Board of Registered Polysomnographic Technologists (BRPT) Practice Test

The condition described, where a patient with mild dementia becomes more confused and/or agitated in the early evening, is most accurately referred to as sundowning. This phenomenon is characterized by increased confusion, agitation, and restlessness that typically occurs in the late afternoon or evening and can be distressing for both patients and caregivers.

Sundowning may be related to changes in the patient’s circadian rhythm, fatigue, or diminished light in the evening hours, all of which can exacerbate cognitive symptoms of dementia. The behavior can lead to difficult situations during care and requires proper strategies to manage and mitigate the effects, such as ensuring a calm environment and maintaining a routine.

In contrast, delirium refers to an acute and sudden confusion, often reversible, typically related to a medical condition or substance. Somnambulism, or sleepwalking, is a disorder of arousal during sleep, and apraxia is a motor disorder affecting the ability to carry out learned movements. Therefore, while these conditions have distinct and significant implications, they do not share the specific characteristics of heightened agitation and confusion associated with evening hours that sundowning does.