Insomnia is a sleep disorder characterized by continuing difficulty falling or staying asleep regardless of the opportunity to do so. It is one of the most common sleep disorders affecting 10-30% of adults. However, people aged 60 and older are at even higher risk of suffering from insomnia due to several different factors such as having other medical and psychiatric conditions, suffering from another sleep disorder, and age-related changes to the circadian rhythm.
Age-Related Sleep Changes
In general, sleep quality gets worse with age and people tend to sleep less and have more waking episodes. What’s more, seniors also tend to have an increased sleep latency, i.e. it takes them lots of time to fall asleep. Namely, a study has shown that middle-aged people lose about half an hour of sleep per night for every subsequent decade.
Furthermore, sleep architecture also changes with age. Precisely speaking, elderly people experience a reduction in both slow-wave non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. As a result, they are more prone to waking episodes which furtherly affects how refreshed they feel after waking up in the morning.
Identifying and Diagnosing Insomnia in Older Adults
We may already conclude that aging and insomnia go hand in hand. If you suspect you may have this sleep disorder and want to get a diagnosis, you have to have at least one of these symptoms at least three times per week for at least three months:
- Trouble falling and/or staying asleep
- Repeatedly waking up too early involuntarily
- Feeling resistant about going to bed
- Overall difficulty sleeping without medical intervention
Yet, remember that insomnia does not only affect sleep. Indeed, it causes many daytime impairments such as excessive daytime sleepiness, fatigue, mood disturbances, irritability, poor concentration, reduced memory, lack of focus, etc. Also, insomnia puts people at a higher risk of accidents.
In addition, the key to getting a successful diagnosis is identifying the true cause of the sleep issues. In the case of primary insomnia symptoms can occur independently. But, secondary insomnia can occur due to another underlying medical or psychiatric condition that leads to sleep problems. Hence, it is crucial to determine the root causes in order to get a diagnosis.
Treating Insomnia in Older Adults
Sleep education and good sleep hygiene practices are the first steps to managing and treating insomnia in seniors. In other words, a person should focus on creating a sleep-friendly bedroom environment by making the room dark and quiet with a temperature not higher that 75 degrees Fahrenheit.
Also, an insomnia patient may be recommended regular exercise and balanced meals, while discouraged from caffeine and tobacco. Plus, to alleviate symptoms they may be recommended other non-pharmacological treatment options which include stimulus control techniques, sleep restriction, cognitive behavioral therapy, or bright light therapy.
Still, if these don’t provide any relief, your doctor may prescribe you some sleep medications such as benzodiazepines (BZDs) and non-benzodiazepines (Z- drugs) which indeed come with many side effects for elderly people. Insomnia medications that don’t come with many risks include ramelteon and suvorexant.
Just make sure you consult your doctor before trying any insomnia treatment. If an underlying medical condition is the root cause of your sleeping issues, then you should address and treat that condition first and see whether insomnia symptoms go away.