Insomnia is more common in the elderly than any other age group. And with ageing populations, it’s becoming an increasingly prevalent health concern – for individuals, governments, and health services alike. But why does insomnia onset as we get older? And is there anything we can do about it? Here, we’ll take a look at the causes and how we can perhaps prevent insomnia in our later years.
Read more: What Is Insomnia and Can You Cure It?
What causes insomnia in the elderly?
Understanding what’s causing your insomnia can be tricky. From caffeine intake to mental health, and through unavoidable bodily changes that come with ageing, there are a wide range of factors. Here, we’ll explore which are most likely to cause insomnia, especially as we reach our elderly years.
1. Natural changes to our sleep patterns
As we age, our body clocks, also known as circadian rhythms, become less and less consistent. These rhythms are what decide when we wake and when we sleep. They generally centre around the rising and setting of the sun. But as we get older and spend more time indoors, they’re more liable to disruption. In more extreme cases, these changes to your body’s natural rhythms can cause sleep disorders, including insomnia. Here’s a quote from the Psychiatric Times on exactly that:
“In the elderly, several factors can contribute to circadian disruption. Circadian rhythms continue to drift earlier in time. If this morningness leads to complaints of falling asleep too early in the evening and waking too early in the morning, the patient may have advanced sleep-wake phase disorder (ASWPD).7 Aging is also associated with reduced light exposure, as less time is spent outdoors and indoor lighting can be very dim.“
2. Medications and stimulants
If you’re struggling with insomnia and have recently changed or taken up a new medication, then you may want to speak with your GP about side effects. Plenty of medicines can cause insomnia, especially in the elderly where insomnia is already more likely. Common medicines that may cause insomnia include some anti-depressants, steroids, and those prescribed to lower blood pressure (alpha agonists and beta-blockers).
Disclaimer: If you’re at all concerned with sleeplessness and think it might be a cause of your medicine, speak to your GP before making any changes.
3. Physical and mental health
Both physical and mental health play a huge role in how well we sleep. For those who suffer from mental health conditions such as depression or schizophrenia, insomnia is, unfortunately, more likely. The same is true for those who regularly experience stress and anxiety.
Physical health plays a role too. If you have heart problems or suffer from a number of other health conditions, you are more likely to experience episodes of insomnia.
According to mayoclinic.org, the following medical conditions may increase your chances of insomnia:
- Chronic pain
- Heart disease
- Gastroesophageal reflux disease (GERD)
- Overactive thyroid
- Parkinson’s disease
- Alzheimer’s disease.
If you suffer from any of the above and are struggling to sleep, there are coping mechanisms and ways to limit the effects of insomnia. We’ll talk about them a little later on.
4. Diet and lifestyle
Another big factor in insomnia for the elderly is diet and lifestyle. Caffeine and alcohol are known stressors when it comes to how well we fall asleep. Cutting these out where possible is important if you’re struggling to sleep. Our nutrition is also important. As with most health concerns, an unhealthy, unbalanced diet can cause problems.
Another problem is smoking. Here’s a quote from the Henry Ford Health Team on how nicotine affects sleep:
” Nicotine disrupts sleep – and smoking can also raise the risk of developing sleep conditions, such as sleep apnea. But since nicotine is a stimulant, smoking can mask your exhaustion. After all, if you’re feeling sleepy, a hit of nicotine can wake you up and make you feel alert.”
The time we spend outdoors is also key to how well we sleep at night. The more our body is exposed to sunlight, the more melatonin it produces. Melatonin is commonly referred to as the sleep hormone, so anything that can boost it is worth considering – especially for those who are older and struggling to get to sleep.
How to prevent insomnia as you grow older
Quite simply, preventing insomnia as you get older boils down to how well you limit the effect of the causes mentioned in the above section. So, here are our top tips for preventing insomnia as you age.
1. Get outdoors in the daytime:
Whether a it’s a gentle jog, a walk to the shop or simply a stroll around the garden, absorbing daylight will do wonders for your body clock and keep your routine as close to normal as possible.
2. Cut out unhealthy stimulants:
Nicotine, alcohol and caffeine are all known to limit our ability to fall asleep. As you age and insomnia becomes more likely, the impact of what you put in your body becomes stronger too. If you can’t cut them out completely, at least try to cut them out as you wind down for bed in the evening.
3. Create a bedtime routine:
Psychology is more effective than most of us realise. Having a bedtime routine and sticking to it tricks the body into recognising when it’s time to sleep and when it’s time to stay alert. Make yours luxurious and incorporate a nice warm bath before sipping a sleep-inducing lavender tea.
Exercise, if it’s not too close to bedtime, is great for helping us sleep. And it’s not just about nodding off but about preventing insomnia too. The John Hopkins Medical Centre states: “recent research indicates that exercise decreases sleep complaints and insomnia in patients. The effects of aerobic exercise on sleep appear to be similar to those of sleeping pills. However, more research is needed to compare physical exercise to medical treatments for insomnia.” Here’s a quote from their Medical Director, Charlene Gamaldo:
“We have solid evidence that exercise does, in fact, help you fall asleep more quickly and improves sleep quality.
“But there’s still some debate as to what time of day you should exercise. I encourage people to listen to their bodies to see how well they sleep in response to when they work out.”
4. Speak to your GP:
This one is especially for those who are using medication over a long or continuous period of time. Many medications can cause alertness and energy levels to rise, making it difficult to sleep. But your doctor will only tell you about the alternatives if they know you’re struggling with sleep. Be sure to tell your doctor as soon as you think getting to sleep is turning into an issue.
How to manage insomnia as an older person:
When looking to treat or manage insomnia, your first port of call should always be your GP. Quite simply, the internet is not quite as qualified and personally responsive as your doctor. But don’t disappear just yet. There are plenty of natural or non-pharmacological treatments which work great for insomnia-sufferers. We’ll talk through some of the most popular below.
Stimulus control therapy is all about reducing the anxiety an individual may feel when they approach their bedtime. It involves a set of instructions and rules to ensure the bedroom becomes a place for sleep. According to the Society of Clinical Psychology, these rules include:
- Going to bed only when sleepy
- Getting out of bed when unable to sleep
- Using the bed/bedroom only for sleep (i.e. no reading, watching TV, etc.)
- Arising at the same time every morning
- Avoiding naps
Sleep education and hygiene
While it may sound a little obvious, educating people about how to get to sleep is often considered one of the most effective insomnia treatments. Quite simply, small steps like limiting caffeine and avoiding blue light before bed can often have a big impact. So for those suffering from insomnia in their later years, a good port of call is to really educate yourself on sleeping habits.
Sleep restriction and compression
These are part of what may be prescribed if you speak to a cognitive behavioural therapist. Seep restriction and compression are both about understanding exactly what your body needs and how your habits match up. Here’s what the Sleep Foundation had to say about the two:
“two methods (which) aim to improve sleep quality and quantity by reducing the amount of time a person lies in bed. A CBT-i practitioner can use records from a patient’s sleep diary to determine how much time they sleep each night compared to the amount of time they lie in bed awake. Sleep restriction involves a sharp curtailing of time in bed while sleep compression is a more gradual process, but both techniques are intended to achieve the same goal: less time in bed awake each night.”
Insomnia is more likely to affect us as we get older. From our lifestyle, diet, and medication we take, to the amount of sunlight and exercise we get each day, there are numerous factors for why sleep can become more difficult with age. Leading a healthy lifestyle and setting routines is the key. But remember, if your insomnia is starting to affect your abilities or your daily life, be sure to speak your GP.