Treating Insomnia in Elderly People
As people age, they start to have more difficulty in getting a good nights sleep. They either have trouble falling asleep or maybe they wake up and can't go back to sleep.
Some elderly people just believe it is a part of the aging process and nothing to worry about. They start to feel tired earlier and move up their bedtime, or doze off during the day for a little nap.
Almost 50% of all older adults report some symptoms of insomnia.
There are several causes for insomnia in elderly people, and while most of them are not dangerous, not getting enough sleep is cause for concern both for the body and the mind.
Let's explore the reasons behind insomnia in older adults and what can be done to help.
What Is Insomnia?
It is recommended that older adults get between seven to nine hours of sleep each night.
Having a few restless nights or waking up after a stressful dream or too much pizza is not really considered insomnia.
In fact, insomnia is classified as not being able to fall or stay asleep with decreased function during the day. A true diagnosis is made when this happens three times a week for a period of three months or longer.
The problem with insomnia is the long-term effects.
Not getting adequate sleep can lead to depression, confusion, fatigue, loss of motivation, a decline in cognitive skills, poor concentration, and just an overall hard time getting through the day.
What Causes Insomnia in Elderly People?
There are many reasons why an aging individual might find it increasingly more difficult to fall, or stay, asleep. Physical changes in the body, as well as lifestyle choices, all affect the quality and length of a good night's rest.
Medical Issues
Some sleep problems are caused by underlying medical problems. The primary health condition keeps the person from being able to rest properly.
Heart problems, and even some lung conditions, that affect breathing can make it hard to sleep at night.
Chronic pain can also make it difficult to go to sleep and often the pain will wake someone up. Until the pain subsides, they will just lay awake unable to rest.
Recurring heartburn is another reason people experience insomnia.
As they age, some individuals often cannot make it through the night without having to go to the bathroom. An overactive bladder or even enlarged prostate increases the urge to urinate and will wake them up.
Anxiety keeps a lot of older people up at night. They worry about their health, having to leave their home, what the future might hold. All these thoughts keep running around in their heads, and they are unable to relax and go to sleep.
Older adults also take a variety of medication. It is possible that the side effects of the medicines or the interaction between them are causing them to experience insomnia.
If a medical condition is the source of insomnia, treating that will increase the chances of them sleeping through the night and waking up refreshed and feeling good.
Sleep disorders are also an early sign of dementia. Here are some early warning signs to see if someone you know may be headed that way.
Sleep-Related Breathing Disorders
There are a few conditions grouped together known as SRBD. This is also known as sleep-disordered breathing. It is where someone's sleep is affected by how they breathe.
Snoring falls into this category.
Another SRBD is sleep apnea. This is a condition where someone frequently has a pause in their breathing while they are sleeping. It is commonly thought to be caused by an obstruction in the airways.
Approximately 50% of older people have some form of SRBD.
Restless Leg Syndrome (RLS)
Restless leg syndrome is when the legs have the feeling of itching, or something crawling on them. A person is unable to keep their legs still. The condition usually does not involve pain, but it is almost impossible to relax enough to go to sleep.
How to Treat Insomnia
There are quite a few ways of treating insomnia in the elderly. Here's how.
Lifestyle Changes
Sometimes, just simple lifestyle changes can help someone fall asleep faster or get them back to sleep after waking.
Getting a little more exercise during the day is one helpful tip. It doesn't have to be strenuous, just getting out and moving around is good for overall health and can help with falling asleep. If the exercise is done outdoors, that's a bonus, because sunlight works to create natural melatonin, which helps with sleepiness, and regulates the wake-sleep cycle.
Cutting back on caffeine consumption is another example of a lifestyle change to help fight insomnia. All caffeine should stop 2 or more hours before the desired bedtime.
Heavy meals should also be avoided near bedtime. A light snack might keep the stomach grumbles at bay, but a big meal could cause discomfort and indigestion.
In addition, if you wake up to go to the restroom during the night, limit all drinking for approximately 2 hours before going to bed.
If a nap is taken during the day, it might be a good idea to either stop or change the timing and duration of the nap. Ideally, a nap should be taken in the early afternoon and last no longer than 45 minutes to an hour. Anything longer requires more time to fully awake and also hinders going back to sleep later in the evening.
Finally, meditation and relaxation techniques, along with releasing negative thoughts or feelings at the end of the day is a good way to keep stress from ruining your sleep.
Setting the Mood
Experts agree the best way to encourage sleep is to create a calm, quiet, cool, and dark environment. The bed should not become a place to work, watch TV or play on a phone.
When it is time to sleep, everything should be turned off. Constant noise from a TV, the light from a clock, anything that will cause a distraction to the mind should be eliminated.
A good mattress and comfortable pillows are also an overlooked valuable component in getting a good nights sleep. If someone tosses and turns all night on a lumpy mattress, it will definitely alter the rest they receive.
If there is a partner who snores or otherwise creates a distraction or hinders sleep, then measures need to be taken to help. Maybe earplugs would help, they could sleep in another room, or get help for the snoring. Real conversations should be had, so no one feels hurt, but everyone is getting plenty of sleep.
It is also a good idea, as much as possible, to go to sleep at the same time and try to wake up at the same time. Keeping a routine puts the body in a rhythm that is easier to maintain.
Sedatives
The least desired way to treat insomnia is with sedatives; either over-the-counter or prescriptions.
Sleep aids are fine for short term use, but it is easy to become addicted to them. Continued use will negatively affect brain function and will also increase the risk of falls.
In addition, it is sometimes difficult to regulate how much someone is taking, and there are also potential interactions with other medications.
Sedatives are sometimes necessary, but they should be monitored closely and not used as a long-term solution.
As a supplement, Melatonin has been shown to improve sleep in the elderly. Unfortunately, it is not truly regulated for strength, and it might take a few tries to find one that works.
Have a Good Night
Everyone needs a good night sleep. This is especially true as we get older and need the time to recoup and refresh our body and minds.
Insomnia in elderly individuals is a concern, but there are proven methods to help get them the rest they need.
For more information on insomnia, or other issues affecting seniors, reach out.