Jun 08, 2016 - 08:54 AM
Have you tried a nail product like Thum- (available on Amazon.com) for nail biting? I believe this product contains cayenne pepper extract as a deterrent. I don't believe this is natural/organic, but there are definitely some out there on Amazon that are. As a pharmacist, I have had patients use this product with good success.
In terms of her sleep, it sounds like she does not have a problem falling asleep, but staying asleep. As we age, our sleep is lighter because we spend less time in stage 3 and 4 of the sleep cycle. REM sleep decrease meaning there is less time for the body to perform restorative functions. There are primary and secondary causes of sleep disorders. Primary causes are disorders like narcolepsy, sleep apnea, circadian-rhythm disorder, and restless leg syndrome. Most sleep disorders in the elderly are secondary in nature and are caused by psychiatric disorders, medical conditions, medications, or substance abuse.
Psychiatric conditions associated with sleep are : depression, anxiety, and psychosis.
Medical Conditions: Parkinson's Disease, dementia, Pulmonary disease, endocrine, arthritis, acute and chronic pain, nocturia (using the bathroom at night)
Medications: alcohol, appetite suppressants, amantadine, benzodiazepine WITHDRAWAL, Bupropion, caffeine, clonidine, corticosteroids, stimulants, decongestants, levodopa, lithium, antidepressants- SSRIs and MAOIs, methyldopa, nicotine, propranolol, selegiline, and diuretics.
I would not give her a sleep aid or an anti-anxiety medication for sleep unless there is an underlying anxiety disorder. I recommend the following;
1. Have her evaluated for the above medical conditions. Chronic pain is an offender that a lot of seniors don't complain about. Make sure treatment is optimized for medical conditions and that they are under control
2. Have her medication list reviewed for medications that are keeping her awake and can be replaced and or discontinued. This is something I do in my own practice. Please see the link to my website in my profile and click on Medication Reviews.
3. Establish hygienic sleep practices. Keep her in a comfortable environment with a regular schedule. Practice relaxation techniques, limit day naps, restrict bedtime fluids. Also, try practicing Stimulus Control:
1. Go to bed only when sleepy
2. Use the bed and bedroom only for sleep (no reading, TV)
3. Get out of bed and go to another room when unable to fall asleep within 15 to 20 minutes.
4. Repeat step 3 as often as necessary, either when trying to fall asleep or to get back to sleep
5. Get up at the same time every morning, regardless of the amount of sleep obtained the previous night.
Source: Christopher Thomas, PharmD, 2013 ASCP:Pharmacotherapy for Psychiatric Disorders