What should you do if an older person complains of not sleeping well at night?
Experts do believe that “normal aging” brings on some changes to sleep. (See this post for more on how sleep changes with aging.) Basically, older adults tend to get sleepy earlier in the evening, and tend to sleep less deeply than when they were younger.
So it’s probably not realistic to expect that as you get older, you’ll sleep as long or as soundly as when you were younger.
That said, although aging by itself does change sleep, it’s also quite common for older adults to develop health problems that can cause sleep disturbances. So when your older relatives say they aren’t sleeping well, you’ll want to help them check for these. Figuring out what’s going on is always the first step in being able to improve things.
And remember, getting enough good quality sleep helps maintain brain health, physical health, and mood.
In this article, I’ll cover the top causes of sleep problems in older adults. I’ll also tell you about what approaches have been proven to work, to help treat insomnia and sleep problems in older adults.
Last but not least, if you (or your older relative) have experienced the very common combination of waking up to pee at night and difficulty sleeping, I highly recommend listening to this podcast episode, which features a geriatrician who is an expert on this: 092- Interview: Addressing Nighttime Urination & Insomnia in Aging.
5 Common Causes of Sleep Problems in Older Adults
1. Sleep problems due to an underlying medical problem. Although older adults do often suffer from what’s called “primary” sleep disorders, many sleep problems they experience are “secondary” sleep problems, meaning they are secondary to an underlying medical condition whose main symptoms are not sleep related.
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
- Painful conditions, including osteoarthritis
- Urinary problems that cause urination at night; this can be caused by an enlarged prostate or an overactive bladder
- Mood problems such as depression and anxiety
- Neurodegenerative disorders such as Alzheimer’s and Parkinson’s
- Medication side-effects
If an older person is having difficulty sleeping, it’s important to make sure that one of these common conditions isn’t contributing to the problem. Treating an underlying problem — such as untreated pain at night — can often improve sleep. It can also help to talk to a pharmacist about all prescription and over-the-counter drugs, to make sure that these aren’t contributing to insomnia.
Alzheimer’s and related dementias pose special considerations when it comes to sleep, which I write about in this post: How to Manage Sleep Problems in Dementia.
2. Snoring, Sleep Apnea, and other forms of Sleep-Related Breathing Disorders. Sleep-related breathing disorders (“SRBD”; it’s also sometimes called sleep-disordered breathing) is an umbrella term covering a spectrum of problems related to how people breathe while asleep.
Sleep apnea is a common condition which is important to diagnose since it’s been associated with many other health problems (especially in middle-aged adults). In sleep apnea, a person has frequent pauses in their breathing during sleep. The most common form is obstructive sleep apnea (OSA), in which the breathing pauses are due to obstructions in the breathing passages. OSA is often associated with snoring. A less common form is central sleep apnea, in which the breathing pauses are related to changes in the brain.
How common it is: The likelihood of having sleep-disordered breathing disorders goes up with age. It’s also more common in men, and in people who are overweight. In one study of 827 healthy older adults aged 68, 53% were found to have signs of SRBD, with 37% meeting criteria for significant sleep apnea. Interestingly, most participants did not complain of excess sleepiness.
Why it’s a problem: Studies have found that untreated OSA is associated with poor health outcomes including increased mortality, stroke, coronary artery disease, and heart failure. However, studies also suggest that these associations are strongest in people aged 40-70, and weaker in older adults. For older adults with symptomatic OSA, treatment can reduce daytime sleepiness and improve quality of life.
What to do if you’re concerned: Helpguide.org’s page on sleep apnea has a useful list of common symptoms and risk factors for sleep apnea. You can also ask the doctor about further evaluation if you’ve noticed a lot of daytime sleepiness. To be diagnosed, you’ll need to pursue polysomnography (objective sleep testing) either in a sleep lab or with a home sleep testing kit.
Whether or not you pursue an official diagnosis for SRBD, avoiding alcohol (and probably other sedatives) is likely to help.
3. Restless leg syndrome (RLS). This condition causes sensations of itching, crawling, or restlessness as a person is trying to fall asleep. The symptoms are unpleasant but not usually painful, and improve with movement. The exact biological underpinnings of this problem remain poorly understood, but it seems to be related to dopamine and iron levels in the brain. Most cases are not not thought to be related to neurodegeneration.
How common it is: Studies suggest that 5-15% of the general population meet criteria for RLS, but only 2.5% of people are thought to have clinically severe symptoms. Poor health, older age, low iron levels, and being female are some risk factors. It also tends to run in families.
Why it’s a problem: RLS has been associated with depression, anxiety, and sleep-onset insomnia. It can also get worse with certain types of medication.
What to do if you’re concerned: Read up on RLS (Helpguide.org’s page seems very good) and then talk to a doctor. Generally, you don’t need polysomnography but you should probably be checked for low iron levels. You can read about possible non-drug and pharmacological treatment options at Helpguide.org.
4. Periodic Limb Movements of Sleep (PLMS). This condition is not easily treatable, but I’m listing it since I’ve discovered it’s much more common than I realized. PLMS causes intermittent movements while asleep, usually in the lower limbs. It can affect the toes, ankles, knees, or hips. The movements may or may not wake the person up; they can be annoying to a bed partner.
How common it is: Studies estimate that 45% of older adults experience PLMS. Many such older adults are otherwise healthy. However, PLMS is also often associated with other sleep problems, such as restless legs and sleep apnea. Experts believe that it’s fairly rare for people to experience clinically significant sleep disturbances solely due to PLMS.
Is it a problem? PLMS can be an issue mainly because it’s associated with other sleep problems. Most people who experience PLMS don’t notice it much, although some do find it bothersome. Only a few studies have attempted to treat isolated PLMS, and it’s not clear that there is a reliable way to treat this. In its 2012 guideline on treating restless leg syndrome and PLMS, the American Academy of Sleep Medicine concluded that there was “insufficient evidence” to recommend pharmacological treatment.
5. Insomnia. Insomnia means having difficulty falling asleep or staying asleep, despite the opportunity to do so (e.g. being in bed), and experiencing decreased daytime function because of this. I consider this the grand-daddy of all sleep problems, because it affects so many people in middle-age and older age.
How common is it: Very common, and it becomes even more common with aging. One study found that 23-24% of older adults reported symptoms of insomnia.
Why it’s a problem: Insomnia has been associated with anxiety, depression, fatigue, worse quality of life, cognitive decline, and a variety of other worse long-term health outcomes.
What to do if you’re concerned: The main thing to do is assess the problem, by tracking sleep and using a sleep journal. And then seek help. For older adults, it is especially important to not simply rely on prescription or non-prescription (e.g. alcohol, over-the-counter pills) substances to help with sleep. That’s because all such substances worsen brain function and increase the risk of cognitive decline. (See “4 Types of Brain-Slowing Medication to Avoid if You’re Worried About Memory” for more details.)
Proven Ways to Treat Insomnia in Older Adults
Insomnia is a very common complaint among family caregivers and older adults. Fortunately, research has shown that it’s possible to treat insomnia effectively, although it does often take a little time and effort.
Why Sedatives Aren’t the Way to Go and Proven Ways to Taper Off Them
Before I go into the recommended treatments, let me say it again: you should only use sedatives as a last resort. That’s because most medications that make people sleepy are bad for brain function, in both the short-term and long-term.
Benzodiazepines such as lorazepam, alprazolam, diazepam, and temazepam (Ativan, Xanax, Valium, and Restoril) are also habit-forming. It can be a lot of work to wean people off these drugs, but research has proven it’s possible.
For instance, in this randomized control study, many older adults who had been on benzodiazepines for sleep (mean duration of use was 19.3 years!) were able to taper off their sleeping pills. 63% were drug-free after 7 weeks. (Yeah!)
Plus, in my own personal experience, it becomes extremely difficult once a person has started to develop a dementia such as Alzheimer’s, because then their behavior and thinking can get a lot worse if they are a little sleep-deprived or anxious. (In the short-term, almost everyone who tapers off of sedatives has to endure a little extra restlessness while the body adapts to being without the drug.) But letting them continue to use their benzodiazepine puts us in a pickle, because it also keeps them from having the best brain function possible, is associated with faster cognitive decline, AND increases fall risk.
I hope you see what I’m getting at. If either you or someone you care for are taking benzodiazepines for sleep or anxiety, and you aren’t dealing with a dementia diagnosis, now is the time to do the work of trying to get off these drugs. (If you are dealing with a dementia diagnosis, you should still ask the doctors for help trying to reduce the use of these drugs, but it will all be harder. It’s still often possible to at least reduce the doses being used.)
The key to successfully stopping sedatives for sleep is to very slowly taper the drug under medical supervision, plus add cognitive-behavioral therapy or other sleep-improving approaches if possible.
For more on this topic, and for a handy (and research-proven) consumer handout that helps older adults stop benzodiazepines, see “How You Can Help Someone Stop Ativan.” This article also addresses the question of whether it’s ever okay for an older person to be on benzodiazepines.
Now, let’s review some proven approaches to improving sleep in older adults.
Proven ways to treat insomnia in older adults:
- Cognitive-behavioral therapy for insomnia (CBT-I). This means special therapy that helps a person avoid negative thought patterns that promote insomnia, along with regular sleep habits, relaxation techniques, and other behavioral techniques that improve sleep. It has a good track record in research, as described in this NPR story. A new study also confirmed that CBT-I also benefits people who have insomnia combined with other medical or psychiatric conditions.
- CBT-I can be done in person, and is also effective when done through online programs. Two online programs with proven clinical efficacy are Sleepio (see here for the study) and SHUTi.
- CBT-I may incorporate several techniques such as stimulus control, and sleep restriction therapy. This Mayo Clinic page has a nice list of specific behavioral therapy components that might be included in CBT-I for insomnia.
- Brief behavioral treatment of insomnia (BBTI). This is a shorter variant of CBT-I; it’s designed to be delivered in 4 weeks. It also has a good track record in research.
- A study also found that BBTI was effective in reducing nighttime urination.
- Mindfulness meditation. A randomized control trial published in April 2015 found that mindfulness meditation was more effective than “sleep hygiene,” to improve the sleep of older adults with a variety of sleep disturbances. Older adults assigned to mindfulness completed a weekly 2-hour, 6-session group-based course.
- Local in-person courses to learn mindfulness are often available; search online to find one near you. They may also be available at certain senior centers.
- An online version of the course used in the study is available here.
- Several smartphone based apps propose to help people with mindfulness. They are reviewed in the scholarly literature here. I personally have used Headspace in the past and liked it.
- Exercise. Exercise is often thought of as a treatment for insomnia, but the evidence seems weaker than for CBT-I. A review article published in 2012 concluded that the effect is modest. A more recent randomized trial comparing CBT-I to tai chi, for insomnia in older adults, found that CBT-I was more effective.
- Although exercise is obviously very important to health, don’t rely on it as the primary way to try to solve sleep problems.
- It’s also possible that exercise may help insomnia, but a fascinating small study suggested that in people with chronic insomnia, it can take a few months for exercise to have an effect on sleep.
Are there any medications or supplements that are safe and effective?
Benzodiazepine drugs and sleeping medications such as zolpidem (brand name Ambien) are definitely risky for older adults, as they dampen brain function and worsen balance. If you or your loved one is depending on such medications to sleep, I recommend you get help tapering off, as described above. Most older adults can learn to sleep without these medications, although it can take a little effort to wean off the drug and learn to get to sleep without them.
Many over-the-counter (OTC) medications that make people sleepy are also a problem, because most of them are “anticholinergic,” which means they interfere with a key neurotransmitter called acetylcholine. A very commonly used anticholinergic is diphenhydramine (brand name Benadryl), a sedating antihistamine that is included in most night-time analgesics, but many prescription medications are anticholinergic as well.
Older adults should be very careful about using anticholinergics often for sleep, or really for anything. That’s because they worsen brain function, and in fact, chronic use of these medications has been associated with developing Alzheimer’s and other dementias. (For more on this, see 7 Common Brain-Slowing Anticholinergic Drugs Older Adults Should Use With Caution.)
Virtually all sedatives are included in the American Geriatrics Society Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.
So those are the medications to avoid if possible.
Now here are a few medications that seem to be less risky, and are sometimes used:
- Melatonin: Melatonin is a hormone involved in the sleep-wake cycle. Several studies, such as this one, have found that melatonin improves the sleep of older adults and does not seem to be associated with any withdrawal symptoms. A 2023 review found that melatonin has a “favorable safety profile” in older adults. However, in the U.S. melatonin is sold as a poorly-regulated supplement, and studies have found that commercially sold supplements are often of questionable quality and purity. So melatonin may work less reliably here than in Europe.
- Ramelteon: Ramelteon is a synthetic drug that mimics the effect of melatonin. A 2009 study reported that ramelteon did not impair middle-of-the-night balance or memory in older adults. However, its efficacy has been questioned; a 2014 meta-analysis concluded that the clinical effect appeared to be “small.”
- Trazodone: Trazodone is an older weak anti-depressant that is mildly sedating. It has long been used by geriatricians as a “sleeping pill” of choice, as it is not anticholinergic and seems to be less risky than the alternatives. A small 2014 study found that trazodone improved sleep in Alzheimer’s patients.
For a detailed and technical review of sleep medicines in older adults, this article is good: Review of Safety and Efficacy of Sleep Medicines in Older Adults.
And again, if you or your older relative has been bothered by the need to urinate at night, I also want to recommend this BHWA podcast episode: 092- Interview: Addressing Nighttime Urination & Insomnia in Aging.
For information on evaluating and managing sleep problems in people with Alzheimer’s or other dementias, see this article: How to Manage Sleep Problems in Dementia.
This article was last updated by Dr. K in January 2024.
Ahmed says
Hello
Thank you for all information
ihave my mother is 66 years old she cant sleep just 1 hour and sometimes non she take for heart medication
1-concor 2.5
2-aspren
She make heart operation she have to close small hole in heart and after the operation all this come and i live in iraq so bad medical care and just want her to sleep
Nicole Didyk, MD says
Insomnia is common after a stay in hospital where routines are disrupted and medications are often changed. Delirium cam be a part of the picture as well, so getting back into a typical routine as quickly as possible is critical. I usually try to avoid prescribing sleeping pills, and here’s a good website that discusses their dangers and alternative approaches, like cognitive behavioural therapy.
Ona Hamilton says
Thank you, Dr. Kernisan, for your excellent site. Regarding insomnia, there is one factor that, once discovered, helped me enormously with sleep. As we all know, seniors become more and more sensitive to substances like caffeine and other drugs as we age. When I started experiencing insomnia, I knew to stop drinking coffee and tea. However, I did not realize I had become sensitive to many of the supplements – and, in one case – foods I was consuming. For example, I learned that coconut oil and indeed all coconut products – can cause insomnia. As soon as I stopped taking a coconut oil capsule my sleep improved markedly. I subsequently tested by taking a coconut oil capsule in the morning and it had the same effect on my sleep as drinking several cups of coffee. Ingredients in many supplements – particularly those that claim to help increase brain power or memory – became overly stimulating for me after age 60 or so. Even a small bite of chocolate can affect my sleep. Life is much better for me now that I discovered this. If I were an MD and I had a patient complaining of insomnia, the first thing I would do would be to ask them to keep a detailed diary of every single thing they consume over a week. Simply Googling will reveal what products are associated with insomnia in aging adults.
Nicole Didyk, MD says
Glad that you were able to figure out a routine that worked for you, Ona! You’re correct that a complete lifestyle review, including diet and habits is very important when managing insomnia in older adults.
Dennis Caulley says
My mom is 89. After her third visit to the emergency and subsequent hospital stay in a six month period, we discharged her into Hospice. She has congestive heart failure, lung issues and easily triggered kidney failure.
She is generally frail (90 lbs) and fatigued at all times — sleeping an average of 16 hours each day. Her average MAX wake period is two hours. She transitions from sleep to wake or wake to sleep between 30 to 45 times each day.
Most transitions to wakefulness are followed by a trip to pee. (She is on Lasix). Consequently, she is walking to the bathroom often — increasing her risk of a fall.
She is NOT having a problem going to sleep, but she is waking after short periods. Do you have any suggestions to improve her sleep efficiency?
We administered .25 ml of morphine last night (her first ever dose) to help with some leg/hip pain she has been experiencing. She slept for 12 hours straight, woke up to pee, and slept another two hours, woke up and drank 500 ml of water and went back to sleep.
We have always preferred minimalism with pharmaceuticals, but now that she is under a hospice protocol, we are trying to figure out whether the outwardly more efficient sleep is better than the constant wake cycles for her.
Any thoughts are appreciated.
Thanks for your input.
Nicole Didyk, MD says
Hi Dennis. Sorry to hear about your mom’s difficulties and glad to hear that she is in hospice. At this stage of life, sleep efficiency is bound to be affected by the progressive medical conditions that you describe: kidney failure, congestive heart failure, pain, and medications for all of the above, and the pattern you describe may be natural given her situation. It’s unlikely that getting more sleep or longer periods of undisturbed sleep will make a difference to someone like your mom’s comfort level or overall prognosis.
You know your mom best and can work with the hospice team to ensure she is comfortable, if not restful. In terms of the peeing, sometimes a catheter is actually more comfortable if it means fewer trips to the bathrooom.
Simeon says
My father hardly eat and find it difficult to sleep…I need help
Leslie Kernisan, MD MPH says
Sorry to hear this. I would recommend having him evaluated by a health provider. For causes of weight loss and not eating, see here: Q&A: What to Do About Unintentional Weight Loss.
Valerie says
I can’t sleep..I never had this prblem.fir 53 yrs of my life. I’m 54 I’m 50lbs overweight ..I cant sleep. I I take 2 bp pills losartan n metoprolol.. I’m very bad out of shape. I joined YMCA. At great reduced rate fir one year. I’m going to gentle yoga today and do aqua aerobics zumba etc ..I’m desperatevto sleep I’ve taken tylenol PM and trazodone. I hate pills. ..I also bought used wii.n games all used. Try play activity games. Help I need ideas.
Leslie Kernisan, MD MPH says
Sorry to hear of your sleep difficulties. You are much younger than my own patients, so along with the sleep problem causes I list in the article, it’s also possible that certain midlife hormonal changes could be playing a role. I would recommend you let your health provider know of your sleep problems and ask for a thorough evaluation. There are medical problems that can cause or worsen sleep difficulties. Good luck!
katy says
Hi! I found your information extremely helpful, thank you!
I am 67 and have had insomnia for over ten years. So many sleepness nights and it becomes a kind of torture. Anyway, I , too, am on gabapentin (neronntin) and I feel it helps somewhat, but not much, it still takes 2/3 hours to go to sleep. I have tried everything that there is and nothing works for me. I am worried about the effects of memory loss of gabapentin, and was wondering if you if this is a problem with this drug? Also, I heard that hemp oil might work, is there anything to this claim?
Thank you for your time.
Leslie Kernisan, MD MPH says
Gabapentin is an anti-seizure medication and slows down brain function to an extent. We don’t know what the exact risks of gabapentin are, but in general, long-term use of any brain-slowing medication is generally not going to be great for an aging brain in the long run. So especially if it isn’t working that well, you may want to look into other ways to address your insomnia.
Have you tried any of cognitive-behavioral therapies? There are programs available online.
I can’t comment on hemp oil, sorry. In general, non pharmacologic approaches are safest in the short-term and long-term. good luck!
Shaju Mathew says
Dr.Kernisan,
I ma 62 years old and I have been taking Xanax for the last 20 odd years. 0.25 mg was prescribed by my doctor for alleviating anxiety after a brief cardiac illness. Everything was fine till about two year ago when I started suffering from Insomnia. On the advice of my doctor I have tried Clonozepam , eszoplicone etc in combination with Xanax but nothing works . Now I have reverted to ,5 mg of xanax every night. I fall asleep around 3 AM and have fitful sleep for about 4-5 hours. It leaves me craving for sleep the next day and I am afraid to drive. HELP.
Leslie Kernisan, MD MPH says
Sorry to hear of your situation. Unfortunately, there is no easy solution available. Many older people can taper off benzodiazepines and can learn non-drug ways to treat insomnia, but it takes time and patience and some effort. It also usually requires a helpful clinician.
I would recommend reviewing the related article on stopping benzodiazepines and asking your health provider for help. Good luck!
Laura Nelson says
Age 58. Female. Lifetime sleep latency insomnia. Doctor at my health clinic started me on 1-1.5 mg clonazepam 14 years ago. it worked. New doctor at my health clinic is taking me off clonazepam because of increased potential for falls and geriatric dementia. So, ok – what next? Even a very very slow taper leaves me sleepless to the extent it is debilitating. Just take a look at the health risks associated with long term sleep deprivation. I had the choice to use gabapentin or mirtazapine to help with sleep. i chose gabapentin because of horrendous looking side effects of the other. Gabapentin does nothing, although I have only titrated up to 200 mg. Should I continue to increase gabapentin, which has its own risk for dependence but apparently not dementia?
You know what helps me to sleep? A hit of weed at night. But you know, nobody talks about that b/c it’s illegal at the federal level, and for this reason there is a paucity of clinical trials. I don’t even dare to talk to me doctor about for fear she’ll think I’m some kind of drug seeker, which I am not, have NEVER taken more than prescribed amount of clonazepam.
Am trying very hard to be a compliant patient, for my own good apparently, but not sleeping is not sustainable.
Leslie Kernisan, MD MPH says
Sorry to hear of your chronic insomnia. If you haven’t already done so, I would recommend trying some kind of therapy and lifestyle change approach to help you sleep. There are online cognitive-behavioral therapy programs that have been proven to be effective, there is one here.
I wouldn’t frame this as being about a “compliant patient.” In the long run, it’s almost certainly better for your brain if you can learn to sleep without any chronic brain-altering medications. This does take some time and effort, but it will likely be good for your health in many ways. Good luck!
Laura Nelson says
Life style change? I’d love to know what you mean by that. I wonder if people who don’t experience severe chronic insomnia have any idea how many “lifestyle” and other approaches to sleeplessness the average insomniac tries. Limit this, eliminate that, more of this, less of that, if it is in any way connected by anyone to better sleep, the insomniac has tried it. That in itself IS the lifestyle of the sleep deprived. I have done cognitive behavioral therapy online and in person with a psychologist. No lasting change. In the long run, of course it would be better for my brain if I could learn to sleep without brain-altering medications. It would have been great if I hadn’t been sleepless since infancy, throughout childhood, adolescence, young adulthood, through a grueling 30 year career, and middle age too. That’s how long I’ve been sleep deprived. Vitamins, herbs, supplements, behavior and thought modification, every possible sleep hygiene tactic imaginable, unisom, benedryl, gabapentin, doxepin, silenor, mirtazapine, hydroxyzine, sleep center consultation/diagnostics, ambien, trazadone, intense daily exercise, meditation, psych eval, the list goes on. You know which of the above helped? none. Effort? Oh my God. You know what helped? Clonazepam and a hit of cannabis. You know what makes my thinking foggy, my thoughts confused and my irritability through the roof? Not sleeping for days on end. If I could trade 10 years of my life for a few years of restful sleep and days that aren’t filled with sleep deprivation hangovers, I would. My point in all this is that sometimes, with some individuals, you need to weigh risk vs benefit of a med – and in a situation like mine if there is a med, like a benzo, that can give me some years of quality of life NOW, then you need to concentrate on now and not how confused I’m going to be when I’m 90. People like me have been tortured by sleeplessness for a life time, and are further shamed about needing a brain altering drug to get some rest, even denied them for “our own good” – At age 59 I’m pretty well versed in what is and is not for my own good.
Leslie Kernisan, MD MPH says
Sorry to hear of your long-time insomnia problems. It sounds like you’ve worked very hard on exploring non-drug solutions. If this is the case and nothing has been successful, then yes, it’s reasonable to resort to a medication despite the risks, because you’ve carefully weighed the likely benefit and the risks, AND you’ve already tried a lot of other options.
Joan says
I just read the article. My father is 95 and recently has been in 5 different places due to health issues from hospital, rehab, home, skilled nursing and assisted living. He goes to bed around 9:30-10pm, is awake at 1, 2, 3 or 4:00 AM wanting to get up. My mother @ 92 is trying to get some sleep. The only solution we find that works is to have the aide get him up and let him sleep in his recliner until 6:30 AM. He can’t exercise much and night lights are used for safety. It is mind boggling as to what else to do. He dozes throughout the day in his recliner. We think the health issues of the last few months have played an important part. We are also noticing confusion. He cannot explain to us why he gets up so early. Any other thoughts?
Leslie Kernisan, MD MPH says
Sorry to hear about your father, that does sound challenging for everyone involved. Probably his current sleep issues are multifactorial. If he was recently in the hospital and rehab, his sleep cycle was most likely disrupted. He also probably already had a vulnerable brain to begin with, at age 95, and hospitalization can put a lot of stress on a vulnerable aging brain.
You could see if you can work with him to try to get his sleep cycle back on track. If there is any way to get him to doze less during the day, and instead have him move around and get some natural light, that might help. Even if he can’t exercise, can he take some short walks with assistance, and can those be done outside? The trick will be to do this without overlying tiring him, as he’s also probably still recuperating from his health issues and the stress of hospitalization.
You could also ask the doctor about trying melatonin, which seems to help some older adults. Good luck!
Gerri says
Your article on sleep has been very affirming. I have been experiencing a new sleep phenomena for me for the past 9 years. As has always been the case , I fall asleep without any problem. Prior to age 60 I slept well for about 7, sometimes 8 hours. Now , no matter what time I go to bed I fall asleep very easily and sleep 5 hours.And then cannot fall asleep again. Absolutely not enough hours for me.
Can you tell me your views on Valerian.( I have tried Melatonin – did not work, Zoplicone and Ativan -have stopped due to fears of dementia materializing) Does it consistently work as a sleep aid ? What dosage is optimal? Has research shown it to be habit forming? And most important – has research shown it could have negative impact on cognition?
I would appreciate hearing from you.Thank you for all the great work you do .
Leslie Kernisan, MD MPH says
Valerian is an herbal supplement. There is not really good research available on its effectiveness to treat insomnia in older adults, and I don’t think we know what the risks really are either. Last but not least, the production of herbal supplements is not well regulated in the US and so quality is very variable.
If you are having difficulty maintaining sleep throughout the night, I would recommend discussing it with your health provider. I would also recommend learning more about Brief Behavioral Treatment of Insomnia, which is a proven and safe treatment; we discuss it on the podcast (and have related links) here: 092- Interview: Addressing Nighttime Urination & Insomnia in Aging. Good luck!