Yes, it happened again. You were exhausted, you went to bed, and now you have trouble falling asleep. Or you fall asleep the minute your head hits the pillow, but you awaken in the middle of the night. Ugh, why does this happen, and what can help? In Seniors and Sleep Disturbance – 1 Sheep 2 Sheep, you’ll explore some reasons that can contribute to sleep disturbance. You’ll also read some suggestions for helping with getting a better night’s sleep.
Let’s take a look at some sleep behavior disorders and reasons that could be the culprit, and rest assured (pun intended) I’ll give you some options to combat those sleepless times.
What is Insomnia – Counting Again and Now She Sticks Out Her Tongue
Insomnia is the experience of difficulty falling asleep or waking up and not being able to go back to sleep.
Insomnia has two classifications, acute and chronic.
- Acute insomnia is short-lived and may occur several nights for a few weeks.
- Chronic insomnia is when you suffer insomnia for three or more nights in a week, lasting for more than three months.
What Are Some Causes Of Insomnia
You’re experiencing some sleep disturbance, but you’re not sure why. Here are some possible causes you might want to look into and see if they apply to you.
Caffeine
Caffeine has a short life, meaning 80% of caffeine leaves the body within 8-10 hours. So if you’re consuming caffeine in the afternoon and evening, it can interfere with your falling asleep.
Medications
As we age, many times, there is an increase in the number of medications we take. If you take medications and suffer from insomnia or sleep disturbances, talk to your doctor. Many times there are alternative medications you can take that may not interfere with sleep.
Please don’t stop taking any medication that your doctor has prescribed or suggested until you talk to him/her, as that can be dangerous.
Some medicines that may interfere with sleep are:
- Alpha and beta-blockers – are used to control high blood pressure, rheumatoid arthritis, gout, angina, glaucoma, and other ailments.
- Ace Inhibitors – Two ailments that ace inhibitors are used for are congestive heart failure and high blood pressure.
- Glucosamine – used for joint pain and inflammation.
- Antidepressants
- Corticosteroids – are commonly used for inflammation, allergic reactions, lupus, rheumatoid arthritis, and gout. I’ve taken prednisone before, and it definitely kept me awake.
- Cholinesterase Inhibitors – are used for memory problems, especially as seen in dementia and Alzheimer’s disease.
- Antihistamines
- Statins are used in the treatment of high cholesterol.
- Nicotine replacement products
- Thyroid hormone
- Diuretics – sometimes used in the treatment of high blood pressure.
- A subcategory – Recreational Drugs and Alcohol can also interfere with the sleep cycle.
Nocturia
Nocturia is waking during the night to urinate.
Depression/Anxiety/Stress
Anxiety and stressful life events such as death, financial issues, surgery, and divorce can cause insomnia.
Depression is a common cause of insomnia. Though an increase in sleep is seen in some people with depression, studies show that 80% of people experiencing depression have trouble falling or staying asleep.
Lack of Exercise
As we get older, we tend not to get out and move as we once did. If you think back on the days of childhood, we were always on the go. We loved to play outside, and we had recess at school; it seemed like we needed no excuse to get up and move.
As adults, when we go to work, we might have a desk job that requires minimal walking. If we are retired or stay at home most of the day, we get minimal exercise.
When I was home from my recent surgery, I wasn’t getting more than 2000 steps in a day, nowhere near the 10,000-step recommendation. I didn’t think I was that inactive, but I was.
Restless Leg Syndrome
Restless leg syndrome (RLS) or restless legs syndrome is a neurological disorder that causes intense and persistent sensations of moving or crawling in the feet and lower legs. It can be incredibly frustrating when falling asleep is difficult because these sensations keep you awake.
There are many types of RLS, but the most common form affects about 1 in 25 people. Symptoms typically start after age 50 but can also occur at any age.
Shift Worker
If you are a shift worker, meaning working throughout the night and sleeping during the day, this can wreak havoc with your sleep cycle.
Even though classified as a shift work sleep disorder and not insomnia, the results can be the same – trouble falling asleep or waking up every few hours.
Obstructive Sleep Apnea Syndrome
Obstructive Sleep Apnea is a sleep disorder that occurs when there is an obstruction in breathing during sleep, and thus, the person wakes up.
Sleep Apnea is not insomnia but could cause the middle of the night awakenings.
Some signs of obstructive sleep apnea are chronic snoring, difficulty breathing/gasping for breath, and choking.
If you do have sleep apnea or suspect you might, this should be taken seriously, and a doctor should check you out, as it can be deadly.
If you experience any of the above symptoms of insomnia, you should seek medical advice.
Video: What Is Sleep Apnea?
Solutions Please
Now that we know what insomnia is and what can cause it let’s look at some ways to help.
Medical Professional
If suffering from sleep disturbances, it’s important to make an appointment with your healthcare provider to rule out any underlying medical conditions.
They will probably take a history of your symptoms and perform a physical exam.
Your provider may have you create a sleep diary or have you participate in a sleep study (polysomnography) to determine which type of sleep disorder you are experiencing.
Polysomnogram Sleep Study
A polysomnogram sleep study is a medical test that uses special equipment to measure your sleep patterns.
This test can help you determine the cause of your insomnia and provide treatment options if necessary.
If you are having difficulty sleeping, a sleep study may be the best way to find out what is causing your problems and get treatment.
A polysomnogram can help identify any sleep disorders, such as insomnia or obstructive sleep apnea (OSA).
Polysomnography also measures heart rate, breathing patterns, brain waves, muscle activity, and leg movements during sleep. This information can help doctors determine how effective different treatments are for you.
Formal sleep studies are appropriate when a primary sleep disorder is suspected.
Sleep Disorders Specialist
A sleep disorders specialist can provide advice on the management of chronic insomnia as well as sleep-related behavioral problems.
A specialist should be sought out, especially if you are experiencing excessive daytime sleepiness.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a type of psychotherapy that enables you to understand the thoughts and behaviors that lead to sleeplessness. These thoughts and behaviors are then changed, leading to improved sleep quality.
Aromatherapy and Essential Oils
Aromatherapy is a holistic treatment that uses essential oils extracted from plants. You can buy essential oils in many stores, including Amazon. You use a diffuser to have the essential oils permeate the air.
You can also apply essential oils to the skin by blending them with coconut oil. You don’t want to apply essential oils directly to the skin.
- Lavender and Frankincense are both used to relax and make falling to asleep easier. I’ve used lavender, and it has worked for me.
Bed/Mattress/Pillow
If you have an uncomfortable or sagging mattress, it may inadvertently be interfering with your sleep. The recommendation is to flip or rotate your mattress twice a year.
A way to remember which to do -flip or rotate- use this famous jingle Spring/Spin, Fall/Flip.
Spin means taking the mattress and walking it 180 degrees so the head becomes the foot side – no flipping involved.
Flip means turning the mattress completely over so the top goes underneath, and the bottom/underneath part becomes the top – though if you have a pillow-top mattress, you really can’t flip.
The average lifespan of a mattress is seven years though some may make it ten years. If your mattress is around this age, it may be time to look into buying a new one.
If you’re over 40, you might want to look into purchasing a mattress for added support more often than the suggested 7-10 years.
Pillow – Is your pillow the right firmness for you? Have you had it a while, and it’s lost most of its support. The recommendation is to replace pillows every two years.
If you tend to go to bed early or live in a part of the country where it stays light longer or the sun rises earlier (both phenomena tend to happen more with daylight savings time), blackout curtains may help.
Blackout curtains also muffle sound, so if you’re not sleeping well because of noise, they may help with this too.
I have them in my bedroom, and I tend to sleep longer now that I have them – it’s nice sleeping longer because the sun isn’t shining through the curtains.
There are also cooling weighted blankets that many find helpful with insomnia and other sleep disturbances.
Avoid Caffeine
As stated above, caffeine usually leaves the body within 8-10 hours after consumption. So if you’re having a cup or two of coffee in the morning, that shouldn’t be affecting your sleep. However, if you’re having coffee or some other type of food or drink containing caffeine later in the afternoon or evening, this could be the culprit and should be limited.
Some people don’t realize that there is caffeine in products other than coffee, tea, and soda. Chocolate has caffeine, as do some ice cream and even decaffeinated coffee.
Chamomile Tea
An herbal tea that has been around for centuries and is used to induce relaxation. Chamomile tea does not contain caffeine.
Exercise
Studies have found that exercise improves sleep.
It seems that moderate-intensity aerobic exercise, such as walking, makes falling asleep faster and helps with the length of sleep.
Try taking a brisk walk a few hours before bedtime. Some people find when they exercise intensely or too close to bedtime, it makes it harder to fall asleep. You can switch up your exercise with videos/DVDs or even exercise equipment you have in your home. To see some options for at-home exercise, feel free to look at two articles I wrote: Best Senior Exercise Videos/DVDs – Buying Guide and Best Exercise Equipment for Seniors – Are You Pumped?.”
Eye Mask
Eye masks can provide a better sleep environment by keeping light out.
If you have a nightlight or even a clock by your bedside that gives off light, this can interfere with sleep.
Eye masks are relatively inexpensive, convenient for travel, and have no side effects.
Food
Some foods found to help with the difficulty of falling asleep are:
- Walnuts – contain melatonin – a sleep hormone
- Fatty Fish
- Turkey – think Thanksgiving
- White Rice
- Milk – Contains tryptophan (the same amino acid found in turkey)
- Cherry Juice – boosts levels of melatonin
- Bananas
- Pretzels
When eating before bedtime, remember you don’t want a lot; just a small amount will do.
Journal
Keeping a journal will allow you to put to rest those pesky thoughts instead of having them go through your head over and over again as you’re trying to nod off.
Jot down those racing thoughts; maybe what happened during the day that upset you that keeps running through your mind as you’re trying to go to sleep; perhaps a list of things to do tomorrow.
Some people like keeping a gratitude journal, listing five things they have to be grateful for.
Lights
Light interferes with the production of melatonin (the sleep hormone). Turn off those lights, including bright bedside lamps, TVs, computers, iPhones, and tablets.
Melatonin
Melatonin is the naturally occurring sleep hormone in the body that helps you go to sleep.
If your body isn’t producing enough melatonin, you can purchase it in a supplement form.
Melatonin supplements can be bought over the counter.
I’ve used melatonin in the past and have found it very useful for inducing sleep.
Reading
Reading has always helped me sleep. At one time, it was hard for me to go to sleep without reading – not ideal either.
If you try reading to fall asleep, it’s better from a paper source and not an iPad because of the light the iPad produces.
Use a soft bedside lamp to read a magazine or book.
If you find that reading keeps you awake in bed, try going to another room and reading until you get drowsy, and then go to bed.
Regular Bedtime Routine
It’s best, especially when dealing with insomnia or another sleep behavior disorder, to have a consistent bedtime routine; going to bed at the same time each night, taking a bath or shower, and maybe a little reading. If you establish a relaxing bedtime routine each night, it will signal your body that it’s time to sleep.
Restroom
If you drink alcohol or other fluids such as water or caffeine beverages before bed, stop drinking them 2-4 hours before bedtime.
Use the restroom right before climbing into bed. Hopefully, this will help with the middle-of-the-night restroom calls, but if you still need to get up, try using nightlights instead of turning the lights on. However, be careful not to trip or bang your toes (ouch, so painful).
As there can be medical conditions causing nocturia (middle of the night restroom uses), talk to your doctor. He/She can perform tests if necessary to see if there is an underlying medical condition.
Room Temperature
Sleeping in a quiet room that isn’t too hot or too cold may help improve sleep. The ideal room temperature for sleep lies somewhere between 62-70 degrees. For the elderly, the ideal sleeping room temperature is 66 to 70 degrees. Temperatures that are lower or higher than this can cause a disturbance in the sleep cycle.
If you feel too cold, some people find wearing socks to bed remedies that feeling.
Relaxation
I’ve often used progression muscle relaxation to get to sleep. To use this method, you start at your feet and contract and squeeze one foot and, count to ten, then relax. Then you contract and squeeze the other foot while counting to ten and then relax. Don’t forget to breathe.
You make your way all through your body one part at a time – calves, thighs, abs, buttocks, arms, neck, back, jaw, forward, and so on.
Some people prefer working from their forehead down to their feet instead. Either way is acceptable.
Warm Bath
A warm bath will relax you and help lower your body temperature to make it more conducive to sleep. How this occurs is when you come out of the bath, the air feels cool and thus reduces your body temperature signaling your body; it’s time to sleep.
White Sound
Some machines produce what is called “white noise.” My favorite is the sound of rain.
White noise helps you sleep in two ways:
- It blocks distracting noises.
- It produces relaxing sounds that help induce sleep.
One study found that a white noise machine helps some sleep as much as medication.
White machines can be readily found in stores and on Amazon as well.
Pharmacological Treatment of Insomnia (Sleeping Medications)
If non-pharmacological interventions are ineffective, your doctor may consider sleep medications.
Under doctor’s care, a sleep medication may be good for short-term use to reset the sleep cycle and can be helpful for a good night’s sleep.
Choosing appropriate insomnia medication for elderly patients requires a lot of care and consideration. Some drugs, such as benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs), produce hypnotic effects and can increase the risk of cognitive impairment and falling.
Also, be cautious and DO NOT drink alcohol at any time when you are using sleeping pills. Alcohol can increase the risks of the side effects of all sleeping pills and make them worse.
FAQs
Why do some people find it harder to fall asleep than others?
As stress is one of the major contributors to sleep problems, the more stress in your life, the more likely you’ll experience a sleep disorder . When constantly stressed, your brain releases cortisol – a hormone known to inhibit sleep. Cortisol also fights off sleep by making you feel alert and stressed.
What should I do if my insomnia is caused by stress or anxiety?
If insomnia is causing significant stress or anxiety for you, then cognitive behavioral therapy (CBT) may be a good treatment option for you. CBT is a type of therapy that teaches you how to change your thoughts and behaviors in order to improve sleep hygiene and sleep quality.
In addition, medications like sleep aids or antidepressants can be used in tandem with CBT if necessary. However, it is always recommended that people consult with their doctor first before starting any sleep-related medication.
Are antihistamines okay to use as a sleep aid?
Over-the-counter antihistamines should be used with caution, especially among elderly, because of their relatively long duration of action and their anticholinergic effects, which may cause confusion, constipation, and urinary retention.
It’s always best to consult your healthcare provider before taking any medication, even over the counter.
Related Posts
Good Night All
I hope in reading Seniors and Sleep Disturbance – 1 Sheep 2 Sheep you are better able to understand the phenomena.
There are many causes of insomnia. Once you look at some of the reasons why you may not be getting a good night’s sleep, take the time to try some of the solutions. You never know which one(s) will be the answer for you, and you’ll figure out the missing puzzle piece. I’m hoping once you find it, you’ll say to everyone with confidence, “Goodnight to all.”
Tell us your experience with insomnia and any solutions that have or haven’t worked for you. Please comment below.
