What are common sleep problems among seniors?

An estimated 40 percent or more of seniors suffer from some form of insomnia, ranging from having trouble falling asleep to failing to reach sleep’s most restorative stages, waking up many times during the night and waking too early in the morning.

Sleep deprivation leaves people drowsy, foggy-headed and unable to think clearly or concentrate. It contributes to car accidents, household mishaps, falls, headaches, depression, anxiety and immune system weakness. Extreme insomnia can trigger delirium and mental breakdowns.

Seniors are also prone to sleep apnea, temporary breathing stoppages that may be associated with high blood pressure and risk for strokes and heart attacks; restless leg syndrome, an uncontrollable and disruptive urge to move the legs while in bed; and narcolepsy, an overwhelming need to sleep. However, many sleep problems seniors suffer respond to simple behavioral changes and don’t require medication.

What causes insomnia in seniors?

Many factors, not all of them fully understood, can play a role. Some causes are:

• Changes in sleep patterns. As people age, they wake up more easily because they spend less time in the deepest stages of sleep.

• Pain. Many illnesses and conditions, such as arthritis, ulcers, cancer and heart conditions, cause chronic pain that prevent sleep. Aspirin, acetaminophen or other painkillers may solve the problem.

• Emotional disorders. Depression, anxiety and stress are common among seniors and contribute to sleeplessness.

• Medications. Drugs prescribed for depression, high blood pressure, pain and heart problems can cause sleeplessness in some people. Many common over-the-counter remedies, including aspirin, decongestants and weight-loss products, can contain caffeine or other stimulants.

• Restless leg syndrome. Little is known about this very common neurological disorder, but it often worsens with age and keeps people awake. Several medications are available to treat it, but the senior or caregiver should consult the primary care physician or a neurologist for specific recommendations.

What can seniors do about insomnia?

Changing the day-to-day routine is often enough. Sometimes treating an underlying cause, such as depression or pain, brings relief. Doctors often are reluctant to prescribe medications for sleep problems because many of the drugs have side effects and can foster psychological or physical dependency. But one recent study showed a combination of behavioral changes and medication sometimes works better than either strategy alone.

If sleep problems persist, seniors should consult a doctor. But you might suggest they consider one or more of these strategies:

• Try not to become anxious about sleeping. Biofeedback, psychotherapy and relaxation techniques, such as meditation and massage, can help alleviate such anxiety.

• Exercise daily, if possible, or at least three times a week for 20 to 30 minutes but not right before bedtime.

• Quit or cut back on caffeine, alcohol and smoking, especially right before bedtime.

• Check medications to see if they might contribute to the problem and change them if necessary.

• Create the best possible environment for sleep, such as darkening the bedroom, turning off the telephone and wearing earplugs.

• Avoid television, which can be over-stimulating, in the half-hour before bedtime.

• Read before going to bed, which can tire the eyes and induce drowsiness.

• Eat or drink a starchy food, such as bread or pasta, half an hour before bedtime.

• Avoid drinking too many liquids before bed to reduce the chance of waking up to urinate.

• Stay quiet and relaxed if they awake during the night.

• Get up at the same time every day, even if they feel they haven’t slept enough.

How effective are sleep medications?

Sleep medications are generally useful for short-term insomnia or sleeplessness caused by an emotional crisis or sudden shock. They are less useful for long-term insomnia because of potential side effects and the possibility of dependence. Some can exacerbate insomnia if used to excess.

Non-prescription sleeping aids

Seniors first should try non-prescription sleeping aids, but they need to beware of potential side effects. Though these medications aren’t physically addictive, they can lead to psychological dependence.

Antihistamines, the active ingredient in most sleep aids, can cause dizziness, dry mouth and blurred vision. They also can worsen high blood pressure, heart arrhythmias, glaucoma and prostate and urinary problems. Also popular recently has been melatonin, a hormone whose production by the body declines with age, but some studies now challenge its effectiveness.

If non-prescription drugs don’t help, prescription drugs are an option. Among the choices:

• Benzodiazepines, the most commonly prescribed, are strong but considered less potentially addictive than the earlier class of hypnotics called barbiturates. The drugs can be dangerous if used with alcohol or ulcer medications. Going off them after regular use can cause severe insomnia for days to weeks.

• Barbiturates can be effective but present high risks for addiction and accidental overdose.

• Estrogen, or hormone replacement therapy, helps some post-menopausal women with sleeplessness.

• Some anti-depressants also have sedating effects and can help, especially if depression is causing or exacerbating the insomnia.

Tips for caregivers

• Anxiety and frustration are seniors’ biggest enemies in fighting insomnia. You can help by reminding them that finding ways to relax is often the most effective sleep aid.

• Encourage them to try different methods, to experiment. Praise them for making consistent efforts to solve the problem; reassure them that eventually they will find a successful approach.

 

 

Source www.caregiverzone.com