Sleep in a dark, quiet, cool room (between 60 and 67 degrees Fahrenheit). Before bed, take a warm bath or practice relaxation techniques such as meditation or breathing exercises. If you can't fall asleep after 20 minutes, get up, go to another room, and do a relaxing activity like listening to calming music.
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.
As you age your body produces lower levels of growth hormone, so you'll likely experience a decrease in slow wave or deep sleep (an especially refreshing part of the sleep cycle). When this happens you produce less melatonin, meaning you'll often experience more fragmented sleep and wake up more often during the night.
Insomnia in the Elderly
In elderly individuals, sleep‐maintenance insomnia and early awakening are more common complaints than sleep‐onset insomnia; this is likely due to the age‐related changes in sleep architecture and circadian rhythm described above.
Studies suggest that low doses of melatonin (0.5-6 mg) improve initial sleep quality in older adults with insomnia.
One study of older adults with insomnia found that magnesium supplementation at a dose of 500 milligrams daily for eight weeks helped them fall asleep faster, 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.
Eszopiclone (Lunesta)
Eszopiclone has a short half-life, of 6 hours. Higher doses (ie, 2 mg for elderly adults and up to 3 mg for nonelderly adults) are more effective for sleep maintenance, whereas lower doses (ie, 1 mg) are suitable for difficulty in falling asleep.
Melatonin might help improve sleep and reduce sundowning in people with dementia. Provide proper light. Bright light therapy in the evening can lessen sleep-wake cycle disturbances in people with dementia.
Traditionally, the “elderly” are considered to be those persons age 65 and older.
Melatonin is generally considered safe to take every night at doses between 0.5 mg and 5 mg. A safe starting dose of melatonin is between 1 mg and 5 mg for adults. More melatonin can cause side effects, particularly in older adults. For older adults, lower doses, such as 1 mg, are usually considered enough melatonin.
Do not use melatonin if you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder or depression. Talk to your health care provider if you have diabetes or high blood pressure.
Magnesium is best for those with magnesium deficiency, insomnia due to stress or anxiety, or muscle pain and cramping. On the other hand, melatonin is considered best for those who suffer from circadian rhythm disruption, hormonal imbalances, or melatonin deficiency.
Umeda recommends taking the supplement about 30 minutes before bedtime. And don't take more than the recommended amount. More won't help you sleep better, but it may cause stomach upset. While magnesium might improve your slumber, it's no substitute for a good sleep routine, Dr.
Magnesium glycinate is considered to be the most effective type of magnesium for bettering sleep, as it may help relax both the nervous system and your muscles.
In the elderly, should prescription medication be necessary, the first-line treatment is nonbenzodiazepines (e.g., zolpidem, eszopiclone, zaleplon, and ramelteon) as they have been found to be safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines.
Compared to younger adults, the prevalence of insomnia is higher in middle and older adults. and increases with age. Up to 50% of older adults report insomnia symptoms; however, this does not mean that insomnia is a normal part of aging.
The FDA has approved Belsomra® to address insomnia in people living with mild-to-moderate Alzheimer's disease. Belsomra is thought to inhibit the activity of orexin, a type of neurotransmitter involved in the sleep-wake cycle.
The primary cause of sleepless nights for those with dementia seems to be the changes that take place in the brain. Leading experts believe that as dementia changes brain cells, it also affects a person's circadian rhythms. When circadian rhythms get disrupted, the individual often confuses morning and evening.
Sleep and Aging
Older adults need about the same amount of sleep as all adults—7 to 9 hours each night.
Most people overdo it with melatonin by taking upward of 10 milligrams or more prior to bed and then claim it doesn't work. Taking too much melatonin can actually cause rebound insomnia —either rendering the supplement ineffective or worse, exacerbating your already sleepless nights further.