Wny Can't I Fall Asleep?

By Sondra Forsyth

According to the National Institute on Aging (NIA), older adults need about the same amount of sleep as young adults—7 to 9 hours each night. But there are a number of reasons why they may not get enough sleep. Here, from the experts at NIA, is close look at the problem, why it happens and what you can do about:

There are many reasons why older people may not get enough sleep at night. Feeling sick or being in pain can make it hard to sleep. Napping during the day can disrupt sleep at night. Some medicines can keep you awake. No matter the reason, if you don’t get a good night’s sleep, the next day you may:  be irritable; have memory problems or be forgetful; feel depressed; have more falls or accidents; or feel very sleepy during the day.

Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling asleep and staying asleep. Insomnia can last for days, months, or even years. If you’re having trouble sleeping, you may: take a long time to fall asleep;  wake up many times in the night; wake up early and be unable to get back to sleep; wake up tired; feel very sleepy during the day

There are many causes of insomnia. Some of them you can control, but others you can’t. For example, if you are excited about a new activity or worrying over your bills, you may have trouble sleeping. Sometimes insomnia may be a sign of other problems. Or, it could be a side effect of a medication or an illness.

Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. This may make insomnia even worse.

Some older adults who have trouble sleeping use over-the-counter sleep aids. Using prescription medicines for a short time might help. But remember, medicines aren’t a cure for insomnia. Developing healthy habits at bedtime may help you get a good night’s sleep.

Sleep apnea is another serious sleep disorder. A person with sleep apnea has short pauses in breathing while sleeping. These pauses may happen many times during the night. If not treated, sleep apnea can lead to other problems such as high blood pressure, stroke, or memory loss.

You can have sleep apnea and not even know it. But your loud snoring and gasping for air can keep other people awake. Feeling sleepy during the day and being told you are snoring loudly at night could be signs that you have sleep apnea.

If you think you have sleep apnea, see a doctor who knows about this sleep problem. You may need to learn to sleep in a position that keeps your airways open. Sometimes a medical device called Continuous Positive Air Pressure (CPAP), a dental device, or surgery can help.

Movement Disorders such as restless legs syndrome, periodic limb movement disorder, and rapid eye movement sleep behavior disorder are common in older adults. These movement disorders can rob you of needed sleep.

People with restless legs syndrome, or RLS, feel like there is tingling, crawling, or pins and needles in one or both legs. It’s worse at night. Moving the legs brings some relief, at least for a short time. RLS tends to run in families. See your doctor for more information about medicines to treat RLS.

Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Some people have hundreds of these movements each night, which may result in loss of sleep and feeling tired and sleepy the next day. Medication, warm baths, exercise, and learning ways to relax can help.

Rapid eye movement sleep behavior disorder, also known as REM sleep behavior disorder, is another condition that may make it harder to get a good night’s sleep. REM sleep is the most active stage of sleep when dreaming often occurs. During normal REM sleep, your muscles cannot move, so your body stays still. But if you have REM sleep behavior disorder, your muscles can move, and your sleep is disrupted.

Alzheimer’s disease often changes a person’s sleeping habits. For example, some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night. The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired for the challenges they face.

If you’re caring for someone with Alzheimer’s disease, there are steps you can take for his or her safety and that might help you sleep better at night. Try the following:

Make sure the floor is clear of objects.

Lock up any medicines.

Attach grab bars in the bathroom.

Place a gate across the stairs.

Getting a Good Night’s Sleep

Being older doesn’t mean you have to feel tired all the time. There are many things you can do to help you get a good night’s sleep. Here are some ideas:

Follow a regular sleep schedule. Go to sleep and get up at the same time each day, even on weekends. Try to avoid napping in the late afternoon or evening, as it may keep you awake at night.

Develop a bedtime routine. Take time to relax before bedtime each night. Some people watch television, read a book, listen to soothing music, or soak in a warm bath.

Keep your bedroom dark, not too hot or too cold, and as quiet as possible.

Have a comfortable mattress, a pillow you like, and enough blankets for the season.

Exercise at regular times each day but not within 3 hours of your bedtime.

Make an effort to get outside in the sunlight each day.

Be careful about when and how much you eat. Large meals close to bedtime may keep you awake, but a light snack in the evening can help you get a good night’s sleep.

Stay away from caffeine late in the day. Caffeine (found in coffee, tea, soda, and hot chocolate) can keep you awake.

Drink fewer beverages in the evening. Waking up to go to the bathroom and turning on a bright light break up your sleep.

Remember that alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Use your bedroom only for sleeping. After turning off the light, give yourself about 20 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.

Safe Sleeping

Try to set up a safe and restful place to sleep. Make sure you have smoke alarms on each floor of your house or apartment. Lock the outside doors before going to bed. Other ideas for a safe night’s sleep are:

Keep a telephone with emergency phone numbers by your bed.

Have a good lamp within reach that turns on easily.

Put a glass of water next to the bed in case you wake up thirsty.

Use nightlights in the bathroom and hall.

Don’t smoke, especially in bed.

Remove area rugs so you won’t trip if you get out of bed in the middle of the night.

Don’t fall asleep with a heating pad on; it may burn.

Sweet Dreams

There are some tricks to help you fall asleep. You don’t really have to count sheep—but you could try counting slowly to 100. Some people find that playing mental games makes them sleepy. For example, tell yourself it’s 5 minutes before you have to get up, and you’re just trying to get a few extra winks.

Other people find that relaxing their body puts them to sleep. You might start by telling yourself that your toes feel light as feathers and then work your way up the rest of the body saying the same words. You may drift off to sleep before getting to the top of your head.

If you feel tired and unable to do your activities for more than two or three weeks, you may have a sleep problem. Talk to your doctor about changes you can make to get a better night’s sleep.

Reprinted with permission from the National Institue on Aging. For more health information from the NIA, click here.