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Insomnia in Elderly Adults: Causes and Prevention

Angelike Gaunt
By Angelike GauntJune 10, 2020

Everyone experiences an occasional restless night, but if your aging parent regularly has trouble falling or staying asleep, they’re not alone. Insomnia is one of the most common sleep disorders in seniors. In fact, up to 48% of older adults have symptoms of insomnia, according to a study in the Journal of Clinical Sleep Medicine.

People with chronic insomnia may have trouble falling asleep. Others wake up several times during the night, or wake up too early and are unable to fall back asleep. During the day, they often feel fatigued, are irritable, and have poor concentration and energy. Chronic insomnia also increases the risk of accidents — such as falls — and other health conditions, like depression, diabetes, heart disease, and cognitive impairment.

Understanding the causes of insomnia in your elderly parent and changing certain habits can help improve sleep. If your loved one regularly has sleep problems, there are steps you can take to help them get better rest at night.

Changes in sleep with aging: What’s normal?

Sleep patterns change with age. An older adult’s internal clock seems to advance, making seniors get tired earlier in the evening and wake up really early in the morning. This can lead seniors to take more naps during the day, which in turn may make it more difficult for them to fall asleep at night.

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A bad sleep routine can become a habit. However, older adults still need the same amount of sleep as younger people to feel restored, according to the National Sleep Foundation. Experts recommend seven to nine hours a night. 

Sleep happens in four stages, beginning with light sleep and progressing to deeper sleep. Starting in middle age, adults begin spending less time in the last two stages of sleep. This means sleep becomes less restful as you age.

Research also shows that seniors tend to sleep lighter and for shorter spans. This change may be a part of the normal aging process, but it can also result from other health problems, lifestyle habits, or a side effect of medications.

Causes of insomnia in elderly adults

Many things can cause insomnia in elderly adults, including:

  • Normal changes in sleep patterns that occur with age
  • Medications, including antidepressants, medicines to treat high blood pressure, or nasal decongestants
  • Other sleep disorders, such as sleep apnea or restless legs syndrome
  • Other health conditions, like dementia, Alzheimer’s, chronic pain, diabetes, or respiratory diseases
  • Mental illness, including depression and anxiety
  • Lifestyle habits, such as napping or lack of physical activity
  • Caffeine or alcohol when consumed excessively or before bedtime
  • Smoking, especially before bed
  • Chronic stress or stress that lasts for a long time

How to prevent insomnia in seniors: do’s and don’ts

It’s a good idea to see the doctor if your loved one regularly has sleep problems. If another condition or medication is causing their insomnia, it’s important to address it first.

You can also talk to your parent about ways to promote healthy sleeping habits and a soothing environment.

Do

Establish a regular sleep schedule. Go to bed and wake up at the same time each day.

Be physically active each day, but exercise early in the day and no later than four hours before going to bed.

Sleep in a dark, quiet, cool room (between 60 and 67 degrees Fahrenheit).

Before bed, take a warm bath or practice relaxation techniques such as meditation or breathing exercises.

If you can’t fall asleep after 20 minutes, get up, go to another room, and do a relaxing activity like listening to calming music.

Don’t

Consume caffeine or alcohol three hours before bed.

Eat heavy meals, spicy food before bed.

Drink excessive amounts of liquid before bed. A glass of warm milk is OK.

Nap during the day.

Use bright lights before bedtime. Turn off your TV or cell phone 30 minutes to one hour before bedtime.

Treating insomnia in elderly adults

Treatment for insomnia usually starts with addressing issues that may be causing sleep disruptions — such as medications or other medical conditions — and changing sleep habits to promote better sleep. This may include creating a calm, soothing environment in the bedroom, practicing relaxation techniques, and following a sleep schedule.

If these techniques don’t help, talk with your loved one’s doctor. They may ask if your parent has trouble falling asleep or maintaining sleep at night. The doctor will also consider your loved one’s age and overall health condition before prescribing medication for insomnia.

However, prescription medicines to treat insomnia have side effects, such as daytime drowsiness. They can increase the risk for falls, hip fractures, and accidents in older adults, so these medicines usually aren’t recommended for long periods of time. Talk to your parent’s doctor about which prescription medicines are safest.

Over-the-counter sleep aids for elderly adults

Common over-the-counter options — such as Unison, Sominex, and Tylenol PM — are readily available at most pharmacies and may relieve short-term sleep issues. However, these medications have side effects that are bothersome for older adults, including drowsiness, confusion, constipation, and dry mouth.

Your parent can also treat insomnia with certain supplements like melatonin, a hormone that plays a key role in regulating the sleep-wake cycle. Some prescription melatonin medications with few side effects have been cleared by the Food & Drug Administration (FDA) for insomnia. Other melatonin supplements are available over the counter, but those are not regulated by the FDA.

Sleep is important for overall health. If insomnia is affecting your loved one, be sure to encourage them to seek medical help. Understanding the root causes of insomnia may be the first step toward finding a solution.


Sources:

Choosing Wisely. “Insomnia and anxiety in older people.” https://www.choosingwisely.org/patient-resources/treating-insomnia-and-anxiety-in-older-people/.

National Sleep Foundation. “Aging and sleep.” https://www.sleepfoundation.org/articles/aging-and-sleep.

Winkelman J.W. “Overview and treatment of insomnia in adults.” https://www.uptodate.com/contents/overview-of-the-treatment-of-insomnia-in-adults.

Bonnett M.H., Arand D.L. “Evaluation and diagnosis of insomnia in adults.” https://www.uptodate.com/contents/evaluation-and-diagnosis-of-insomnia-in-adults?topicRef=97867&source=see_link.

Matheson E., Hainer B.L. “Insomnia: pharmacologic therapy.” American Family Physician, 2017: https://www.aafp.org/afp/2017/0701/p29.html.

Angelike Gaunt
Author
Angelike Gaunt

Angelike Gaunt is a content strategist at A Place for Mom. She’s developed health content for consumers and medical professionals at major health care organizations, including Mayo Clinic, the American Academy of Family Physicians, and the University of Kansas Health System. She’s passionate about developing accessible content to simplify complex health topics.

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