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Insomnia in Seniors: How to Tackle An Age-Old Challenge

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by Dr. Reut Gruber
Oct 15 • 4 min read
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Seniors can be fit, active, and independent, yet their bodies do change gradually over the years. Sleep, too, changes as people age. Let’s explore different reasons why that can be, and how we can maintain good sleep hygiene through our golden years.

Factors Contributing to Changes in Sleep Among Seniors

Age-related biological changes. Individuals 65 and older tend to fall asleep early, wake up early, and nap during the day. They get less deep sleep, wake up more often during the night, and sleep less overall—not because they require less sleep than younger people, but because they have a harder time getting the sleep they need.

Lifestyle changes. People’s daily routines change once they retire. They don’t have fixed work schedules, which often results in irregular meal and sleep schedules and less exposure to daylight. These changes can confuse the body’s internal clock and disrupt its biological day-night rhythm.

Health issues. Common physical or emotional conditions in seniors, such as nighttime urination, chronic pain, physical illnesses, and loneliness can disrupt sleep.

Sleep Health: A Key to Healthy Aging

With so many factors affecting sleep, it’s not surprising that 40-70% of older adults have chronic sleep problems. Since poor sleep can contribute to many health issues, assessing sleep, diagnosing sleep disorders, and treating these disorders is key to aging happily and healthily.

Insomnia symptoms in older people include difficulty falling and staying asleep, as well as early morning awakenings; they’re accompanied by daytime impairments like irritability, inattention, forgetfulness, fatigue and increased risk of falling. These symptoms must occur at least three times per week over a period of at least 2 months.

Assessing and Treating Insomnia in Older Adults

Insomnia needs to be assessed and treated in its own right, even if it occurs alongside other medical and psychiatric problems. Treating an insomnia disorder leads to improvements in both sleep and medical disorders. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended intervention for insomnia in older people (and younger ones too!). This intervention uses multiple strategies to change common thoughts and behaviors that interfere with sleep and prolong insomnia.

Sleep medications aren’t recommended for treating insomnia in older adults. If prescribed, medications should be used cautiously, at relatively low doses, and only for a short period of time. If insomnia problems persist despite treatment efforts, a sleep specialist should perform a thorough assessment to identify potential additional undiagnosed sleep disorders and to help guide treatment.

How Seniors Can Improve Their Sleep

Stay active. Older people who exercise regularly fall asleep faster, sleep longer, and report a better quality of sleep.

Reserve the bedroom for sleep. This helps train the brain to associate the bedroom with sleep, as opposed to other activities.

Avoid bright light in the evening. This type of stimulation can make it difficult to feel sleepy and fall asleep naturally. Removing all electronics from the bedroom helps prevent this problem.

Follow a regular sleep/wake schedule. It’s best to go to bed and wake up around the same time every day, and avoid napping late or for long periods of time.

Design a relaxing night routine. Taking a bath, reading, or engaging in other quiet activities before going to bed helps people get in the right mindset for sleep.

Avoid stimulating substances in the evening. It’s recommended not to have alcohol, tobacco, or caffeine at least 4 hours before bedtime.

Create a safe nighttime environment. The risk of accidents or falls can be greatly reduced by using a night light in the bedroom and lights with motion sensors in hallways and/or the bathroom, if possible. Make it easier to call for help when needed by installing a landline phone on the nightstand and keeping a list of important phone numbers nearby.

Sleep may become a challenge in older individuals, but this issue can often be treated with professional guidance and by taking the right precautions. Good sleep is important at every stage of life, and it’s never too early or too late to start forming healthy sleep habits.

Old age is like everything else. To make a success of it, you’ve got to start young.” -Theodore Roosevelt

Author Bio

Dr. Reut Gruber is a scientist, psychologist and sleep expert. She is an associate professor in the department of psychiatry at McGill University and director of the Attention, Behaviour and Sleep lab at the Douglas Mental Health University Institute; Diplomate of the American Academy of Cognitive Therapy (ACT) USA; Licensed Psychologist, l’Ordre des Psychologues du Québec (OPQ), QC, Canada.

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