An air conditioner may be helpful during hotter times of the year. Doctors will also promote regular exercise and balanced meals, and discourage stimulants like caffeine and tobacco. Other non-pharmacological treatments can help alleviate insomnia symptoms for seniors without prescription medication.
Suvorexant or low-dose doxepin can improve sleep maintenance. Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance. Low-dose zolpidem sublingual tablets or zaleplon can alleviate middle-of-the-night awakenings. Benzodiazepines should not be used routinely.
Cognitive behavioral therapy for insomnia (CBT-I) is the preferred first-line treatment for chronic insomnia in adults and has been endorsed as first-line therapy by multiple societies and guideline panels [1-5]. Overall, the evidence base is stronger for CBT-I than for medications.
In the elderly, nonbenzodiazepines such as zolpidem, eszopiclone, zaleplon, and ramelteon are safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines. Pharmacotherapy should be recommended only after sleep hygiene is addressed, however.
Cognitive Behavioral Therapy for Insomnia
CBT-i is considered a first-line treatment for insomnia because it does not carry the health risks.
Melatonin: Melatonin is considered one of the safest over-the-counter sleep aids, with few side effects. A prescription drug called ramelteon is designed to mimic the effects of melatonin. Like melatonin, it is not considered habit-forming and it does not affect balance.
They may advise you on good sleep habits, or refer you to another doctor to treat any medical conditions that may be contributing to your insomnia. Before trying medicine, sleep experts suggest that you start with cognitive behavioral therapy for insomnia (CBT-I). There's less chance of side effects or dependency.
Recent studies have shown that low-dose doxepin improves sleep parameters in older adults with a safety profile comparable to placebo. Higher doses of doxepin should be avoided in older adults because of high anticholinergic side effects. Avoid in patients with glaucoma or urinary retention.
One study. View Source of older adults with insomnia found that magnesium supplementation at a dose of 500 milligrams daily for eight weeks helped them fall asleep fast, stay asleep longer, reduced nighttime awakenings, and increased their levels of naturally circulating melatonin.
Melatonin is generally regarded as safe for seniors by physicians and pharmacists because its side effects are mild, it's not habit forming, and it does not cause withdrawal symptoms if you stop taking it suddenly. However, some of the side effects listed above may present additional challenges for older adults.
Daridorexant, classified as a DORA, was recently approved in January 2022 by the United States Food and Drug Administration (US FDA) for treating insomnia.
Take regular exercise. Adequate aerobic exercise improves the ability to fall asleep. Exercise in the early morning and early evening promotes deep sleep and improves sleep quality; however, exercise just before bedtime should be avoided. Keep bedroom dark and quiet.
As people age, they tend to sleep more lightly and often awaken during the night from achy joints or the need to go to the bathroom. Many people compensate for this lost sleep by catching a restorative nap during the day. That's normal.
Typically, subjects cycle through non-REM and REM sleep stages with a periodicity of 90 to 120 minutes. Physiologic changes of aging, environmental conditions, and chronic medical illnesses contribute to insomnia in the elderly.
Your doctor may recommend prescription or nonprescription sleep medicines. Or you may take other medicines that can help you relax and fall asleep, such as benzodiazepines or antidepressants. Many sleep medicines cause side effects, such as low blood pressure, anxiety, and nausea.
Common causes of insomnia and sleep problems in older adults. Poor sleep habits and sleep environment. These include irregular sleep hours, consumption of alcohol before bedtime, and falling asleep with the TV on. Make sure your room is comfortable, dark and quiet, and your bedtime rituals are conducive to sleep.
Common health conditions that can disrupt sleep in older adults include: Heart and lung conditions which affect breathing, such as heart failure and chronic obstructive pulmonary disease. Gastroesophageal reflux disease, which causes heartburn symptoms and can be affected by big meals late at night.
Pain from arthritic joints, sleep apnea, the need to urinate more often, and a variety of medications as well as exercising less are just some of the physical factors. Stress from moving home or losing loved ones and anxiety or depression are often experienced in later life and can keep our parents awake at night.
Who is Defined as Elderly? Typically, the elderly has been defined as the chronological age of 65 or older. People from 65 to 74 years old are usually considered early elderly, while those over 75 years old are referred to as late elderly.
Insomnia is rarely an isolated medical or mental illness but rather a symptom of another illness to be investigated by a person and their medical doctors. In other people, insomnia can be a result of a person's lifestyle or work schedule.
Sleeping pills, especially over-the-counter (OTC) sleep aids, are generally not meant to be taken every night.
Practicing good sleep hygiene and sleep habits can help you overcome insomnia. This means that you should try to stick to a regular sleep schedule every day. Set a regular bedtime and a regular time to wake up so that your body gets into the habit of sleeping during those hours.
Z-drugs like zolpidem (Ambien) and zaleplon (Sonata) are commonly prescribed to help you fall asleep, especially if you don't have chronic insomnia. They can be taken as needed and usually work within an hour. Benzodiazepines are another option.
Antihistamine sleep-aids (like doxylamine succinate and diphenhydramine) are largely considered to be “non-habit-forming,” because they do not cause physical dependence.