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.
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.
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.
Cherries
Cherries (especially sour cherries like the Montmorency variety) are one of the only (and highest) natural food sources of melatonin.
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.
Results from multiple studies indicate that valerian — a tall, flowering grassland plant — may reduce the amount of time it takes to fall asleep and help you sleep better. Of the many valerian species, only the carefully processed roots of the Valeriana officinalis have been widely studied.
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.
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.
Those who turn to medications may not realize that prescription, over-the-counter and even “natural” sleep aids carry health risks, especially for older adults, either alone or in combination with other substances. In fact, national guidelines strongly warn against prescription sleep medicine use by people over age 65.
There is a wide selection of over-the-counter sleep supplements to choose from. Some of the most common are cannabidiol (CBD), synthetic melatonin, valerian, and chamomile.
Reasons this might happen include drinking caffeine or alcohol late in the day, a poor sleep environment, a sleep disorder, or another health condition. When you can't get back to sleep quickly, you won't get enough quality sleep to keep you refreshed and healthy.
Melatonin: Melatonin is the most common sleep aid.
It's often used for insomnia but can also help reduce negative feelings that are associated with anxiety (that keep us awake at night). It's relatively tolerable in doses of 1 to 10 milligrams.
Folate and B6 vitamin are supposed to boost the formation of serotonin from TRP as coenzymes. Zinc and magnesium, instead, are supposed to enhance the formation of melatonin from serotonin by binding to AANAT enzyme, thus activating it and increasing the affinity of serotonin for binding to AANAT (74, 75).
Ambien, Lunesta, and Sonata are three non-benzodiazepine medications used to help with sleep. The medications are similar in how well they work and their side effects. All three medications have a generic form available. Talk with a healthcare provider if you are considering or have questions about these medications.
Common prescription sleeping medications include: Ambien® (zolpidem) Lunesta® (eszopiclone) Rozerem® (ramelteon)
Sleep in a comfortable, dark, quiet space. Make sure you're sleepy enough before going to bed, and don't lie there for 20 minutes or more if you can't fall asleep. Adopt a nighttime routine that helps you relax, such as reading or meditating before bed. Turn off screens well before you turn the lights out.