Insomnia in Seniors

Apr 21, 2016

Insomnia in Seniors

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Sleep is an essential part of life, restoring our energy for the day to come. A solid night of rest can make all the difference in our overall health, especially as we grow older. Unfortunately, nearly 50 percent of all seniors suffer from insomnia, or the inability to fall, and stay asleep.

Senior Sleep Essentials

Seniors need the same amount of sleep as younger adults, which is around 7-9 hours a night. However, The National Sleep Foundation reports that our patterns and sleep requirements begin to shift as we age. For many, these changes can result in mild to severe insomnia in addition to many other factors. 

During the night, we experience various stages of sleep starting with 4 levels of what is known as non-rapid eye movement (NREM). As we drift into the first stage, we move subtly between a waking and resting state, eventually reaching the second level where eye and muscle movements cease. During the third level, our brain emits a mixture of slow modulations (Delta waves) and shorter, faster frequencies. As we reach the forth level, the brain operates exclusively in the delta wave state until shifting to rapid eye movement (REM) sleep.

The switch to REM sleep is a necessary component of achieving adequate rest, serving to increase the production of vital proteins, help with mental acuity, and allowing us to feel refreshed the next day.

Insomnia Sleep Patterns 

First of all, insomnia sleep patterns are defined in two ways:

  • Sleep onset insomnia – Difficulty with falling asleep, although sleeping throughout the night is relatively uninterrupted.
  • Sleep maintenance insomnia – Difficulty staying asleep, general restlessness or inability to fall back asleep upon waking prematurely.

Although we all experience the occasional night of sleeplessness, chronic insomnia can be a debilitating condition. As a senior, it becomes increasingly important to make sure your body and mind can maintain the highest possible state of functionality.

Symptoms of Insomnia May Include:

  • Taking more than 30-45 minutes to fall asleep
  • Trouble staying asleep
  • Restlessness
  • Lack of concentration during the day
  • Impaired memory
  • Irritability
  • Exhaustion
  • Depression

Factors Contributing to Insomnia in Seniors

These symptoms can result from any number of compounding factors that may, or may not be obvious to recognize.

  • Waking up to use the bathroom - Incontinence issues in women and prostate enlargement in men are often causes of sleep disruption 
  • Stress and anxiety are two very common causes of sleeplessness, often resulting in a vicious cycle of stress due to sleeplessness and so on.
  • Caffeine, nicotine, and other stimulants are best to avoid several hours before sleep, if not entirely. Even alcohol, which may help you fall asleep, is significantly limiting to a brain trying to reach deep sleep states.
  • Existing health conditions - Heartburn, arthritis, and cancer can also cause seniors to lose sleep. Neurologic conditions like Dementia and Parkinson's disease are also a source of sleep problems.
  • Lifestyle changes in sleeping and wake patterns - As we age, our sleeping and wake patterns begin to change. Seniors tend to become more tired earlier and wake up earlier in the morning hours. Not making these adjustments can also contribute to difficulty falling asleep.

Professional Treatment Options

By recognizing the aspects of your lifestyle that may be hurting your sleeping habits, finding a solution can be a dream come true. Although, given the variety of causes and factors involved with diagnosing sleep disorders, it can be useful to consult a sleep specialist or your doctor about any other underlying medical conditions.

By evaluating the frequency of your insomnia and other health concerns, a diagnosis can be made through the following methods:

  • Physical Exams: A routine physical examination is a good starting point to begin assessing how any variety of factors may be causing sleeplessness. Talking with your doctor about any and all medications you are taking can help to see if there are any side effects contributing to your insomnia.
  • Clinical Sleep Studies: Usually involving an overnight stay, these comprehensive tests can reveal the specifics of what goes on during your sleep (or lack thereof).
  • Nocturnal Polysomnography: This comprehensive test monitors your heart, lung, and brain activity, measuring breathing patterns and bodily movements. Oxygen levels are monitored to observe the possibility of moderate to severe sleep apnea as a contributing factor.
  • Home Sleep Tests: People may find it difficult to reproduce their sleeping habits in a clinical setting, so your doctor may recommend this method. These tests produce similar, yet simplified results compared to nocturnal polysomnography. Any drops in oxygen corresponding to waking up are recorded for later evaluation.

Your doctor may recommend you keep a diary of your sleeping, and pre-sleeping habits. By recording the processes involved with bedtime, it will be easier to tell what changes you can make in order to sleep better.

Sleep Medications

There are many medications and other substances available as sleeping aids, just be sure to check with your doctor before adding something new to your regimen. Prescription sleeping pills may not always be the best choice for older adults, especially when used continuously. Aging slows the breakdown of drugs and can have negative polypharmacological effects. It is usually recommended that seniors try non-drug treatment options first, opting for medicine as a last resort.

Even over-the-counter medications like Nytol, Sominex, and Tylenol PM, which help in the short term, may eventually become ineffective. Of course, there are natural alternatives to these medications: valerian root, chamomile, and kava are all plant-based sleep aids. The problem is that the FDA does not currently regulate these substances, making their long-term effects relatively unknown.

Also among this group of alternative remedies is melatonin, a natural hormone found in our brains believed to be responsible for regulating our sleeping rhythms.

Developing healthy sleeping habits is sometimes very difficult to do. Luckily, a quick trip to your physician or doctor is likely to reveal some useful recommendations for getting the rest you need.

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Frequently Asked Questions

I just turned 63 and I can’t seem to fall asleep or stay asleep as well as I used to. Do you have any recommendations for what I can do to treat this that doesn't involve medication?

Sleep disorders are a common problem in elderly adults. To help combat this issue, most doctors will recommend a number of treatments. Here are a few: avoid large meals before bedtime, avoid stimulants starting mid-afternoon, do not take naps, patriciate in regular exercise, have a consistent bedtime schedule, and avoid using the bed for things other than sleep and sexual activity. 

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Our grandmother’s assisted living home recently told us that she is waking at night and having intense night terrors. What is the cause of this?

Oh my! It’s possible she might be suffering from a REM sleep disorder, something that causes people to act out their dreams. Although this is very rare, such sleep disorders may also cause intense and terrifying experiences at night. In some cases, people can become violent, kicking and flailing in their surroundings. It’s best to consult a professional before making any changes, but there are some medications that can be useful!

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