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Insomnia in seniors: important facts and answers to commonly-asked questions
What is insomnia?
Insomnia is difficulty falling asleep or difficulty staying asleep, and feeling poorly rested in the morning. It must persist for at least one month. There may be something that precipitates the insomnia, such as working shifts or sleep interruptions and you cannot revert back to a normal sleep pattern. It can impact on functioning during the day, especially with concentration and energy.
Is insomnia normal in older people?
As we grow older, we tend to have shorter sleep cycles and may wake up more frequently, but insomnia is not a normal part of aging. Sometimes people may have medical problems such as urinary frequency or urgency which causes multiple awakenings. If your sleep is disrupted, try to avoid daytime naps. If you must nap, limit the naps to ½ hour, even if you have to set an alarm clock. Prolonged naps can interrupt your night-time sleep. Older people experience quantitative and qualitative changes in sleep: length of sleep, distribution of sleep throughout the day, sleep quality, and stages of sleep patterns change. Total sleep time is decreased by frequent awakenings, taking longer to return to sleep, and lying in bed for longer periods of time awake.
Is insomnia dangerous?
Yes, it can be stressful and increase the medical burden on the body. Stress can deplete the immune system and can leave you vulnerable to colds. People with insomnia often worry, as night-time approaches, that they will not be able to sleep that night. Worry can increase the heart rate and cause distress to other body systems. Sleep can affect activity levels with effects on health in general. Good sleep is necessary for attention, activity, and learning, as well as it benefits health and well-being, emotions, energy, behavior and moods. If you are deprived of sleep, you may become irritable, disoriented, confused and even depressed. Changes in lifestyle, for example, retirement or increased family responsibilities, may cause stress, which may increase disruptions in the sleep/wake cycle
What can I do to sleep better?
Sleep hygiene is important for a good night's sleep. Make sure the room is comfortable in terms of temperature, and darkness. Avoid alcohol and caffeine, as well as nicotine. Try to retire at the same time each night and get up at the same time each morning, even if you have not slept well. If you have difficulty falling asleep, get up and leave the room. Do not engage in stimulating activities, but try to read a boring book until you feel sleepy again. Exercise should be done in the morning or early afternoon, not before going to bed.
Is there treatment for insomnia?
Yes; both medication and behavior modification methods can treat insomnia. Keeping a diary of sleep habits is helpful to review and to change behaviors. There are several medications specifically to aid sleep but these are not recommended for long term use. These include lorazepam (Ativan), zolpidem (Ambien), and Sonata. Research is beginning at the University of Pittsburgh Medical Center on the use of a low dose antidepressant, paroxetine (Paxil), which may be used to assist insomniacs.
Treatment should focus on the cause and a thorough workup by a sleep expert is important to diagnose the cause. People may have sleep disruptions due to sleep apnea or periodic limb movements. Both of these problems can be treated, but they must be properly diagnosed by having a polysomnography performed in a sleep evaluation center.
How do I get treatment for insomnia?
You should talk to your primary care physician about your sleep difficulties. A thorough history of your sleep problems is the first step. Your doctor may want to refer you to a specialist who deals mainly with sleep problems. There are doctors at the University of Pittsburgh Medical Center who are able to provide this special care. Finally, you may qualify for a study at the Late Life Mood Disorder Evaluation and Treatment Center: in addition to completing a regulated sleep study, medication and sleeping recommendations may be offered to assist you with insomnia. CLICK HERE FOR MORE INFORMATION.
What is a sleep study (polysomnography study)?
A sleep study is a laboratory test of your brain and motor function during sleep. Also called a polysomnogram, it consists of spending a night in a sleep laboratory (just a bed with special measuring tools and technicians standing by). Electrodes are attached to the scalp, which will measure brainwave patterns (comparable to an EEG, or electroencephalogram), and also eye movements, muscle movements, and pulse are monitored. This study can diagnose many sleep disorders, such as narcolepsy and sleep apnea.