The sundowning syndrome: A conceptual analysis and review

The increased agitation, and confusion in late afternoon, evening or night, shown by some victims of dementing disorders, has been called “sundowning,” or “the sundowning syndrome.” This paper reviews the available literature and examines the definition of this condition, the observed symptoms, reported time of occurrence, incidence, stability or regularity, relative importance, its relationship to other processes in dementia, etiology, treatment-as well as its diagnostic implications. Patterns in the literature are discussed. It is concluded that in spite of many references to it in clinical texts, sundowning remains a poorly understood phenomenon.