What condition involves becoming restless and agitated in the late afternoon, evening, or night?

• A. Delirium
• B. Sundowning
• C. Restlessness
• D. Circadian Disruption

Answer: (B)

Sundowning. This pattern describes becoming restless, agitated, and sometimes confused as daylight wanes, typically in the late afternoon, evening, or night. It’s common in people with dementia and relates to shifts in the sleep-wake cycle and circadian rhythms, plus factors like fatigue, less lighting, or overstimulation as the day ends. That time-specific behavior is what makes sundowning the best fit.

Delirium would involve acute, fluctuating confusion with impaired attention that can occur at any time and usually has an identifiable medical or environmental trigger. Restlessness by itself is too non-specific, and circadian disruption refers to a broader disruption of the sleep-wake cycle, not the particular late-day pattern described here.