Many older people experience insomnia, which can be due to mental health issues, medical conditions, and lifestyle changes. Treatment may involve improving sleep habits, therapy, and medication.
Some estimates suggest that up to
Insomnia occurs when a person has difficulty falling asleep or getting good-quality sleep. Several treatments and therapies may help that a doctor should tailor to a person’s needs.
This article reviews the causes of insomnia, its symptoms, the effects of inadequate sleep, and treatment.
As a person gets older, they often experience changes in routines, behaviors, medications, and overall health. These
For example, a person may develop a new underlying condition, take new medications, and alter their lifestyle following retirement, all of which can put them at a higher risk of developing insomnia.
In addition, evidence suggests that a person will experience changes in their circadian rhythm as they age. These changes
There are several possible risk factors and causes of insomnia in older adults. They include both underlying medical or psychiatric conditions as well as reactions to medications.
Medical conditions
Possible medical condition causes include:
- psychiatric disorders such as depression, anxiety, and personality disorders
- dementia
- hormone level changes
- increased blood pressure
- arthritis
- hyperthyroidism
- cancer
- heart failure
- asthma
- diabetes
- gastrointestinal reflux disease (GERD)
- chronic pain
- disordered breathing, such as obstructive sleep apnea syndrome (OSAS)
- restless legs syndrome
Medications or drugs
Possible medication or substance causes include:
Other causes
Other possible causes or risk factors
- shift work
- interruptions to sleep in a hospital setting
- death of a family member
- changes in routine due to retirement or irregular sleep schedule
- changes to environment, such as moving to a new home
- excessive napping during the day
- being female
Symptoms of insomnia in older people are similar to other age groups.
An older adult may have insomnia if they experience
- issues initiating sleep
- difficulty maintaining sleep
- resistance to going to bed on an appropriate schedule
- waking up earlier than desired
- difficulty sleeping without caregiver intervention
Sleep disturbances can lead to a person experiencing daytime symptoms. They can include:
- daytime sleepiness
- fatigue or malaise
- mood disturbances or irritability
- reduced motivation, energy, or initiative
- impaired social, family, occupational, or academic performance
- memory, concentration, or attention impairment
- behavioral issues, such as impulsivity, aggression, or hyperactivity
- dissatisfaction with sleep
- increased risk of accidents or errors
Insomnia can occur alongside several other conditions. According to a
- depression, anxiety, or other mental health condition
- increased risk of suicide
- heart attack or stroke
- high blood pressure
- long term insomnia may increase the risk of cognitive impairment
- increased risk of certain cancers, such as prostate cancer
- increased risk of work-related disability or underperformance
- higher healthcare costs
Learn more about the link between insomnia and mental health.
A healthcare professional may ask about a person’s sleep habits and any symptoms they are experiencing.
Healthcare professionals define insomnia as a person experiencing
In addition to assessing sleep, a healthcare professional may perform additional checks to determine if the lack of sleep is occurring alongside other conditions, such as heart disease, depression, or other conditions.
Treatment can vary between people. It often involves a combination of medications, natural remedies, and changes to sleep routines.
Experts
Cognitive behavioral therapy for insomnia (CBTi) is a first-line treatment for insomnia. The technique incorporates several cognitive and behavioral techniques to help improve both short- and long-term sleep quality.
Medications
Several medications may help with insomnia. A person should work with a healthcare professional to determine the best medications for them and discuss any potential side effects before starting a new medication.
Some options
- benzodiazepines
- nonbenzodiazepine hypnotics
- melatonin receptor agonists
- antihistamines
- antidepressants
Natural remedies
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As with other medications, a person should discuss the use of melatonin, valerian root, or other herbs or supplements with a healthcare professional before taking them.
Other treatments
Several nonpharmaceutical options may help with insomnia. Some suggestions
- eating a balanced diet that includes sufficient iron and vitamins
- getting regular exercise
- avoiding alcohol, nicotine, and caffeine close to bedtime
- making the bedroom an inviting space for sleep with cool temperatures, making it dark, and not having electronic devices
- avoiding naps
- eating meals on a regular schedule
- avoiding certain medications
- taking steps to manage stress
- limiting fluids before bedtime
- going to sleep and waking up around the same time each day
Several primary sleep disorders can affect older adults,
- restless legs syndrome or periodic limb movement disorder, which may be more common in those with iron deficiency or low levels of vitamin B12
- sleep apnea
- circadian rhythm sleep‐wake disorders
- rapid eye movement (REM) sleep behavior disorder
In addition, several chronic illnesses can affect sleep, such as allergies, pain, or other conditions.
A person should speak with a healthcare professional if they experience symptoms of insomnia or other sleep disorders.
Lack of sleep can affect daily activities, mood, and overall function. Treatment can help improve symptoms and a person’s quality of life.
People can aid diagnosis by keeping a sleep diary or journal, so they are aware of symptoms and their duration when speaking with healthcare professionals.
Insomnia is a very common sleep disorder in older adults. The condition can make it difficult to fall asleep, stay asleep, or get quality sleep.
This can lead to several issues that can affect a person during the day as well as increase the risk of several comorbid conditions.
Treatment typically focuses on improving sleep length and quality. This may involve medication use, cognitive behavioral training, and other lifestyle changes to help a person improve their sleep quality.