Elderly Insomnia: Its Causes And How To Treat It
No one is immune to a restless night here and there. If you’ve had one, you know they’re not fun in the moment or during the next day. But for many, tossing and turning for hours every night is the norm, which can not only be frustrating, but cause health problems down the road as sleep is just as vital to our bodies as food and water.
Those who have difficulty falling and staying asleep on a regular basis have a disorder known as insomnia. Insomnia is more widespread than you might think, but its especially common in adults aged 60 and over. Unfortunately, insomnia doesn’t go away easily. It can disrupt sleep for months or even years, causing plenty of issues like memory loss, depressions, irritability, as well as contributing to physical health problems.
Sleep: The Basics
Human sleep needs change as they move through life. Infants need around 16 hours of sleep within 24 hours. As they progress towards adolescence, that shrinks to about 9 hours. Both adults and seniors need between 7 and 9 hours of sleep, but seniors often sleep lighter and for less time.
But even if they sleep for the same amount, how is lighter sleep worse? Well, quality is important as quality. See, our bodies go through 4 stages of progressively deeper non-REM (Rapid Eye Movement) sleep, eventually landing in REM sleep. As the name implies, your eyes move around rapidly during this phase. Your limbs are also immobilized and breathing becomes shallow and irregular. Dreams occur at this stage (although you don’t always dream). This whole cycle takes 90-110 minutes, meaning a healthy night’s sleep should consist of 4-5 of these cycles.
However, seniors don’t always get all this sleep in, which can be attributed to aging. Other health problems can interrupt the sleep cycle as well.
During the day:
- Drowsy/tired all the time
- Complaints about lack of sleep
- Bad memory
- Difficulty concentrating
- Accidents from lack of sleep
- Taking 30-45 minutes to fall asleep
- Difficulty staying asleep, or waking up and failing to fall back asleep
- Night falls
Insomnia may be a primary disorder; however, it usually has roots in some other health condition. There are a variety of factors thought to contribute to insomnia:
- Stimulant Consumption – Consuming caffeine and other stimulants in the evening makes it difficult to relax and fall asleep.
- Alcohol Consumption – A night cap might appear to relax you for bedtime, but alcohol can inhibit REM sleep and mess up your whole sleep cycle.
- Anxiety/Stress – Stressors are distracting and make falling and staying asleep difficult. Work, money, family, and other aspects of life can cause this anxiety and stress.
- Poor sleep rituals/habits – Some things are best done long before nighttime. Blue light exposure (electronic device screens), exercise, and even drinking too much water can increase sleep difficulties.
- Sleep environment – Uncomfortable bedding, insufficiently dark rooms, and too much heat causes difficulty falling asleep.
The following problems may further exacerbate sleep issues especially in seniors:
- Sleep cycle changes – Aging generally shifts the brain’s internal clock earlier, requiring a change in sleep habits.
- Depression – Common in the elderly.
- Aches/pains – Diseases like arthritis cause pain that makes sleep difficult.
- Frequent urination – Needing several bathroom trips throughout the night makes restful sleep tough for seniors.
- Medication – An increase in medication use can cause sleep-inhibiting side effects.
- Sleep disorders – Sleep apnea is a big one.
- Movement disorders – Restless Leg Syndrome is a big one.
- Neurodegenerative disorders – Alzheimer’s, Dementia, Parkinson’s, etc.
Here are some tests your physician can run if you suspect your loved one may be suffering from insomnia:
- Sleep diary – Ask their physician for this. Record sleep/wake times, difficulties, disturbances, and other relevant information.
- Physical exam – Looking at their medical history, current medications, and discussing their sleeping habits with the physician. You should bring the sleep diary to this.
- Sleep study – These are one overnight stay. Sleep specialists monitor time taken to reach each stage of sleep, as well as observing what happens at each phase. They also monitor other occurrences like breathing patterns and changes in heart rate.
The root cause should always be addressed if it’s related to medication or disease. However, to both prevent insomnia and minimize its effects, there are many actions to take, as well some to avoid.
- Create a consistent sleep/wake schedule, meaning go to bed and wake up at about the same time each day.
- Make the bedroom dark, quiet, and cool.
- Engage in relaxing activities, such as listening to calming music.
- Exercise, but earlier in the day. Exercise at least 4 hours before bed, but preferably more.
Don’t do these:
- Consume any stimulants.
- Consume heavy meals or large quantities of liquids.
- Napping. Keep them to a minimum.
- Activities like reading or TV that make the mind start working.
Most prescription sleeping pills are pretty safe, but they have many side effects and other issues to consider before using them. It’s best to consult a physician especially for seniors, as they don’t metabolize drugs as fast. This can lead to drug interaction issues and other problems.
Non-prescription sleep aids can help with insomnia in the short-term, but their effectiveness decreases over time. Don’t rely on them for anything more than a temporary fix.
Then, there are supplements like the hormone melatonin. Your body produces this naturally to help regulate sleep, but melatonin supplements are available as sleep aids at plenty of stores. Other supplements like valerian and chamomile are believed to assist with sleep, too. None of these are regulated by the FDA and their long-term effects aren’t well-known, so use discretion.
Restful sleep is critical to good health; plus, it just feels so great. So when you notice a loved one suffering from insomnia symptoms, encourage them to visit their physician. Their physician can thoroughly examine their health so the proper steps can be taken to get your loved one the sleep they deserve.