The Most Effective Sleep Aids for the Elderly
Everyone has their own individual sleep needs, but this becomes even more important as you age. As your body changes, so do its reactions to certain medications. Treatment methods that worked at 40 may not work at 60. Many older individuals also have an increased number of medical issues that require medicine and lifestyle changes.
Another thing impacted by age is sleep quality. Nearly 50% of senior citizens struggle with insomnia, claiming difficulty initiating or maintaining sleep. Without sufficient sleep, many people wake feeling groggy, disorientated, and sluggish. It’s increasingly difficult to recover from sleep deprivation as you age, creating an unhealthy pattern of behavior that leaves many people discouraged, fatigued, and at greater risk of illness due to a weakened immune system.
If any of these scenarios describes you or a loved one, you may be searching for the best sleep aids for the elderly. And you’ve come to the right place. Here, we’ll discuss the types of sleeping pills and medication available, which ones are best suited for senior citizens, and tips for choosing the right treatment method.
Things to Consider When Choosing Sleep Aids for the Elderly
Lots of things change as you age from your flexibility and energy levels to your general health and sleep patterns. Several factors impact sleep in the geriatric population including a shift in hormone production. This includes vital hormones for sleep like melatonin and cortisol. Without adequate levels of these hormones, some people struggle to maintain a balanced circadian rhythm (sleep-wake cycle).
Nearly 95% of the senior citizen population has at least one chronic condition, with 80% having two or more. Because of this, many seniors are on myriad medications to treat any number of conditions from heart disease and high blood pressure to arthritis, respiratory disease, and diabetes. These medications plus the medical conditions themselves could interfere with or interact poorly with certain sleep aids.
That’s why choosing the most effective and safest sleep aid for the elderly is so important. The wrong combination of medications could have serious, long-lasting, or even fatal side effects. As with any drug – over-the-counter or prescription – there are potential risk factors and side effects. There’s no way to label a single medication as the “best” for elderly patients, however, you can take each patient’s unique needs and medical conditions into account. Choosing the right sleep aid comes down to how it interacts with other medications you’re taking, its efficacy, and if the risks and side effects outweigh the negative impact sleep deprivation is having on your life.
What Causes Insomnia in the Elderly?
Countless studies show that individuals over the age of 65 struggle more with chronic sleep issues than their younger counterparts. But why is this? There are numerous factors at play that make it increasingly difficult to achieve quality sleep as you age. But here are some of the main causes for this shift in sleep patterns.
For starters, many elderly individuals lack the energy and stamina they once had. For this reason, they tend to nap more frequently throughout the day. While certain naps can be beneficial, sleeping too much or too often during the daytime can make it increasingly difficult to fall asleep at night. This disrupts your sleep-wake cycle and natural sleep patterns, creating a vicious cycle of being too awake to sleep at night and too tired to stay awake during the day, increasing the desire to nap.
Arthritis pain affects over 50% of all seniors, making it difficult to find a comfortable sleep position. Chronic pain is a common cause of insomnia in all age groups but is especially prevalent in the geriatric community. Another common cause of insomnia in older women is hot flashes caused by menopause. Although menopause usually sets in long before the age of 65, hot flashes and night sweats can persist for several years, disrupting sleep for many women.
Certain antidepressants and blood pressure medications are also known to cause insomnia in older patients. Before choosing a sleep aid, it’s important to make sure that the medications you’re currently taking aren’t the underlying cause of your sleep trouble.
The Best Sleep Aids for the Elderly
There are several types of sleep aids available including over-the-counter, prescription, and natural sleep supplements. Each product offers its own benefits and risks. Based on the most common medical issues facing elderly individuals, here’s a list of the best and most effective sleep aids for senior citizens.
These drugs can be purchased OTC without a prescription, however, you should still speak with your primary care physician or another medical professional before taking any new medication. Be sure to present them with a full list of your current medications, plus an extensive medical background history and any other concerns you might have.
Diphenhydramine is one of the most popular antihistamines used to treat myriad allergies and is found in some of the most popular medications including Benadryl, Aleve PM, and other nighttime drugs designed to help you sleep. Antihistamines work to block chemicals in the central nervous system known as histamines which promote wakefulness. By blocking these chemicals, antihistamines induce drowsiness.
Known for its sedative properties, diphenhydramine is a mild, yet effective sleep aid for short-term use. Potential side effects include dry mouth, constipation, urinary retention, blurred vision, and daytime drowsiness. These side effects can be especially bothersome for many elderly patients. Medications containing diphenhydramine should only be taken at night when you can dedicate several hours to sleep.
Found in popular sleep aids like SleepMetls and Unisom, doxylamine is another sedating antihistamine that offers the same benefits and side effects as diphenhydramine.
One of the most popular and well-known sleep aids, melatonin is a hormone that your body naturally produces to help regulate your circadian rhythm. The hormone is produced as night falls, interacting with receptors in your brain and triggering sleep. Taking a natural melatonin supplement can be beneficial for elderly patients who are melatonin-deficient. Potential side effects include headaches and daytime drowsiness.
Another natural supplement known for its sleep-inducing benefits is valerian. Valerian supplements are made from a tall, flowering plant with the same name. The natural herb is said to reduce the amount of time it takes you to fall asleep, while also helping you sleep better, longer, and deeper. While there are many different variants of the valerian plant, the processed root is most commonly used to produce supplements and sleep aids.
Research on valerian’s efficacy is still ongoing, but potential side effects include uneasiness, heart disturbances, upset stomach, headache, mental dullness, and vivid dreams. Some users even report increased insomnia or excessive daytime drowsiness after taking higher doses.
CBD is quickly being recognized as one of the best and most effective natural herbs for treating a wide variety of mental and physical health conditions including anxiety, stress, chronic pain, and insomnia. CBD products that contain less than .03% THC are generally mild and work well to ease various symptoms that may cause insomnia in the elderly.
CBD products interact with certain neural receptors in an area of the brain known as the amygdala. Here, CBD works to relieve stress and promote feelings of relaxation and calm. By blocking anxiety receptors, many senior citizens find it easier to fall asleep at night. Some studies also show that CBD has anti-inflammatory properties, as well as antioxidants linked to pain relief, all of which can improve sleep in older chronic pain sufferers.
When OTC drugs and supplements aren’t enough, you may need to consider prescription medications for sleep. It’s important to note that there are two separate categories – benzodiazepines and nonbenzodiazepines.
Many benzodiazepines double as both sleep aids and anti-anxiety medications. They work by interacting with GABA neurotransmitters in the brain to help calm your mood and slow down electrical excitement. Non-benzodiazepines also interact with GABA in the brain but focus on activating specific receptors that are linked to sleep. Most doctors recommend trying non-benzodiazepines first because they’re milder, safer, and tolerated more easily by those with underlying health issues and the elderly.
Here is a short list of the best benzodiazepines and nonbenzodiazepines used to treat insomnia in geriatric patients.
- Zolpidem (a central nervous depressant that slows down the nervous system)
- Eszopiclone (a type of hypnotic that slows brain activity)
- Zaleplon (a sedative-hypnotic that also suppresses CNS activity)
- Ramelteon (a melatonin agonist that binds to melatonin receptors, inhibiting neuronal firing and promoting sleep)
- Ativan (enhances work done by the GABA in the brain to send calming messages throughout the body)
- Xanax (also binds with neurotransmitters and GABA receptors in the brain to make you feel less anxious and more calm and relaxed)
Other Ways to Treat Sleeplessness in the Elderly
Not all insomnia sufferers are comfortable taking sleep aids and for some elderly patients, it’s not an option. If you’re over the age of 65 and have several medical conditions that are both causing insomnia and preventing you from taking the above-mentioned sleep aids, you can make small lifestyle changes that will have a big impact on your overall health, well-being, and sleep quality.
Set a Consistent Sleep Schedule
One of the main causes of insomnia in elderly people is an unbalanced sleep-wake cycle. The best way to correct this is to set a consistent sleep schedule that you follow 7 days a week. This includes weekends, holidays, and even those days you’re feeling especially tired during the day. If you have to nap, keep it brief (20 minutes or less) and make sure it’s not too late in the day.
Choose a time to go to bed and a time to wake up in the morning each day. By following this schedule, over time, your body will fall into a natural (circadian) rhythm where you find yourself getting increasingly tired as your bedtime approaches. You may even wake up in the morning without the help of an alarm. You’ll also feel increasingly well-rested, alert, and energized.
Get Plenty of Exercise
Daily physical activity is an important part of any healthy lifestyle, but even more so as you age. Getting adequate exercise during the day (preferably in the morning), better prepare you for sleep at night. Added benefits include increased energy levels, improved mood (which may combat feelings of depression or anxiety), a stronger immune system, and a lower risk of many ailments that plague most senior citizens. These include, but aren’t limited to, certain cancers, diabetes, and heart disease.
Start by exercising 30 minutes per day, 5 days a week. Moderate exercise includes walking, swimming, bike riding, yoga or pilates, and aerobics. If possible, get outside and get active. Studies show that increased exposure to light during the day can help promote a balanced circadian rhythm. Plus, you’ll get your daily dose of vitamin D from the sun’s natural rays.
Eat a Balanced Diet
Consuming a healthy, well-balanced diet can help combat insomnia and ease symptoms associated with sleep troubles. For example, foods high in antioxidants like fruits and vegetables can reduce inflammation, strengthen your immune system, and reduce your risk of developing heart disease and diabetes. You can also include sleep-inducing foods and drinks into your diet including chamomile tea, which is known for its mildly sedative effects. Bananas are high in magnesium and can help promote natural muscle relaxation, whereas oatmeal and almonds contain high levels of L-tryptophan, an amino acid that helps promote sleep.
The foods and drinks you avoid are just as important as the ones you consume. Avoid drinking caffeinated beverages too close to bedtime or eating heavy meals high in fat prior to laying down at night. Caffeine makes it increasingly difficult to fall and stay asleep, whereas heavy meals can cause gastrointestinal discomfort including bloating and heartburn. Coffee, in particular, is a diuretic and may result in frequent trips to the bathroom, interrupting your sleep cycle.
Create a Calming, Soothing Sleep Environment
Because anxiety plagues many elderly people and can lead to chronic insomnia, creating a relaxing and calming sleep environment is key in getting quality sleep. Invest in comfortable and supportive bedding including a firm mattress and pillows and breathable sheets and blankets. Keep your bedroom cool, dark, and quiet. Reduce noise disturbances using a sound machine or sleep headphones. Room darkening shades and sleep masks are great for blocking out unwanted light. You should also keep your thermostat around 65 degrees to create the optimal sleep conditions.
Avoid Blue Light Before Bed
It can be tempting to watch TV, read on your tablet, or scroll through your phone before bed. But exposure to the blue light from these types of electronic devices can actually make it more difficult to achieve quality sleep. Your brain confuses this light for sunlight, preventing the release of the sleep hormone melatonin and tricking your body into thinking it should be awake and alert. Try to avoid using digital devices approximately 90 minutes before bed. Instead, read a book, listen to soothing music, write in a journal, or perform a guided meditation. All of these sleep habits promote relaxation and set you on the right path for a night of quality rest.
Are Sleep Aids for the Elderly Safe?
Research on how sleep aids and medications affect the geriatric population is still ongoing. Although every patient is different, it’s clear that older individuals are at an increased risk of experiencing the side effects of sleep aids based on their general physical health. In most cases, lifestyle changes and other holistic approaches to easing insomnia and identifying the underlying cause of the patient’s sleep troubles are recommended for people over the age of 65.
One reason is that many sedative-hypnotic sleeping pills (also known as tranquilizers) directly affect the brain and spinal cord, which can be dangerous for aging adults. Additionally, the risks of these types of sleeping pills far outweigh the benefits in most cases. Studies show that most people that take both benzodiazepines and nonbenzodiazepines for sleep only sleep a little longer than patients that try alternative treatments for their insomnia.
Sleeping pills also cause greater risks for senior citizens than younger adults. For example, confusion and dizziness put older individuals at risk of falling and experiencing serious injuries, including hip fractures which are a leading cause of hospitalization and death in the elderly. Senior citizens that take sleep aids at night and then attempt to drive the next day before the side effects have worn off are also at an increased risk of being involved in a motor vehicle accident.
Consider All Options Before Choosing a Sleep Aid for the Elderly
Before you purchase an OTC sleep aid or talk to your doctor about prescription sleeping pills, you may want to explore other, safer options. As an aging adult, you’re at greater risk for both side effects and harmful drug interactions. Making a conscious effort to improve your sleep takes time and consistency. But the sleep experts at Somnus Therapy can help. Our online sleep therapy program is designed to help you identify and understand the cause of your insomnia and choose the best treatment methods and path for success.