You put on a blackout sleep mask. You counted sheep. You tried listening to whale sounds. You attempted everything possible to fall asleep, but you’re still wide awake an hour after getting under the bedcovers. You’re panicking, too, because you have a big day tomorrow and want to be well-rested, and the panic is making you wider awake. You’re acutely aware that every minute that ticks by is one less minute of rest.
What is insomnia
Insomnia is having difficulty falling asleep, or difficulty staying asleep. It is a common sleep disorder and can affect anyone, of any age. Research shows that 1 out of every 2 senior adults in the US has reported symptoms of insomnia and more than 1 in 10 Americans suffer from acute insomnia.
Sleep durations and patterns for older adults
Senior adults should ideally get 7-9 hours of sleep in a 24-hour period of time.
Some are able to sleep this long at a single stretch. Others may sleep in 2 or more chunks, with several hours of wakeful time in between. This is known as segmented, biphasic, or polyphasic sleep. Segmented sleep is not the same as insomnia.
What are the symptoms of insomnia
The main symptom of insomnia you’re most likely to experience is lying awake in the dark, anxiously willing yourself to drift to sleep.
Other symptoms of insomnia include:
- Waking up in the middle of the night and knowing you’ve woken up. But you can return to sleep quickly, without much effort.
- Waking up in the middle of the night multiple times and not realizing it.
- Waking up way too early in the morning (with regards to your personal schedule) and not being able to fall asleep again.
- Feeling sleepy, tired, and lethargic during the day.
- Feeling cranky and moody. Snapping at others.
- Finding it difficult to focus or concentrate on what you’re doing.
What can cause insomnia
While there is no one single cause of insomnia, perhaps the most prevalent reason you can’t fall asleep is that there’s something on your mind. Worry, stress, tension, call it what you will, keeps you awake at night when you should be asleep.
Other reasons for insomnia in senior adults could be:
- Napping too much during the day
Daytime napping is a normal part of aging, and senior adults tend to nap more than younger or middle-aged adults. Longer or more frequent naps may make it difficult to fall asleep at night.
Fix: Limit naps to one per day, no longer than 30 minutes. Use an alarm clock or the alarm feature on your phone to wake yourself up. Harsh, unpleasant alarm sounds are more effective than twinkling melodies.
- ‘Goldilocks’ pillows and broken beds
A pillow that is too hard or too soft can make it difficult to sleep. Similarly, a lumpy or sagging mattress, broken mattress springs, creaking bed frame, and unstable bed frame may prevent you from falling asleep, or wake you up multiple times during the night.
Fix: Replace pillows and mattresses. Check your bed frame for broken slats, loose screws, wobbly or uneven legs, warping, any other damage, and repair accordingly.
- Temperatures that are too warm or too cool
Ambient temperatures, or the temperatures of your surroundings, are often a personal preference. However, temperature plays a huge role in quality of sleep, and scientists have determined that temperatures between 68°F and 77°F are ideal for senior adults to sleep well.
Fix: Since regulating temperatures can cost a lot, especially during colder months, you might choose to wear a sweater over pajamas. Several blankets layered one on top of the other are better than one heavy comforter as you can add or remove blankets as needed.
- Medications
Taking 1 prescription drug is pretty standard among senior adults. Almost 2 in 5 adults over the age of 65 take at least 5 different prescription drugs. Drugs can have numerous side effects, and time sensitive drugs can induce drowsiness during the day and wakefulness at night.
Fix: Speak to your doctor about medication timings and dosage. If a drug is time sensitive and makes you sleepy, your doctor might reschedule it for closer to bedtime. With drugs that keep you awake, your doctor may reschedule them for daytime.
- Hormonal fluctuations
Insomnia may impact menopausal women quite strongly, as sleep disturbances affect 3 out of every 5 senior women. Other symptoms of menopause that disrupt sleep include nighttime itching, sudden hot flashes, cold flushes, and tingling in the hands and feet.
Fix: Follow a relaxing and calming bedtime routine. Eat your last meal of the day at least 3 hours before bedtime. Over-the-counter melatonin supplements may help, or you could ask your doctor to prescribe a sleep aid medication.
Other illnesses can cause insomnia
Many chronic and acute illnesses can be an underlying reason for insomnia because of the pain and discomfort they bring. The pain and discomfort may jolt you continually during the night, subconsciously keeping you awake.
Arthritis, Parkinson’s disease, Restless Legs Syndrome, diabetes, Alzheimer’s disease and other forms of dementia, sleep apnea, various allergies, and many other health conditions can contribute towards insomnia.
Is there an insomnia symptoms test?
Insomnia isn’t a disease, so there’s no specific diagnostic test that can ‘catch’ it. However, there are tests to identify whether you’re dealing with chronic insomnia or acute. Other testing methods are used to uncover the underlying causes of insomnia.
How to fight insomnia with insomnia therapy
Treatments for insomnia focus on helping patients fall asleep faster and stay asleep (without disruptions) for longer.
As a first step, your doctor may ask you to keep a sleep diary to track your sleep pattern. Your care provider may then follow up with Cognitive Behavioral Therapy for Insomnia (CBT-I).
Sleep journaling, or maintaining a sleep diary
A sleep diary can be pre-printed forms provided by your doctor, or a simple notebook kept on your bedside table. Senior adults who have trouble holding a pen may choose to make an audio or video diary instead, using their smartphone.
Sleep journaling is simple. Every night, just before you turn off the lights, note the time in your sleep diary. You can continue noting the time at intervals as long as you remain awake. If you wake up in the middle of the night and remember to do so, note the time in your sleep diary. Note the time again when you wake up in the morning.
You should also write down how you feel when you wake up for the day. Use words that describe your physical and mental state, such as ‘sluggish’, ‘tired’, ‘confused’, ‘drowsy’, ‘disoriented’, and so on.
Other things you can record in your sleep diary are:
- The temperature in your room
- The clothes you slept in (fabric of your pajamas, whether you wore a sweater, etc)
- How many and what kind of blankets and comforters you used
- Noise levels (absolute silence, insect sounds, partner’s snores)
- What you ate and drank before bed, including medications you took
- Disturbances because of your spouse, children, or pets
The information collected in your diary is invaluable for your doctor or sleep specialist as they can use it to pinpoint problems and develop a treatment and care plan to help you fight insomnia.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
In CBT-I sessions, a therapist works with patients to develop and adhere to a bedtime routine and follow certain practices that help train the body and mind to sleep quickly and well.
Effects of insomnia on your health and well-being
In multiple surveys asking people to define “the best feeling in the world”, one of the top-ranking answers is some variation of “feeling completely rested after a good night’s sleep.”
Sleep deprivation resulting from insomnia can have terrible consequences for your body and brain. Not getting enough restful sleep at night may lead to:
- Difficulty functioning during waking hours
- Weight gain
- Mood swings, irritability, depression
- A weakened immune system
- Greater susceptibility to heart disease
Bedtime beverages for insomnia: Do they actually work?
Certain drinks have long been touted as miracle workers in promoting sleep. Scientific evidence to support their claims is not always strong, but most foods that go into making these drinks contain some amount of tryptophan, melatonin, and other nutrients that encourage sleep.
These remedies to fight insomnia have been used for centuries, so it doesn’t hurt to try them.
- Warm malted milk
- Nut milks, like almond and cashew
- Chamomile tea
- Tart cherry juice
- Yogurt smoothie
While you’re at it, avoid alcohol and caffeinated drinks as much as possible. Alcohol may be good at helping you wind down and even fall asleep quickly, but this is not restful sleep. Meanwhile, the stimulant caffein can stay in your system for up to 6 hours after consuming it.
Caffeine is present in coffee, black tea, green tea, chocolate, cocoa powder, many sodas, energy drinks, kombucha, and matcha.
When to speak to your doctor
Insomnia and the resultant sleep deprivation can create problems in your healthcare progress, aggravate any existing chronic conditions you may have, and put you at risk of falls and other injuries.
Good doctors do not want that, because it undoes all the hard work you and they have put into keeping you healthy. If you notice any signs of insomnia, let your doctor know at the earliest.