In these settings, melatonin is considered the preferred pharmacological option for elderly patients. It is also an option for patients who are blind and suffer from non–24-hour sleep–wake rhythm disorder, given evidence supporting circadian entrainment.
There are several pharmacological options available for use in older patients with insomnia. Pharmacological treatments are primarily classified as benzodiazepine sedatives, nonbenzodiazepine sedatives, melatonin receptor agonists, antidepressants, and orexin receptor antagonists.
Sleeping pills can have serious, or even deadly side effects. All sedative-hypnotic drugs have special risks for older adults. Seniors are likely to be more sensitive to the drugs' effects than younger adults. And these drugs may stay in their bodies longer.
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.
These are the most commonly used sleeping tablets in Australia and include temazepam (Temaze, Normison), zopiclone (Imovane) and zolpidem (Stilnox). They work by enhancing the activity of sleep pathways in the brain. They are recommended for short term use (less than 4 weeks). Melatonin (Circadin).
Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger.
Dr. Epstein advises taking one to three mg of melatonin two to three hours before bedtime, if you're trying to better align your sleep cycle because of jet lag or a night-shift job. He says you can take melatonin safely for the long term.
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.
Older people wake up an average of 3 or 4 times each night. They are also more aware of being awake. Older people wake up more often because they spend less time deep sleep. Other causes include needing to get up and urinate (nocturia), anxiety, and discomfort or pain from long-term (chronic) illnesses.
Benzodiazepine sedatives such as triazolam (Halcion), estazolam, lorazepam (Ativan), temazepam (Restoril), flurazepam, and quazepam (Doral) and non-benzodiazepine sedatives such as zolpidem (Ambien, Intermezzo), eszopiclone (Lunesta), and zaleplon (Sonata) are drugs that can help induce sleep.
The Buzz on Modafinil
Available only by prescription, modafinil is only approved to treat narcolepsy, a disorder in which sleepiness is uncontrollable even during daytime. "It's a good wake promoter," Walsleben tells WebMD. "It takes two hours to get going but has a half-life of 10 hours, so it works all day long.
Not only can magnesium help you get to sleep, but it plays a part in helping you achieve deep and restful sleep as well. In one study, older adults were given 500 mg of magnesium or a placebo. Overall, the magnesium group had better quality of sleep.
It may help you fall asleep faster, stay asleep longer, and lessen how often you wake up during the night, so you can get a better night's rest. Temazepam belongs to a class of drugs called benzodiazepines. It acts on your brain to produce a calming effect.
You should not take temazepam if you are pregnant or planning to become pregnant. If you become pregnant while taking temazepam, call your doctor immediately. Temazepam may harm the fetus. talk to your doctor about the risks and benefits of taking temazepam if you are 65 years of age or older.
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.
Sleep Changes in Older Adults. Most healthy older adults aged 65 or older need 7-8 hours of sleep each night to feel rested and alert. But as you age, your sleep patterns may change. These changes can cause insomnia, or trouble sleeping.
Eat lighter meals at night and at least two hours before bed. Stay active, but exercise earlier in the day. Take a hot shower or bath at the end of your day. Avoid screens one to two hours before bed.
Lower doses may help older adults sleep better without disrupting their circadian rhythms and causing prolonged drowsiness. Older adults with dementia should avoid melatonin, according to the American Academy of Sleep Medicine.
Doses of melatonin between 1 mg and 6 mg appear to be effective for improving sleep in older adults; however, further studies are needed to find the optimal minimum effective dose.