Insomnia, or not being able to sleep, is a common problem for older adults. Many accept it at a normal part of aging, however illness, inactivity, poor sleep habits, and using alcohol, caffeine, and tobacco may contribute to it.

All adults need seven to nine hours of sleep a night, but only about half of all seniors get a good night’s rest. As you age, sleep becomes less restful because less time is spent in the deeper levels of sleep, which are the most restorative.

Older adults also tend to get tired earlier in the evening and wake up earlier in the morning. Being older exposes you to risk factors for sleep disturbance such as being less physically active, having more health problems that disturb sleep, and using more medications.

Stress, anxiety, and depression may contribute to insomnia, as well. Unfortunately some people use alcohol to treat these symptoms, but alcohol produces very poor sleep and causes premature awakening after only a few hours.

Sleeping Pills

Doctors who work with older adults emphasize “sleep hygiene” — improving environmental factors to help promote sleep — rather than sleeping pills as the best approach to treat insomnia. Sleep medications, particularly for older adults, generally hold more health risks than benefits.

Sedative medications take longer to wear off in older adults and interact with other medications, making them last longer, sometimes running into the next day. This may lead to slower reaction, poor balance, inattention, and risk of falls, accidents, and hospitalizations.

“Before you ask your physician for a sleeping pill prescription, you owe it to yourself to touch all the “sleep hygiene” bases first,” says Dr. Lawren Hicks, MD, medical director of Senior Services for John Muir Health.

“Ask yourself if lack of sleep has affected your daytime functioning. If not, a sleeping pill will certainly not improve it,” he says. “Ask your physician whether any of your current medications might be causing your sleep disturbance.”

Tips for Improving Your Sleep Hygiene

Sleep hygiene refers to a number of things you can do to improve your quality of sleep:

  • Get enough daylight. Light exposure helps maintain a healthy sleep-wake cycle.
  • Avoid caffeine, nicotine, and alcohol; don’t eat right before bedtime.
  • Exercise regularly during the daytime and try relaxing exercise before bedtime, such as yoga.
  • Avoid daytime naps.
  • Establish a regular nighttime routine and try to go to sleep at the same time every night. 
  • If you cannot get to sleep or cannot get back to sleep after awakening in the middle of the night, don’t toss and turn. It is best to get up for 15 to 20 minutes and do something else, then try sleeping again when you begin to nod off.
  • Associate bed with sleep. Make sure your bedroom is used only for sleeping or sex. Hours spent watching TV or reading in bed is counterproductive to quality sleep.
  • Keep your sleep environment comfortable and relaxing. At night your bedroom should be a few degrees cooler than during the day, pleasant, and dark.
  • Do not take over-the-counter sleep aids without first consulting your doctor. These pills usually contain diphenhydramine (the main ingredient in Benadryl), which is a major contributor to daytime fatigue, slowed reaction time, and not being able to think clearly in people over 70.
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