Causes of insomnia in elderly.

• Chronic insomnia affects only 20% of the elderly.

• Most older people sleep OK.

• Most elderly who complain of insomnia are women.

• Sleep generally becomes lighter, shorter duration, and more fragmented in some older people.

• There are more awakenings during the night.

• Ageing can be associated with a decrease in sleep quality. This is caused by lowered melatonin levels, altered circadian rhythms, and multiple medical co-morbidities (other illnesses).

• Older people can have delayed sleep onset, and more daytime sleepiness/tiredness as a result of poor sleep.

• Deep stage 4 sleep (REM sleep) is important for good health. It allows the body to “recover”, it stabilises metabolism, and consolidates memories.

• REM sleep comes in 90 minute cycles. The percentage of time spent in REM sleep decreases with age.

• Circadian rhythm (healthy 24 hour body clock) disturbances are more severe and more disabling in people with dementia compared with healthy older adults.

• Parkinson’s disease patients frequently have sleep disturbances due to the Parkinson’s disease tremor, rigidity, restlessness and overactive bladder. They may also get nocturnal confusion, agitation, hallucinations from side effects of their Parkinson’s medications.

• These symptoms are all treatable!

• Common causes of insomnia in the elderly include-

  • restless legs

  • leg cramps

  • back pain

  • general arthritic pains

  • gastro-oesophageal reflux symptoms causing coughing at night

  • constipation.

  • breathless from heart failure

  • nightmares from drug side-effect.

  • too many day-time naps.

  • nocturia- getting up to go to the toilet on multiple occasions.

  • untreated depression.

• All of these medical problems can be treated to improve sleep in the elderly.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.