Insomnia is the most common sleep disorder at any age, but nearly half of adults age 60 and older have trouble falling asleep and staying asleep. While poor sleep may just seem like an annoyance to be remedied with an occasional nap or over-the-counter sleep aid, untreated insomnia can result in a significant sleep deficit and take a serious toll on a senior’s physical and mental health.
Symptoms of Insomnia
Insomnia may be acute or chronic, depending on how long symptoms last. Short-term insomnia only lasts for a month or less while chronic insomnia persists for much longer. Seniors who suffer from insomnia may experience any of the following symptoms:
- Taking a long time (more than 30 to 45 minutes) to fall asleep
- Waking up many times throughout the night and being unable to go back to sleep
- Waking up early and being unable to get back to sleep
- Waking up feeling tired and unable to function well during the day
What Causes Insomnia in Seniors?
Short-term insomnia can have many different causes. The stress of significant life changes, such as moving, changing jobs or the death of a loved one, can cause temporary fluctuations in sleep. Other causes of acute insomnia include illness, medications, changes in routine and environmental factors like noise and light.
Long-term insomnia typically presents due to a more serious underlying cause, such as depression, anxiety disorders, chronic pain or chronic stress. Chronic medical conditions can also seriously affect one’s sleep quality for a prolonged period. Neurological conditions like Parkinson’s disease, dementia and multiple sclerosis (MS) are notorious for causing sleep disturbances that, in turn, exacerbate other symptoms.
Many different factors can cause insomnia. However, the most common reason older adults wake up at night is to go to the bathroom. Prostate enlargement in men and continence problems in women are often the culprit. Disorders that cause discomfort during the night, such as heartburn, arthritis and menopause, can also cause fractured sleep patterns.
Seniors’ lifestyle choices can prevent them from getting a good night’s sleep, too. They may nap more frequently during the day or lead more sedentary lives. Spending less time outdoors can reduce exposure to sunlight and upset circadian rhythms that govern the sleep/wake cycle. Drinking more alcohol or caffeine can affect sleep quality as well.
Furthermore, as people age, their sleeping and waking patterns tend to change. It is a pervasive myth that seniors require less sleep as they age. Sleep needs remain somewhat constant in adulthood, but older adults usually become sleepier earlier in the evening and wake up earlier in the morning. Sleep quality may change as one gets older, too, requiring many seniors to use naps to play catchup on their shut-eye.
Emerging research suggests that aging eyes may even play a role in reduced sleep quantity and quality. It is normal for the lenses of the eyes to yellow with age—this is often a symptom of early cataract development. However, yellowing of the lens prevents blue light from reaching the retina. This doesn’t necessarily affect a senior’s ability to see, but blue light helps govern sleep cycles by spurring the production of the sleep-inducing hormone melatonin.
Treatments for Insomnia in Seniors
The first defense against dealing with insomnia is treating the primary cause(s). A doctor can help find medical solutions for issues like incontinence, pain, depression and heartburn. For example, many older adults take a variety of different medications that may negatively affect their sleep. Side effects can include drowsiness that inhibits normal daytime functioning. Exploring alternative prescription medications can help minimize sleep disturbances and improve alertness during the day. Once the primary problem (or problems) has been addressed, lifestyle changes may still be necessary to retrain the body to sleep better.
There are several therapies available to help seniors fall asleep and stay asleep. Try limiting excessive noise and/or light in the sleep environment. Proper sleep hygiene requires limiting time spent in bed while not sleeping and using bright lights to help with circadian rhythm problems. Increasing activity during the day and even beginning a gentle exercise routine can help improve sleep quality as well. Refraining from excessive caffeine, alcohol consumption and large meals late in the day will minimize indigestion and wakefulness.
Because stress can contribute to sleep problems, relaxation techniques like meditation are helpful in reducing physical and emotional tensions that interfere with good rest. There are also cognitive therapies aimed at changing attitudes and concerns people may have about insomnia and not being able to sleep well. Essentially, accepting the amount of sleep you receive as enough can help you reframe your thoughts and anxieties about sleep and help you rest better.
In some cases, specialists believe that sleep medications can be useful early in treatment, and, if necessary, they can continue being used from time to time. Some prescription and over-the-counter sleep aids are associated with bothersome side effects, especially in seniors, and can lead to dependency and dangerous falls. It’s important to discuss the use of any sleep aids—even herbal supplements like melatonin—with a physician to avoid dangerous interactions and additional health issues.
How Sleep Deprivation Can Affect Memory
If insomnia is not addressed, it can seriously affect a senior’s mental and physical health, including their memory. Uninterrupted quality sleep is a crucial part of memory formation. If an elder is having trouble sleeping through the night, minor symptoms like fatigue and mood swings can worsen and begin causing lapses in memory. Sleep patterns have been shown to have a direct link to the formation of Alzheimer’s disease.
Furthermore, researchers from the Washington University School of Medicine discovered that a prolonged sleep deficit led to an increase in beta-amyloid plaques—a principal biomarker of Alzheimer’s disease—in the brains of mice. In fact, the most sleep-deprived mice in the study had beta-amyloid levels that were 25 percent higher than normal.
To make matters worse, people with Alzheimer’s generally have difficulty sleeping, which can exacerbate symptoms and accelerate the progression of the disease. Finding sleep solutions for dementia patients can be tricky, but with some trial and error, it is possible to help improve a loved one’s sleep quality.
Quality Sleep Is Crucial for Healthy Aging
Sleep problems are increasingly common in older adults, but they don’t have to be. If you or a loved one is experiencing symptoms of insomnia or another type of sleep disorder, it’s important to see a doctor right away. Difficulty sleeping is not a normal part of aging and there are treatments to help ensure quality rest at night. Without good sleep, seniors are at risk of developing other serious health issues.
Source: National Institute on Aging (NIA), https://www.nia.nih.gov/health/good-nights-sleep