Senior Health Center  
Format to print

November 17, 2004
More In This Center
Show Get the Basics
Show Explore Health Issues
Show Take Control

Free, Weekly newsletter from Mayo Clinic



More Information
Sleep and seniors: Insomnia isn't inevitable

By Mayo Clinic staff

After years of rising early to put in time at the office, you looked forward to retirement — when you'd toss out that annoying alarm clock and catch some quality ZZZs. But now you're finding that even though you'd like to sleep late, you're still rising with the sun. And the sleep you do get overnight isn't restful.

Having difficulty getting to sleep and staying asleep is common as you age. But that doesn't mean insomnia can't be avoided. Explore what could be causing your sleeping difficulties. Once you've figured out what's causing the problem, there's plenty you can do to get a good night's rest.

 
Why you need sleep

Getting enough sleep — so that you wake refreshed and ready to start your day — is just as important now as it was when you were younger. Sleep refreshes your body and your mind.


 
What's normal sleep as you age

As you age, your body secretes smaller amounts of key chemicals that help your body decide when to sleep and when to wake up. Levels of growth hormone, which promotes deep sleep, and melatonin, which regulates your sleeping and waking cycle, decrease as you age. As a result, your circadian rhythm — the internal clock that tells you to go to sleep at night and wake up in the morning — changes. You might find yourself going to bed earlier and waking up earlier.

As you get older, you might find that getting a good night's sleep becomes more difficult. You might find that:

  • You have a harder time staying asleep
  • You sleep lighter
  • You wake up three or four times each night

But despite the frustrating disturbances, you still need the same amount of sleep that you needed when you were younger — generally seven or eight hours a night. Because you likely wake up more often during the night and don't sleep as soundly, you may spend more time in bed at night or you might need a nap during the day to get those same eight quality hours of sleep.

On their own, these age-related changes don't usually signify a sleep disorder. If you're experiencing insomnia, your age usually isn't to blame.


 
Causes of insomnia

About half of all seniors report difficulty falling asleep and staying asleep. Several different factors can cause this problem, including:

Health conditions
As you age, you're more likely to develop health problems that could cause your sleep patterns to change. Examples include:

  • Arthritis
  • Osteoporosis
  • Heartburn
  • Cancer
  • Diabetes
  • High blood pressure
  • Parkinson's disease
  • Alzheimer's disease
  • Incontinence
  • Gastroesophageal reflux disease (GERD)
  • Stroke
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Heart disease
  • Enlarged prostate

Some conditions, such as arthritis, cause pain, which can make falling asleep difficult. Also, if you have chronic pain, you might wake yourself up if you adjust your sleep position during the night.


If you have diabetes, leg edema, enlarged prostate or incontinence, these conditions might cause you to urinate more frequently. Add to that the fact that your bladder capacity shrinks as you age, and you might find yourself getting up at night to use the bathroom more often. Getting up so often can make it hard to get back to sleep.

Other conditions, such as heart disease and COPD, can cause breathing difficulties. If you have trouble maintaining steady, rhythmic breathing while you sleep, you might wake up several times in the middle of the night. Waking up like this may prevent you from reaching deep sleep.

Pay attention to what wakes you up at night or what keeps you from sleeping. Talk to your doctor about your specific health condition. Changes to your treatment plan may reduce your sleep disturbances.

Anxiety and depression
Anxiety, depression and other emotional problems can make it harder to sleep at night. At the same time, not sleeping at night can add to your anxiety and depression. Understand that anxiety and depression can be serious conditions. Don't hesitate to tell your doctor if you have feelings of sadness or anxiousness that keep you up at night. These feelings can be treated.


Medications
Some common medications can make it difficult to fall asleep or stay asleep, including:

  • Antidepressants
  • Beta blockers
  • Bronchodilators
  • Calcium channel blockers
  • Corticosteroids
  • Cardiovascular drugs
  • Decongestants
  • Gastrointestinal drugs

As you get older, you're more likely to be taking some type of medication. Talk to your doctor about your medications and the chance that they might be causing your sleepless nights. Your doctor might prescribe a different drug that doesn't cause insomnia, or he or she might discuss changing the time of day you take your medication.

Common nonprescription drugs such as alcohol, caffeine and nicotine also can make it harder to fall asleep. Try cutting down on these or eliminating them altogether. Be aware that nicotine withdrawal symptoms and even the nicotine patch can keep you up — but this is usually only a temporary problem.


Lifestyle changes
As your responsibilities and daily activities change, your body adjusts accordingly. You might not get as much exercise as you did in the past. Being in a more rested state during the day means that your body doesn't feel the need to sleep like it used to. If your doctor says it's OK, increase your daily activities, for example, by taking a walk or spending more time in the garden.

Do your exercising during the day, or at least more than two hours before you go to bed. Exercise increases your core temperature, making it harder to fall asleep.


You might not spend enough time outdoors these days. Sunlight helps keep your body's circadian rhythm working appropriately. In general, you need about two hours of bright light exposure each day to help your body gauge when to sleep and when to wake up. If you can't get outside to enjoy the sunshine, talk to your doctor about a light box — a box that emits a bright light that mimics sunlight.


With more indoor time and less activity, you might find it tempting to nap during the day. If you nap for more than 20 minutes, you could find yourself having more trouble getting to sleep at night.

Sleep disorders
Some sleep disorders are more prevalent among older adults, including sleep apnea and restless legs syndrome. Both can wake you up in the middle of the night. If you think you might have either condition, talk to your doctor. Your sleep partner might be aware of your sleep disorder because loud snoring or movement might wake him or her up. Your partner might be able to give your doctor some information about your sleep behavior.


 
What you can do

The key to helping you get back to sleep is treating the problem that's causing your sleeplessness. If your sleep problem is affecting your daytime functioning, talk to your doctor about your concerns. Also talk to your doctor if:

  • You have disruptive snoring or irregular breathing
  • You think your sleep problems might be related to depression or anxiety
  • You depend on pills to sleep
  • It's been a month or more since you've been able to sleep soundly or fall asleep when you wanted to
  • You generally feel anxious, and it's associated with lack of sleep
  • You routinely feel sleepy at times when you need to be alert — such as when you're driving


 
Sleeping pills: Not a long-term solution

Sleeping pills, whether over-the-counter or prescribed by your doctor, aren't a long-term solution to your sleeplessness. Medications can sometimes be used short-term and should be used only as directed by your doctor. Using prescription sleeping pills incorrectly can cause addiction or dependence. Sleeping pills, which can make you drowsy, can also put you at risk of falls and broken bones.

If you're struggling with your sleep, ask your doctor if sleeping pills might help. But don't turn to sleeping pills rather than remedying the underlying cause of your sleep problems.

 
When someone else's snoring keeps you up

The loud sound of your partner snoring next to you can be enough to wake you up and make it impossible to fall back to sleep. Snoring is common, and chances are that you or your partner has done a fair share of snoring every now and then. As you get older, snoring becomes more common, so as you both age, you and your partner are more likely to snore.

Sometimes snoring indicates something more serious, such as sleep apnea. But usually it's just annoying. Snoring can be caused by:

  • Drinking alcohol before bed
  • Taking sedatives, such as sleeping pills or antihistamines, before bed
  • Congestion from a cold or allergies
  • Enlarged tonsils and adenoids
  • Being overweight

Talk with your partner about what could be causing his or her snoring. If avoiding alcohol or losing weight doesn't seem to stop the snoring, your partner might want to talk to his or her doctor.

In the mean time, try to block out the noise by:

  • Wearing earplugs
  • Creating white noise by running a fan
  • Playing music


 
Don't accept sleeplessness

Don't accept sleeplessness as part of the aging process. The sooner you talk to your doctor, the sooner you and your doctor can get to work on a solution. Then you can get back to a good night's rest.

Related Information


July 06, 2004

HA00056

© 1998-2004 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.  A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research. 



Advertising and
sponsorship policy







About this siteSite helpContact use-NewsletterSite map
Privacy policy updated June 03, 2004Terms and conditions of use updated June 03, 2004


LEGAL CONDITIONS AND TERMS OF USE APPLICABLE TO ALL USERS OF THIS SITE. ANY USE OF THIS SITE CONSTITUTES YOUR AGREEMENT TO THESE TERMS AND CONDITIONS OF USE.

© 1998-2004 Mayo Foundation for Medical Education and Research. All rights reserved.