do older adults need more sleep?
Sleep disorders are fairly common in older
adults. As you get older, sleep patterns and habits change. As a result, you
- have trouble
- sleep fewer
- wake up
frequently in the night or early morning
- get less
This can lead to health concerns like increased
risk for falling and daytime fatigue.
Many older people report
trouble maintaining a good night’s rest, not so much falling asleep. Most
studies conclude that behavioral therapies are preferable to medications, which
can have unwanted side effects like nausea.
Talk to your doctor if you or someone you
know has trouble sleeping. You may see benefits from lifestyle changes or
medication, depending on the cause.
What causes sleep disorders in older adults?
A primary sleep disorder means there isn’t
another medical or psychiatric cause.
Primary sleep disorders can be:
both a symptom and disorder. Conditions like depression, anxiety, and dementia
can increase risk for sleep disorders, especially insomnia, according to a study
in Nurse Practitioner.
A study about sleep problems in older Singaporeans reported that those who had trouble sleeping were
more likely to have existing conditions and be less physically active.
These conditions include:
Many older adults are on medications that can
disrupt sleep. These include:
- diuretics for
high blood pressure or glaucoma
- anticholinergics for
those with chronic obstructive pulmonary disease (COPD)
- antihypertensive drugs for
high blood pressure
- corticosteroids (prednisone) for
blockers (Zantac, Tagamet) for gastroesophageal reflux disease
(GERD) or peptic ulcers
- levodopa for
drugs for life-threatening conditions like asthma attacks or
Caffeine, alcohol, and smoking may also
contribute to sleep problems.
How are sleep disorders diagnosed?
To make a diagnosis, your doctor will ask
about your symptoms and conduct a physical examination. This is to look for any
underlying conditions. Your doctor may also ask you to complete a sleep diary
for one to two weeks to learn more about your sleeping patterns.
If your doctor suspects a primary sleep
disorder, they will send you for a polysomnogram, or a sleep study.
A sleep study is usually done at night in
a sleep lab. You should be able to sleep as you normally would at home. A
technician will place sensors on you to monitor your:
- body movement
- snoring or
- heart rate
- brain activity
You may also have a finger device to
measure the oxygen in your blood.
The technician will watch you through a
video camera in the room. You can talk to them if you need any help. During
your sleep, the devices will continuously record your information on a graph. Your
doctor will use this to diagnose if you have a sleep disorder.
How therapy helps sleep disorders
For older adults, it’s
recommended to use nonpharmaceutical treatments like behavioral therapy first. This
is because older adults tend to already be taking multiple medications.
Therapy can happen
over six weeks or longer and include sleep education, stimulus control, and
time in bed restrictions.
A randomized controlled trial showed that cognitive behavioral therapy (CBT) largely
improved sleep quality for people with insomnia. The study suggests that CBT is
more effective because it helps target the quality of sleep rather than the
transition into sleeping.
You can develop good
sleeping habits by:
- going to bed and waking
up at the same time each day
- using the bed only for
sleep and sex, not other activities like work
- doing quiet activities,
like reading, before bed
- avoiding bright lights
- keeping a soothing and comfortable
- avoiding naps
have trouble falling asleep within 20 minutes, you may want to try getting up
and doing something before going back to bed. Forcing sleep may make falling
about managing sleep disorders in older adults also suggests:
- limiting liquid before
- avoiding caffeine and
- eating three to four
hours before bedtime
- exercising regularly,
but not right before bedtime
- taking a warm bath to relax
changes aren’t enough, then your doctor may recommend medication. Read on to
learn more about sleeping pills and other medical treatments.
Which medicines help with sleep disorders?
If you have underlying
diseases that are interfering with your sleep, your doctor may prescribe
medications. Medication shouldn’t replace good sleeping habits.
Melatonin, a synthetic hormone, helps induce
sleep faster and restores your sleep-wake cycle. The Mayo Clinic recommends 0.1 to 5 milligrams two hours before bedtime for several
months if you have insomnia. But melatonin doesn’t improve the quality of
Sleeping pills and side effects
Sleeping medications may help ease the
symptoms of your sleep disorder, especially as a supplement to good sleep
habits. Your doctor may be able to recommend what drugs will work best for you
and how long you should take them, depending on the cause of your insomnia.
It’s recommended to only take sleeping
pills on a short-term basis. This means less than two to three weeks for benzodiazepine
drugs like Triazolam
and only six to eight weeks for nonbenzodiazepine drugs (Z-drugs) like
zolpidem, or Ambien.
use of sleeping pills can cause complications, especially in older adults. Other common side effects of benzodiazepines and
You should avoid drinking alcohol while
taking sleeping pills.
Other medical treatments
Other medical treatments include:
- continuous positive
airway pressure (CPAP) device to treat sleep apnea
- antidepressants to
- dopamine agents for
restless leg syndrome and periodic limb movement disorder
- iron replacement
therapy for restless leg symptoms
remedies include over-the-counter
which induce drowsiness. But tolerance to antihistamines can build up in three
Talk to your doctor before taking any OTC
medications. They may interact negatively with medications you’re already
What you can do now
In older adults, ongoing sleep
disorders can lead to bigger concerns like depression and risk of falling. If
quality of sleep is the main issue, behavioral therapies may be more beneficial. This means developing good sleeping habits through sleep education, stimulus control, and time in bed
restrictions. Changes can take up to six weeks or more.
If behavior therapies don’t work,
then your doctor may prescribe medication or other treatments. But sleep
medication isn’t a long-term solution. You’ll find that the best way to get quality
sleep is to take control of your sleeping habits.