Insomnia in Older Adults: Tips to Master Sleep as We Age
Dylan J. Jester, BS; Doctoral Student, University of South Florida School of Aging Studies
Insomnia; perhaps even reading the word elicits a rapid heartbeat, sweaty palms, and future worries about the success of sleep tonight.
A disorder characterized by trouble falling asleep, staying asleep, or waking up too early and being unable to fall back asleep, insomnia impairs our ability to function day-to-day. These symptoms occur several times per week and last for months. Although symptoms may be common in older age, the prevalence of full-blown insomnia in older adults is much lower – between 4% and 11%.
How does our sleep change as we get older?
Scientists have suggested that our sleep becomes more “fragile” as we age, which may contribute to light sleep, falling asleep during the daytime, waking at night, and obtaining fewer total hours of sleep.
Not all older adults will experience decreases in sleep quality and quantity that are noticeable enough to cause dissatisfaction. However, if you find yourself with poorer sleep than you would like, try some of these steps to combat sleep problems.
Sleep Tip 1: Reduce Technology in the Bedroom
Technology is an incredible invention that has changed the way we communicate with each other, changed the way we learn, and is a main source of our entertainment. Unfortunately, it has intruded into our bed; a space solely devoted to sleep and sex for thousands of years. Do you have a cellphone near your bedside? A television?
In truth, many of you will have read this article from the comfort of your own bed! And although these technological gifts have brought us joy, they also interrupt our circadian rhythms.
Scientists suggest that bright screens make us release lower levels of melatonin in our brain at night. Melatonin is a hormone that our body produces to regulate our sleep cycle. When disrupted by technology, artificially lower levels can affect our sleep quality.
What can be done? For starters, using the bedroom solely for sleep and sex will prime your mind for bedtime. Playing phone games, reading emails, watching television, and checking Facebook should be left to earlier hours in the day. If technology is absolutely necessary at nighttime hours, lowering the brightness on the screen may help.
Sleep Tip 2: Reduce Smoking and Alcohol, and Check Medications
Smoking cigarettes has long been associated with poorer sleep. Additionally, users rely heavier on caffeine to get through the day. Caffeine, like many drugs, has a “tolerance,” suggesting that more is needed to get the same benefits. This can be detrimental to our sleep process if consumed later in the evening.
Alcohol has been used as an over-the-counter bedtime sedative for decades. Unfortunately, this practice is likely giving you worse sleep. As a depressant, alcohol may help in falling asleep, but it significantly disrupts the sleeping process later on. For those who frequently consume alcohol before bedtime, the effect of sleepiness goes away, yet the consequences remain.
Psychoactive and occasionally blood pressure medications may also affect insomnia and should be consulted on with a physician. Melatonin should not be consumed frequently, as the over-the-counter dosages are unusually high for older adults; this may lead to side-effects.
Sleep Tip #3: Improve your Sleeping Habits
Maintaining approximately the same sleep schedule (+/- 30 minutes) is ideal and may reduce daytime sleepiness. Falling asleep during the daytime is not only frustrating (grogginess!) but it directly impacts our ability to fall asleep later on. It should be avoided if at all possible.
If you are in bed with your mind racing in the middle of the night, get out of bed! By transporting your busy mind from the bedroom to a dark room, you will better associate sleep with the bedroom; though be sure not to access technology during this brief period, as it will cause more stimulation to an already anxious mind. It may also be helpful to hide the alarm clock, as it may bring frustration.
Reducing light in the bedroom is of the upmost importance, as darkness naturally allows our body to release melatonin. Conversely, getting enough bright light during the daytime will keep your body’s natural circadian clock ticking.
Keeping your bedroom slightly colder is beneficial, as “night sweats” can make sleeping impossible.
Finally, exercise! The more that you can do before 2:00 p.m., the easier it will be to tire yourself out by bedtime.
American Sleep Association. (2007). Sleep hygiene tips. Web: https://www.sleepassociation.org/about-sleep/sleep-hygiene-tips/. Crowley, K. (2011). Sleep and sleep disorders in older adults. Neuropsychology Review, 21(1), 41-53.
Higuchi, S., Motohashi, Y., Liu, Y., & Maeda, A. (2005). Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleep and REM sleep. Journal of Sleep Research, 14(3), 267-273.
Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA, 281(11), 991-999.
Ohayon, M. M., Carskadon, M. A., Guilleminault, C., & Vitiello, M. V. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep, 27(7), 1255-1273.
Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.
Ohayon, M. M., & Vecchierini, M. F. (2005). Normative sleep data, cognitive function and daily living activities in older adults in the community. Sleep, 28(8), 981-989.
Roth, T. (2007). Insomnia: definition, prevalence, etiology, and consequences. Journal of Clinical Sleep Medicine, 3(5 Suppl), S7.
Wurtman, R. J. (2012). Use of melatonin to promote sleep in older people. European Neurological Review, 7, 90e1.
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