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Sleep Problems Are Not Inevitable as You Age

Sleep Problems Are Not Inevitable as You Age

“To sleep, perchance to dream,” from Hamlet, is an elusive wish for a lot who are 65 and older. In fact, almost half of Americans over the age of 65 say they have sleep troubles at least once a week, and 15 percent say it happens to them three or more nights a week. Sleep disruption can include a hard time falling or staying asleep, waking too early and waking up feeling not rested.

What’s the cause of all this mid-night misery?
According to data from the University of Michigan/AARP National Poll on Healthy Aging, for 23 percent of folks ages 65 to 80, pain is what’s keeping them awake at night. Other sleep-busters include having to get up to go to the bathroom and stress or worry.

Most of the seniors surveyed thought insomnia was an inevitable part of aging, not a health problem, and very few bothered to talk to their doctor about their sleep issues.

What’s being done?
To cope, 14 percent of those participating in the poll said they take a prescription sleep medication, prescription pain medication, OTC sleep aid or herbal supplement. Another 23 percent said they do so occasionally (usually an OTC sleep aid). The rest, we guess, just try to tough it out.

Well, poor nighttime sleep (whether from insomnia or a messed up sleep cycle) is not an inevitable part of getting older. If you’re affected, talk with your doctor to determine the cause and find a solution. If left unattended, chronic sleep deprivation in older folks can lead to an increase in traffic accidents, memory problems, mood swings and falls. It can also make pain harder to handle, increase existing medical problems or disrupt management of those conditions. Sleeplessness is also associated with depression and it can upset your digestive system.

The risks of sleep medications
Around 8 percent of older folks with insomnia take Rx sleep meds, even though they are not advised because of the damaging side effects—confusion, memory loss, falls and poor sleep quality. Even so-called “natural” alternatives, such as melatonin, or PM pain relievers can trigger falls, constipation and confusion, and they don’t do all that much to improve quality sleep.

In fact, the Beers Criteria, a guide to the use of medications for folks 65-plus, established by the American Geriatrics Society, gives a strong warning against use of prescription sleep drugs. And the FDA does not recommend switching from Rx sleep meds to OTC ones. Those often contain diphenhydramine and doxylamine that can cause confusion, urinary retention and constipation.

The solution
The best way for older folks (really, anyone!) to reverse chronic sleep problems is to use non-medical, sleep-inducing techniques. They can take some time—after all a lot of sleep problems come from a lifetime of bad habits—but they work.

1. Practice good sleep hygiene:

  • Limit daytime naps to 30 minutes or less.
  • Reduce time spent in bed when not sleeping.
  • Establish and maintain a regular sleep schedule.
  • Establish a calm bedroom setting; no digital devices; no bright lights, only red light; maintain a comfortable temperature.
  • Limit consumption of alcohol (it causes sleep fragmentation and REM disruption) and caffeine, particularly before bedtime.
  • Eat a light snack before bed, but avoid heavy meals within two to three hours of bedtime.

2. Get at least 30 minutes of physical activity daily and walk or do seated exercises as much and as often as possible.

3. Make sure to get exposure to bright light or sunshine every morning to help your internal clock get on schedule.

4. Try aromatherapy—anecdotally, we’ve heard an essential oil mix of 90 percent lavender can help induce restful sleep. Use a diffuser that is set for 10 minutes on and 30 minutes off, over eight hours.

5. Try cognitive behavioral therapy to relieve stress and pain responses and learn new sleep habits.

Medically reviewed in March 2020.

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