How to prevent sundowning: a daily routine for calmer evenings

Can you prevent sundowning?

If you're searching for how to prevent sundowning, here's the honest answer: you can't always stop it, because sundowning is linked to changes in the brain caused by dementia. But you can often reduce how often it happens and how intense it gets.

The key insight is that a calm evening is mostly built earlier in the day. Exhaustion, too little daylight, late naps, caffeine, a busy afternoon, and dim rooms all feed into sundowning. Small, consistent changes to the day can take a lot of pressure off the evening.

Build a steady daily routine

Predictability is calming for someone living with dementia. Aim to wake up, eat, and go to bed at roughly the same times every day, including weekends. Here's what a sundowning-friendly day can look like:

1. 1

   Morning: light and movement

   Open the curtains soon after waking. If you can, get outside or sit by a bright window. This is a good time for appointments, bathing, errands, and anything that takes effort.

2. 2

   Midday: the main meal

   Make lunch the bigger meal of the day. Follow it with a gentle activity rather than a long doze in the chair.

3. 3

   Early afternoon: short rest, if needed

   If a nap is needed, keep it short and early. After that, a walk or a simple, enjoyable task helps burn off restlessness.

4. 4

   Late afternoon: get ahead of the window

   Before the time episodes usually start, turn the lights up, offer a drink and a snack, and switch to calm, familiar activities.

5. 5

   Evening: light meal, low stimulation

   Serve a lighter evening meal, keep the TV and noise down, and move toward a predictable bedtime routine.

6. 6

   Bedtime: same place, same time

   Go to bed at the same time in the same place each night, in a quiet, comfortable bedroom.

Use light on purpose, including light therapy

Light is one of the strongest signals for the body's internal clock, and dementia can leave that clock confused. Getting light right in both directions helps:

• Daylight during the day. Time outdoors, a walk, or a chair by a sunny window, ideally earlier in the day.
• Lights on before dusk. Turn on lamps before the house gets dim so rooms never slide into shadow. Low light can create shadows that are misread and cause fear or confusion.
• Even, glare-free lighting in the evening, especially in hallways and the rooms your loved one uses most.
• Darkness at bedtime, with a small night light on the way to the bathroom for safety.

What about sundowning light therapy?

Cleveland Clinic lists light therapy, which typically means spending time near a special bright light, among the non-medication options for sundowning. If you're curious about it, talk to your loved one's doctor first about whether it suits them and how and when to use it.

Keep naps short and early

Being overtired can make late-afternoon restlessness worse, so rest matters. But long or late naps can make it harder to sleep at night, and waking from a doze can be disorienting.

• If a nap is needed, keep it short and early in the day.
• Discourage dozing in front of the TV late in the afternoon. A short walk or a chat can help bridge the dip.
• If your loved one isn't sleeping well at night, try limiting daytime naps and tell the doctor.

Meals, caffeine, and alcohol

• Make lunch the bigger meal and keep the evening meal lighter.
• Limit caffeine after the morning. Coffee, tea, cola, and chocolate can all contain it.
• Reduce or avoid alcohol and nicotine, which can affect sleep.
• Offer drinks regularly through the day. Dehydration can make sundowning worse, and your loved one may not always ask for a drink.
• Keep an eye on bowel habits. Constipation is uncomfortable and can be a hidden cause of agitation.

Plan activities for the right time of day

Too little to do can cause restlessness and boredom. Too much can cause exhaustion by evening. The goal is a gently full day, not a packed one.

• Schedule doctor appointments, trips, and bathing in the morning or early afternoon, when most people are more alert.
• Aim for some physical activity every day, such as a walk, gardening, or seated exercises.
• Build in meaningful, familiar tasks: folding laundry, setting the table, sorting photos, or watering plants.
• Protect the late afternoon. Avoid big outings, busy visits, or new places just before the usual sundowning window.
• Make time for connection. Loneliness is a trigger for agitation, and a phone call or visit from someone familiar can lift the whole day.

Create a calm sundowning evening routine

The hours around dusk are when calm matters most. A predictable evening routine tells your loved one what's coming next, which is reassuring in itself.

• Lower the stimulation. Turn off the news, avoid loud music, and save chores like vacuuming for earlier in the day.
• Keep familiar things close: family photos, a favorite blanket, well-loved music.
• Make sure glasses and hearing aids are on, so they can see and hear clearly and misread less.
• Choose soothing activities they enjoy, such as listening to calm music, looking through photographs, or watching a favorite film.
• Watch your own stress. People living with dementia pick up on the mood around them, so a few slow breaths before evening can help you both.

Gentle conversation about happy memories, known as reminiscence, fits beautifully into an evening routine. For tips on phrasing, see how to talk to someone with dementia.

Track triggers with a simple sundowning log

Patterns are easy to miss when you're tired. A few notes each evening for one to two weeks can reveal what's driving the episodes. Write down:

1. The time restlessness started and how long it lasted.
2. What happened in the hour or two before: naps, visitors, noise, meals, drinks, outings.
3. How they slept the night before.
4. Any signs of pain, constipation, or bladder trouble.
5. Any new or changed medications.
6. What helped and what made it worse.

Once you see a pattern, such as episodes after a late nap or a busy afternoon, you can adjust the day around it. Bring the log to your next doctor's appointment too.

Ask for a medical and medication review

Some of the most important prevention happens in the doctor's office. Physical problems that your loved one can't describe can cause or worsen sleep problems and evening agitation. Ask the doctor to check for:

• Pain, including from arthritis, teeth, or constipation.
• Urinary tract infections or incontinence problems.
• Sleep disorders such as sleep apnea or restless legs syndrome.
• Hearing or vision problems that make the evening more confusing.
• Medication side effects, and whether the timing of doses could be adjusted to help evenings and sleep.

And if confusion ever changes suddenly over hours or days, that's not a routine problem. It may be delirium, which needs a doctor the same day.

Have a plan for the evenings that still happen

Even with the best routine, some evenings will be hard. That's not failure. Having a plan ready means you're not improvising when you're exhausted.

• Know your first moves: check for a physical need, stay calm, validate the feeling, and redirect. Our guide on how to calm sundowning walks through each step.
• Keep a short list of what usually works, such as a certain song, a photo album, or a snack.
• Line up a trusted voice. Many people settle fastest for a familiar family member. Hamton lets families have a call in a trusted, recorded voice ready for the moment an episode starts.
• If your loved one tries to leave, see our guide to dementia wandering for safety steps.

Finally, prevention includes you. A rested caregiver is a calmer caregiver. If the evenings are wearing you down, read our guide to caregiver burnout and ask for help.

Frequently asked questions