Insomnia in Elderly Adults: Causes, Management, Treatment

Few things are worse than not being able to fall asleep.

The tossing and turning, the blankets on and blankets off cycle, the knowledge that you’re probably annoying your partner even if they won’t admit it, the judgmental side-eye from your pets because you’re disturbing their slumber. Insomnia in older adults, though, could be caused by more than just the wrong room temperature or having too much on one’s mind. If you’re struggling with insomnia, help is out there. 

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Causes of Insomnia in the Elderly

An estimated 10-30% of adults have difficulty falling asleep or staying asleep, and the number only increases as we age. There are many reasons for insomnia in elderly adults. As we age, our internal circadian clocks change, which leads to needing more time to fall asleep and also more wakeful moments during the night. It also tends to make a person tired earlier in the evening and causes them to wake up earlier in the morning. 

Some additional causes of insomnia in old age include arthritis pain or conditions like sleep apnea or restless leg syndrome. Urinary incontinence or gastrointestinal issues like constipation or diarrhea that require a person to keep getting out of bed to visit the bathroom will certainly disrupt sleep and lead to insomnia. Hot flashes due to menopause can be a contributing factor along and there are several drugs that cause insomnia in the elderly, including histamines, decongestants, antidepressants, and central nervous system stimulants. 

Treating Insomnia in the Elderly

One remedy for insomnia for elderly adults is being mindful of their sleep hygiene. Some tips to improve sleep hygiene and combat insomnia in seniors include:

• Limiting drinking for around 3 hours before bedtime as much as possible
• Avoid naps, especially after 2 pm, or take one afternoon nap of no longer than 30 minutes
• Increase exposure to natural light during the day
• Keep the bedroom as dark as possible at night (of course, keeping walking areas lit for safety)
• Avoid large meals about 3 hours before bedtime
• Stay active during the day
• Keep a sleep schedule, going to bed and waking up at the same time every day, even on weekends
• Try relaxation techniques, like breathing exercises, stretches, or meditations, as you lie in bed

Getting enough sleep is important, and insomnia shouldn’t be blown off as a “normal part of aging.” Don’t be afraid to speak to your doctor if insomnia is starting to get in the way of your daily life. They can recommend things like cognitive behavioral therapy, stimulus control, and relaxation training.

Cognitive behavioral therapy focuses on eliminating naps and going to bed and waking up at specific times to quite literally train your body to know when it should be sleeping. Similarly, stimulus control focuses on a set bedtime and waking time, and also using the bedroom for only sleep and sexual activities.

Relaxation training is a bit more intense than simply stretching or doing some deep breathing. It typically involves a pattern of tensing and releasing the muscles, sometimes called progressive muscle relaxation, or PMR.

Your doctor can also go through your medications with you to see if they are contributing to or causing your insomnia and potentially make adjustments. If all else fails, your doctor may recommend trying medication to help you fall asleep and or stay asleep. They can help you find the best fit for your situation.

Insomnia in seniors is common, but not something you just need to live with. With a little focus and work on your part, you may be able to look forward to restful sleep, rather than dreading another night lying awake in bed. 

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