many with sundowners may get worse in the winter as we see less and less sunlight. Summer can sometimes present a problem in the sense that those who suffer may seem even more confused as the amount of daylight increases. They often will suffer from the symptoms of sundowners earlier because of their internal clock. This means their body still thinks it is 6pm while the world outside is still seeing sunshine until 9pm. Some eventually change with the adjustment of time and increase of sunshine; while others seem to have no change with their internal clock and will continue to worsen at the same time as they did during other seasons. Unfortunately, what happens with many is that they slowly begin to adjust to the “new time” as we once again change seasons. Time is thrown back one hour in most places, the amount of sunshine lessens, and sundowners worsens. It’s a vicious cycle.

Symptoms of Sundowner Syndrome

There is no certainty that any two people are alike with any condition; but, generally these are typical symptoms of those who have sundowner syndrome. It is thought that exhaustion can sometimes exacerbate these symptoms; so it is important that the patient get the proper amount of exercise regularly without over- exhausting them.

  • Crying
  • Irritability
  • Confusion
  • Abusive Language
  • Wandering
  • Restlessness
  • Fearfulness
  • Depression
  • Violent Outbreaks
  • Paranoia
  • Rocking
  • Sleeplessness
  • Hallucinating
  • Yelling Out
  • Swift Mood Changes
  • Tantrums


While these symptoms may also be common with dementia itself they often worsen while sundowning. This is why it can be extremely important to find alternative methods of caring for a loved one.

Some tips that may help include:

•           Music, white noise (ocean waves, birds) have all shown to help improve symptoms

•           Ask For Help From Family & Friends

•           Healthy Diet (eliminate caffeine)

•           Try Adjusting Your Schedule to Work with Their Schedule

•           Hire Professional Caregiving Services for Evenings

•           In Home Physical Therapy – wellness, prevention, or rehabilitation

•           Soothing Touch (not suggested for those who get violent or become angry)

Caregivers usually want quality of life for their loved one. Some studies have shown that having someone with dementia who suffers from sundowners may be helped with an exercise regimen. However, there is a fine line between exhausting the individual and giving them enough exercise to help them sleep at night. Live Your Life Physical Therapy will do a comprehensive assessment to determine what exercises are appropriate and how many to give them. Some physicians may also prescribe medication that will help them sleep. Be sure to keep the lines of communication open with the physician to prevent falls from the side effects of the medication. We can work closely with you to create an atmosphere that is best for your loved one and hopefully get more restful evenings for everyone.

Dedicated to Keeping You Healthy & Active,

Dr. Eva Norman
President & Founder
Doctor of Physical Therapy
Live Your Live Physical Therapy, LLC


Citations of Reference:
Alzheimer’s Disease Health Center –

U.S. Library of Medicine NIH – “Sundown Syndrome in Persons with Dementia”


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