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Intermediate Technical IVT

sundowning

Increased confusion and behavioral symptoms in dementia patients occurring in late afternoon or evening.

Full Definition

Sundowning, also known as sundown syndrome, refers to the phenomenon where individuals with dementia experience increased agitation, confusion, anxiety, and behavioral disturbances during late afternoon and evening hours. This circadian-related symptom affects approximately 45% of Alzheimer's patients and can include wandering, pacing, verbal outbursts, or resistance to care. The exact mechanism is unclear but may involve disrupted circadian rhythms, fatigue accumulation, or decreased lighting affecting visual perception. In clinical documentation, sundowning should be distinguished from general behavioral and psychological symptoms of dementia (BPSD) by its temporal pattern and relationship to time of day.

Usage

Usage note: May be written as one word or hyphenated (sun-downing). Specify timing pattern when documenting.

In Context

  • "The patient's sundowning episodes required increased supervision and environmental modifications after 4 PM." — Care plan documentation
  • "Light therapy was initiated to address severe sundowning behaviors disrupting the household." — Treatment intervention note

Also known as

sundown syndrome late-day confusion

Contrasted with

stable behavior circadian stability

Don't confuse with

delirium general agitation BPSD

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