Namely, data show that 10 to 30 percent of adults have insomnia. People with this disorder experience difficulty falling and staying asleep and they also suffer from daytime sleepiness and other cognitive impairments resulted from lack of sleep.

There are two main types of insomnia people can be diagnosed with including sleep-onset and sleep maintenance insomnia. First, sleep-onset insomnia is characterized by difficulties falling asleep. Second, sleep maintenance insomnia is characterized by difficulties staying asleep after starting to nod off.

But, did you know that the elderly (aged 60+) are at higher risk of suffering from insomnia? - Probably not. This is a result of several factors including:

• Being more susceptible to medical or psychiatric conditions;
• Being at higher risk of developing other sleep conditions like restless legs syndrome or sleep-disordered breathing;
• Having the circadian rhythm changed due to age.
• Taking medications for treating geriatric conditions.

That said, let’s have a look at how aging and sleep are connected.

Aging and Sleep

The truth is, as we age, sleep quality gets worse, the waking episodes are more frequent, and sleep latency (how much time a person needs to fall asleep) increases. According to studies, the average person sleeps about half an hour less per night for each decade after getting into middle age.

The main cause for these sleep quality and quantity decreases is the body not being able to properly process circadian signals. This is why the elderly tend to go to sleep and wake up at earlier times than normal.

Another cause is the fact that sleep architecture also changes when we get older. Briefly put, the usual sleep cycle contains four stages: two light non-rapid eye movements (NREM), one slow-wave or heavy NREM sleep, and one rapid eye movement (REM) stage.

However, in older people, both slow-wave NREM and REM stages occur in a lower percentage than in younger people. This leads to frequent waking episodes and reduced alertness and energy in the morning.

How to Recognize and Diagnose Insomnia in Older People?

Although many old people have sleep issues due to the natural changes in the circadian rhythm, to be diagnosed with insomnia they have to meet some criteria. In other words, they have to experience at least one of the below-listed symptoms:

• Facing difficulties falling or staying asleep
• Frequently waking up before than intended
• Being resistant about going to sleep at reasonable times
• Excessive daytime sleepiness and fatigue

So, if any of these symptoms occur at least three times a week for three months, as we already mentioned above, the patient will probably get diagnosed with chronic insomnia. Otherwise, he or she will be diagnosed with short-term insomnia.

Treating Insomnia in Older People

The go-to approach when treating insomnia in older people is paying attention to sleep education and sleep hygiene. Then, a sleep specialist may recommend regular exercise, a healthy and balanced diet, and quitting or limiting the consumption of caffeine and tobacco.

Furthermore, there are also certain non-pharmacological treatments for treating insomnia in elderly people like stimulus control technique, sleep restriction method, cognitive behavioral therapy, and bright light therapy.

Yet, if all of these therapies prove to be ineffective for alleviating insomnia symptoms, sleep medications may be considered as an option, some of which include benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs). However, they carry many risks and should therefore be prescribed with caution.

Finally, some medications don’t carry high risks. Such medications include ramelteon and suvorexant. However, make sure you discuss your options with your doctor before choosing any of the treatments.