“Early to bed and early to rise, makes a man healthy, wealthy, and wise.” Advice can be forgotten over time, but there’s still a great deal of truth behind what Benjamin Franklin said. Sufficient and restful sleep are basic and essential needs for humans; however, both can be short-changed, specifically later in life.
Seniors may find themselves tossing and turning more and often waking up earlier that they did in their younger years. The benefits of a good night’s sleep are many and include better physical and mental health, improved mood, heightened energy level, decreased stress, and heightened quality of life. Reduced sleep will have completely opposite – and far more negative - results. Sleep apnea and sleep problems can contribute to developing Alzheimer’s disease, and other problematic health consequences.
For those interested in learning more about sleep problems, there is no shortage of educational books about the subject for all generations. Just one of these is The Senior Sleep Solution: A Guide to Improving Sleep Later in Life, co-authored by Kathy N. Johnson, PhD, CMC; James H. Johnson, PhD; and Lily Sarafan, MS. This trio of authors agree that sleep can become compromised as we get older and offer some sensible senior sleep solutions for achieving better sleep each night.
Before proposing answers to sleep problems, however, it will be necessary to identify the cause(s) behind these issues. For seniors (and others), there are many reasons leading to sleep deprivation. Scientific research points to the benefits of getting seven to eight hours of restful sleep each night - so if you’re having troubles sleeping, you may be greatly missing out.
The 7 Most Common Causes of Sleep Problems
Sleeping issues can plague people of all ages. What affects sleep can be simple, more complex, conspicuous, or less obvious. In addition, insomnia may be caused by only one issue, or a combination of several issues. Consider any, or all, of the following factors which can lead to difficulty sleeping.
- Noise. The most common cause of sleep problems is noise. Johnson, Johnson, and Sarafan write, “Across age groups, noise is cited as one of the chief causes of occasional insomnia. Whether it’s loud housemates, the noise from the television or radio, or a loudly snoring partner, the brain can become distracted by processing sounds rather than preparing for sleep.” Passing traffic can also keep a person awake … cars, trucks, and motorcycles will be most obvious, but also consider intermittent emergency vehicles, trains, and/or overhead airplane flight paths.
- Light. A neon sign from the business across the street can glow through a bedroom window. An early-morning sunrise can shine through thin curtains. Vehicle headlights can flash inside a home as a car passes by. Light, from whatever source, can creep into a person’s bedroom and keep a person awake.
- Temperature. If a bedroom is too hot or too cold, sleepers may find it uncomfortable. A person may also have too many or too few blankets on the bed. Interestingly, natural body temperature may also change by about 0.9 °F from morning to late afternoon and evening. The slight fluctuation is often based on increased human activities and is not serious. It may, however, lead to sleeping problems.
- Excessive alcohol. People may drink a glass (or two) of a favorite alcoholic beverage just prior to bedtime to help relax. While this action may encourage a person to fall asleep sooner, his/her bladder may require emptying overnight. This means the person will be far more likely to wake up once or twice overnight to go to the bathroom. Alcohol has also been known to decrease the quality of sleep, especially in large quantities, leading to feeling drowsy and tired the next day. Know the signs of alcohol abuse in seniors, since alcohol abuse is harmful at any age, but especially so for the elderly.
- Excessive eating. When a person eats too much before bedtime, he/she does not have enough time to properly digest before retiring for the night. As with alcohol, food will fill a person’s bladder and an overnight trip to the bathroom may become necessary.
- Bad dreams. Nightmares can often frighten a person to wake up overnight. Even if not completely awakened, a person experiencing a nightmare may lash out trying to fight off a dreamed attacker or “run” from an imagined wild animal or some other threatening pursuer.
- Uncomfortable mattress. Does this seem to be an obvious problem? People can, in fact, ignore what they are sleeping on. If a mattress is old, sagging, and/or lumpy, a good night’s sleep on it is often impossible.
6 Additional Underlying Causes of Sleep Problems for Seniors
Over and above the general factors leading to sleep disruptions, there are specific problems of relevance to seniors. Family caregivers can easily monitor the following:
- Medication. While many medications come with the warning that they may cause drowsiness, there are others which may keep a senior awake. A family doctor or pharmacist can easily distinguish between beneficial and more harmful medications. Before taking any new medication, seniors (and family caregivers) should read and understand the pill bottle label. Is sleepiness a listed side effect?
- Urinary problems. Seniors have reduced bowel control and may need to visit the bathroom repeatedly overnight. Waking up, getting out of bed, and turning on the bathroom light may make getting back to sleep more difficult.
- Mood disorders. Is your loved one depressed or anxious? Either condition can impact sleep patterns for seniors.
- Body pain. Aging seniors can suffer from more physical impairments resulting in either mild or more severe pain. A broken hip, for example, can be painful for seniors standing up, sitting, or lying down in bed. No matter how tired a senior is, a nagging injury can keep him/her awake or moving around trying to find a comfortable sleeping position overnight.
- Sleep apnea. As seniors age, their muscles and human tissue both weaken. Human tissue at the back of the neck often relaxes. When this occurs, partial or complete airway obstruction results and leads to snoring or more severe hypopnea – where airflow can stop.
- Restless Leg Syndrome (RLS). Does your loved one’s legs twitch or otherwise move without any explanation? This could point to restless leg syndrome. RLS isn’t just seen in sleepers; symptoms have been witnessed in seniors who are awake as well. A caregiver may see a senior’s leg(s) move uncontrollably during the day – perhaps when the senior is sitting comfortably and watching television. The condition itself is more annoying (for both the senior and a bed partner) than serious. Several drugs, including Pramipexole (Mirapex), Ropinirole (Requip), and Rotogoltime (Neupro), have been used as treatment.
11 Ways to Improve Sleep for Older Adults
The answers to solving sleep problems may be easy or more difficult to diagnose. Sleep sufferers may begin by speaking with their own family doctor but may be referred along to a sleep specialist. Experimentation with several options may be required before finding the best solution. A person may start with a breathing test, try numerous over-the-counter and/or prescribed medications, and finally may resort to a Continuous Positive Airway Pressure (CPAP) machine. Therefore, finding a solution may seem like a process of elimination, and patience is often required.
- Combat noise. Try removing the television and/or other electronics from the bedroom, discuss excessive noise with neighbors, address concerns with property management, hang thick curtains over the windows (to muffle sound), purchase a white noise machine, try wearing earplugs, and/or try another bed in the second bedroom.
- Develop a routine. Remember Ben Franklin here! Going to bed at night and getting up in the morning at the same times may also help as it becomes habitual. The human body and mind both work better when knowing what to expect. Another regular practice that can help is completing harder activities earlier in the day and more relaxing activities later in the evening. Evening television viewers can benefit by choosing something less disturbing to watch.
- Spend time with pets. Walking the dog or sitting with a cat on your lap can both be very relaxing. Seniors partaking in either activity in the early evening can better unwind from the day.
- Read. Depending on a senior’s eyesight, reading a book prior to bedtime can also be calming. Books with larger print will be easier for a senior to read. If these cannot be found, introduce your senior to audiobooks instead. E-readers are also useful tools. While these require holding, the background light and text font size can both be adjusted to make reading easier.
- Reduce light. Blackout curtains can do an excellent job with limiting the amount of light which can enter through a bedroom window. With suffering from sleep deprivation myself, I’ve installed these curtains. Doing so was an easy fix and has proven to be helpful.
- Close the bedroom door. This may seem like an over-simplified answer to sleeping problems, but a closed bedroom door not only blocks incoming light, but also muffles outside noises.
- Switch the mattress. Is the senior’s bed seven to eight years old? If so, the mattress may be showing its age and may need to be replaced. When bed-shopping, bring a senior along to personally test each mattress before making a purchasing commitment. Expect to pay more for a higher-quality (and larger) mattress. Seniors may also be tempted by attractive options including mattress heating and cooling technology, pillow-tops, and inclining ability. Other considerations will include mattress firmness, the senior’s weight, and the senior’s sleeping position. Less costly, but temporary, solutions may include placing a mattress pad on the bed, trying a firmer pillow, or using silk sheets (which help prevent sleepers from overheating, soothe sore skin, and reduce allergies).
- Use a fan. An electric fan, placed strategically on a bedside table, can help keep a sleeper cool overnight. Many models of electric fans can be found for sale; however, the best types will feature various speed settings and timer controls, swivel (to cool more of the room), and run quietly.
- Try medications. Initially, a senior could consult with a pharmacist for over-the-counter sleep medications (e.g. Melatonin). If these prove to be unhelpful, a senior should further discuss the problem with his/her family doctor. Be cautious as sleep medications could become addictive and have unpleasant side effects. Try to finish off one bottle of prescribed sleep medication completely before moving on to another. Any unused medication(s) can be returned to a doctor for safe disposal. Seniors may be taking multiple medications presently and may resist adding anything more to their list. In this case, fragrances may be effective and can be a more natural cure. Recommend a cup of chamomile tea before bedtime or sit a lavender plant on a bedside table.
- Use a CPAP machine. A person with sleep apnea may have to use a Continuous Positive Airway Pressure (or CPAP) machine. These machines will supply a regular airflow to the sleeper and prevent snoring. Perhaps one of the hardest things for CPAP machine users to get used to is wearing a mask. The right-fitting mask can be quite comfortable and worth it to sleep more soundly. The hose is long enough to allow for some movement from the sleeper. Depending on the climate CPAP machine users live in, it can be advisable to get a heated hose (which plugs into a separate electrical outlet). Heated hoses will prevent condensation forming inside the hose and stop any annoying sputtering or even water splashing in the face.
- Increase daily activity. A busy senior will tire him/herself out and better sleep will become more likely. Seniors could join a walking group through their local senior’s association (if there isn’t such a club, recommend one), play a round of golf, visit with grandchildren, or perform light housework.
You may have heard similar advice before or this may be all new to you. No matter which, there is a lot here to digest. Promise me that you’ll at least sleep on it?