Insomnia In Senior Citizens: How To Sleep Well

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Insomnia in senior citizens is quite common and research indicates that up to 4 in 10 people above the age of 60 suffer from lack of good quality sleep. Here’s a look at the condition and what you could do to sleep better at night.

Are you finding it difficult to fall asleep or to stay asleep? Do you avoid an afternoon nap so that you can sleep better at night? Insomnia or the inability to sleep is a common issue many senior citizens face. Research indicates that up to 4 in 10 people above the age of 60 suffer from lack of good quality sleep, indicating a high prevalence of insomnia in senior citizens. It is much more common in the elderly than the younger population. Reasons for insomnia in senior citizens are mostly related to medical and psychological issues and even our own habits. Dr. Anoop Amarnath, Chairman, Geriatric Medicine, Manipal Hospitals, Bangalore explains the condition and also ways to deal with the same.

Why Sleep Is Important
While individualistic, every individual needs an average of 6-8 hours of quality sleep to feel rejuvenated and rested.

Insomnia in senior citizens

An average of 6-8 hours of sleep is important for good health.
Photograph: Pixabay/CC0 Public Domain

Both quality and quantity of sleep are equally important for good health and well-being. However, many face Insomnia, the most common sleep disorder. In the elderly, it presents as lack of sleep – both in terms of quality and quantity. It is the inability to initiate or maintain sleep. Lack of sleep in the elderly can lead to a lot of medical and psychosocial issues. Insomnia causes tiredness, irritability and loss of concentration. Frequent falls are also reported in those people who have inadequate sleep. Sleep deprivation is also known to cause impaired glucose metabolism/ diabetes. Long standing lack of sleep can lead to cardiac problems, depression and have an impact on family relationships.

However, it is important to understand that Insomnia is not a normal part of ageing. There are various causes of Insomnia such as these:

a. Medical problems: heart, lung, kidney or intestinal disorders, diabetes, high blood pressure, pain of any sort, neurological problems like stroke, Parkinson’s, dementia
b. Psychological issues: stress, anxiety, depression
c. Habits: High intake of caffeine, alcohol, heavy meals at night, daytime naps
d. Drugs: certain medicines like anti-depressants, Parkinson’s medications, diuretics
e. Environmental: noisy surroundings, lack of adequate space for sleeping, uncomfortable mattresses, light disturbances

The condition is common among the elderly because of a few factors. The elderly tend to sleep lighter and for shorter spans and take longer time to fall asleep. They also experience frequent awakenings. This may be related to medical factors like having to urinate more frequently. All these lead to reduced sleep quality.

Insomnia in senior citizens

Are you waking up refreshed?
Photograph: Pixabay

How To Identify Insomnia
Insomnia is more of a subjective description of lack of sleep. It is a symptom (like fever) rather than a diagnosis. Lack of good quantity and quality of sleep can be identified easily. Following may all be symptoms of insomnia.

* Early awakening
* Unrefreshing’ sleep
* Inability to fall asleep once going to bed
* Irritability
* Tiredness
* Lack of interest in day to day activities
* Lack of appetite
If the symptoms persist, a visit to the doctor is advised as the condition, left untreated, can persist for years.
In addition to a physical exam and study of ailment history doctors request a ‘sleep diary’ to confirm insomnia. This should chart not only the sleep duration, wakefulness episodes and their timings, but also the type of foods eaten and type of activities performed. This is usually done over a period of time. In some cases, polysomnography and actigraphs are considered but their use is fairly limited.

Management of Insomnia
Maintaining basic sleep hygiene and a balanced approach to diet can help one deal with the condition. Some of these are:


Do You Need To Take Sleeping Pills?
The treatment of insomnia in senior citizens is subject to identifying the cause for the same, as explained above. Sometimes identifying and treating the primary cause of insomnia may take a long time. In the interim, as long as there are no specific contraindications, doctors tend to prescribe sleeping pills. This alleviates symptoms to a large extent. Drugs are also used in patients with chronic insomnia (i.e. insomnia lasting more than 6 months).
Behavioural therapy is known to help seniors deal with insomnia. Certain relaxation techniques and aromatherapies are also claimed to benefit.
All of us need a good night’s sleep to carry on our daily activities uninterrupted and for our general well-being. If sleeplessness aka insomnia is bothering you, do visit a physician or a geriatrician at the earliest to identify the root cause for the same and get it treated to banish those blues.


About Author

Dr Anoop Amarnath

Dr. Anoop Amarnath is Chairman, Geriatric Medicine, Manipal Hospitals, Bangalore. He has a specialisation in Geriatric Medicine from the Royal College London with certification in Geriatric Nephrology from the American Society of Nephrology and has been practicing since 2004.