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Evaluating sleep disorders in older adults

Eran Metzger, M.D.'s picture
elderly dancer
elderly dancer

There’s no question sleep disturbances affect most of the population at some point in time. However, over half of the elderly suffer from difficulty sleeping. More than 50 percent of people over the age of 65 who live in the community and nearly two-thirds of seniors living in an institutionalized setting are affected by sleep disturbances.

Why is this so?

Sleep patterns and stages change as individuals age. Older adults require more time to fall asleep. Seniors also suffer from more frequent nighttime arousals and awakenings. The circadian rhythm which governs wakefulness and sleep shifts as we age, with the result that we tend to go to sleep earlier in the night and awaken earlier in the morning.

In addition to the factors listed above, numerous other items can affect seniors’ quality of sleep, including: 

•   Medical illnesses - acute and chronic conditions such as arthritis,  gastrointestinal disorders, pulmonary and neurodegenerative diseases, as well as general pain and discomfort, can disrupt sleep
•   Medications - many seniors take medications, including antidepressants, decongestants, diuretics and high blood pressure drugs, that can upset sleep patterns.
•  Poor sleep habits - an inadequate diet, excessive consumption of caffeine or alcohol, and an inconsistent bedtime are among the things that can make sleep more difficult
•  Psychiatric disorders - acute symptoms of psychiatric disorders, including depression and anxiety, can result in disturbed sleep.

I frequently discuss the following tips with my senior patients to help improve the quality of their sleep:

•  Develop a regular bedtime and wake-up schedule and stick to it each day
•  Reduce stress and worries at bedtime by dealing with them earlier in the evening or the following day
•  Make sure your bed and bedroom are quiet and comfortable
•  Use your bed only for sleeping or quiet reading, not work
•  Discontinue caffeine and alcohol consumption at least six hours before bedtime, as they can disrupt sleep later at night
•  Establish quiet before-bed routines which you find are relaxing
•  Exercise regularly (but never just before going to bed)
•  Avoid heavy meals late in the evening
•  Developing relaxation techniques, such as yoga, meditation or deep breathing

Getting a good night’s sleep is a wonderful and healthy thing. I hope these tips will help you get the most out of your 40 winks.

Read about other common sleep issues

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Director of Psychiatry

Eran D. Metzger, M.D., is director of psychiatry at Hebrew Rehabilitation Center. Board certified in psychiatry, neurology and forensic psychiatry, Dr. Metzger's clinical interests focus on the interfaces between medical illness and emotional disorders, as well as medical ethics. He is a graduate of the Pennsylvania State University College of Medicine and completed his internship at Brockton Hospital and his residency and fellowship at Beth Israel Deaconess Medical Center. An assistant professor of psychiatry at Harvard Medical School, Dr. Metzger's research interests include...

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