The Surprising Link Between Medications and Sundowning

You made it through another busy day. Dinner’s wrapped up, the kitchen’s clean, and you’re finally catching your breath. Then, like clockwork, the shift begins. Your loved one with dementia starts to act differently—more anxious, more confused, maybe even angry. The calm you hoped for slips away, and suddenly, you’re back in the thick of it.

Sound familiar? You’re not alone. This common late-day change is called sundowning. While many family members are all too familiar with the struggle, fewer realize the link between medications and sundowning.

What’s Really Going On With Sundowning?

Sundowning refers to a pattern of behavior seen in people with dementia, where confusion, agitation, or restlessness intensify in the late afternoon or evening. It can feel like a daily cycle—mornings are manageable, but evenings bring chaos.

Common causes include fatigue, changes in light, and sensory overload. But a major contributing factor is often overlooked: the side effects of common medications.

Medications That Can Make Symptoms Worse

Certain drugs—especially those frequently prescribed to older adults—can impact cognition and mood, even if they’ve been used for years. Watch out for:

• Anticholinergics – These are found in many medications for allergies, bladder control, and sleep, and they’re known to cause confusion.
• Benzodiazepines – Drugs like Ativan or Xanax may increase agitation and reduce impulse control in people with dementia.
• Antidepressants and antipsychotics – These might seem helpful but can trigger side effects like anxiety, restlessness, or heightened confusion.
• Over-the-counter sleep aids – Even something as simple as a nighttime cold medicine can be problematic.

These medications aren’t necessarily harmful on their own, but their effects in dementia can be more pronounced—especially later in the day.

What Should You Do Next?

If you notice sundowning symptoms worsening, especially after starting a new medication, talk to your loved one’s healthcare provider. Bring a complete list of prescriptions, supplements, and OTC meds with you.

Ask questions. Could something be adjusted? Could the timing of the dose be changed? Would another medication be safer?

Even small tweaks can lead to big improvements.

It’s Not Just the Medication

Of course, medication is just one piece of the puzzle. Poor sleep, hunger, overstimulation, or even just a long day can lead to increased evening distress. And you’re not just a caregiver—you’re human, too. You deserve support.

We’re Here When Evenings Get Hard

At Responsive Home Care, we specialize in supporting families navigating dementia, especially the challenges that come with sundowning. We serve Fort Lauderdale, Parkland, Weston, and throughout Broward County with compassion and experience.

Our caregivers are trained to recognize triggers, respond calmly, and provide a grounding presence. We can help monitor medications, establish soothing routines, and offer overnight care so you can finally rest.

If evenings have become your hardest time, let’s talk. Call Responsive Home Care at 954-486-6440 for a free in-home consultation to learn more about how our specialized dementia care services can help someone you love. Help is closer than you think.