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Sleep Difficulties in the Elderly

Often people think of trouble sleeping as simply a part of growing older. It is not. The body does require less sleep as we age, but severe sleeping problems or insomnia in the elderly are the cause of poor sleep habits, side effects of medications, untreated sleep disorders or other medical conditions –  and not a part of the normal aging process.

"[All seniors] should implement good sleep habits and keep up daily physical activity to help create an environment conducive to restive sleep." – Dr. David N. Neubauer with the Johns Hopkins Sleep Disorders Center

At any age, a good night’s sleep is important, but for seniors already facing the cognitive difficulties and weakened immune system that come with age, enough sleep is even more critical. Lack of sleep can affect concentration and memory, and suppress cell repair and the immune system. A study by the National Sleep Foundation found that there is a direct relationship between general health and enough sleep in older people. According to the survey, the better the health of an older person, the better sleep they reported. The survey also said that respondents over 65 who reported seven to nine hours of sleep per night and experienced little or no sleep problems had more positive moods, and had more active and engaged lifestyles. On the other hand, the greater the number of diagnosed medical conditions, the more likely were the respondents to report sleep problems.

Causes of sleep problems in the elderly
There are many reasons our sleep patterns may change as we age. Some of the most common reasons for sleep problems or insomnia in the elderly are:

     
  • Poor sleep habits – The most common cause of insomnia in seniors is poor “sleep hygiene,” or an inappropriate sleep environment. Examples of a poor sleep environment include: too many naps during the day, keeping irregular sleep hours, or consuming caffeine or alcohol drinks in the evening.
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  • Pain – The pain of arthritis, cancer or other debilitating and chronic conditions can keep the elderly from sleeping properly.
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  • Medical conditions – Medical conditions can affect sleep in ways other than pain. Conditions that cause a frequent need to urinate, Alzheimer’s, asthma and other breathing disorders, menopause, GERD, diabetes, all can interfere with sleep.
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  • Medications – The average senior is taking anywhere from six to eight prescription drugs. Many drugs and drug interactions can cause insomnia.
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  • Lack of exercise – Regular exercise promotes good sleep.
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  • Stress and emotional disorders – Many seniors suffer from stress and anxiety due to some of the major life changes brought on by aging or retirement. Stress and anxiety can lead to lack of sleep.
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  • Undiagnosed sleep disorders – A senior may be suffering from a sleep disorder such as Sleep Apnea or Restless Legs Syndrome (RLS).

According to Dr. David N. Neubauer with the Johns Hopkins Sleep Disorders Center in Baltimore, Maryland, there are so many reasons that an elderly person may be experiencing insomnia that treatment needs to be individualized, based on a complete evaluation of a given patient. If a specific sleep disorder such as RLS or Sleep Apnea is determined to be the cause, there are treatments available. However, Dr. Neubauer suggests that in general, any elderly person experiencing sleep problems should implement good sleep habits and keep up daily physical activity to help create an environment conducive to restive sleep.

Other tips for better sleep include:

     
  • Limit caffeine consumption
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  • Do not consume alcohol prior to sleeping
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  • Limit intake of all fluids just before bed, to avoid the need for frequent urination
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  • Do not go to bed hungry and avoid spicy foods prior to sleeping
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  • Keep the room dark


     
  • Chronic insomnia is common among older adults, with as many as a quarter of this age group having chronic sleep problems, such as trouble falling asleep and frequent waking during the night. (Source: American Psychiatric Association)
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  • Seven out of 10 patients with chronic insomnia never talk with their doctors about it. (Source: National Sleep Foundation)
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  • Seniors who get seven to nine hours of sleep every night are in better general health. (Source: National Sleep Foundation)