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Successful Aging

Poor Sleep Often Goes Unrecognized in Elderly

For more information on sleep and sleep disorders:

Getting a Good Night's Sleep, Nancy Foldvary-Schaefer, D.O. (Cleveland Clinic Guides Series)

American Academy of Sleep Medicine

American Sleep Association

National Sleep Foundation

by Eileen Beal

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As people age, they often experience sleep disorders: difficulty falling asleep; frequent awakenings during the night; and early-morning awakenings. This usually leads to daytime fatigue, dozing, catnapping and an out-of-sync sleep-cycle “that makes it even harder for them to get the night time sleep they need,” says Bert Rahl, director of mental health services for the Eldercare Services Institute of Benjamin Rose.

A growing body of research indicates that chronic sleeplessness can take a toll on older people's physical and mental health. Not only can it accelerate the aging process, it can also help worsen many medical conditions — including high blood pressure, diabetes, and obesity; impair brain function, especially in the areas of the brain responsible for focus and attention, complex planning, and judgment; cause people to be more prone to falls; and cause them to feel depressed, less social, and irritable. The latter, explained Rahl, “are secondary effects of sleep deprivation that directly affect everyone that person relates to.”

Causes of sleeplessness

In many cases, said Rahl, insomnia is situational. For instance, worry about a trip or the anxiety and pain generated by a fall could bring on a bout of sleepless nights. For these situations, sleeping pills are a viable solution. However they are not risk-free: According to the September 2006 Consumer Reports, using sleeping pills can lead to dependency or rebound insomnia (i.e. the problem gets worse if you stop taking the pill) and some pills have caused bizarre side effects (sleep eating, sleep driving, etc.).

In other cases insomnia could be due to:

“Curing” sleeplessness

Some sleep disorders can be cleared up without seeing a physician, said Rahl.

Since many people tend to get up at night to go to the bathroom, one of the best ways to insure a full night's sleep is to limit liquids in the evening.

For many people, sleeplessness is due to the fact that they are simply not tired enough to go sleep. Recent research says the solution that problem could be exercise.

As little as 30 minutes a day in the late afternoon, but at least 3 hours before bedtime, has shown a positive effect on sleep duration.

For others the problem may be what Rahl calls “poor sleep hygiene.” To deal with that, he suggests creating a going-to-bed routine (i.e. a warm shower, 10-15 minutes of relaxing reading, lights out) and making sure the bedroom is sleep-friendly: a room that is dark, quiet and as cool as possible signals the body that it's time to sleep.

If the problem is psychological — i.e. mild-to-moderate boredom, stress or depression — talking to someone can often help clear up the sleeplessness. If the problem is due to severe stress or depression, sessions with a therapist are probably in order. “The best treatment plan involves talk therapy and medications,” said Rahl.

If insomnia doesn't improve using these options, it's time to seek the advice of a physician, “To rule out a medical problem,” explained Rahl, or a sleep clinic, where problems can be analyzed and customized treatment options offered.

Eileen Beal is a health care writer specializing in issues related to aging and caregiving. This Successful Aging column sponsored by the Benjamin Rose Institute was published in the Sun Newspapers in Sept 2007.