For all adults, dealing with persistent sleeping problems can be frustrating, confusing, and literally tiresome. There are not always simple or fast-acting solutions to getting more sleep, and sometimes many factors are at work in causing insomnia. The good news is that in many cases, there are steps that can be taken to help older people fall asleep and stay asleep.
See Your Doctor
An important first step can be to talk with your doctor. In a significant number of cases, insomnia is caused by an underlying health condition or by a medication that you’re taking. Your doctor can start by reviewing your health history and list of current medications. If you have an already-diagnosed health condition, the doctor can address whether there are any other treatments that may be available to try to manage it. If you haven’t been diagnosed with any health issues that might be causing insomnia, your doctor can begin an appropriate diagnostic process to try to bring you relief. In most cases, resolving or mitigating a coexisting health problem can stop or substantially reduce insomnia.
Talking with your doctor is especially important if you have experienced any symptoms of sleep apnea. Because this condition can be related to a number of serious medical problems, diagnosing and managing it can improve your sleep and your overall health. Sleep apnea can usually be resolved by wearing a positive airway pressure (PAP) device at night. The most common of these is a continuous positive airway pressure device (CPAP). The CPAP maintains a flow of air through a mask that prevents the obstruction of the airway. It can take some time to adjust to wearing the mask, but today’s masks are lighter and better cushioned than in the past. People with sleep apnea typically adjust to using the CPAP within a few days and find that they get dramatically better sleep.
Another way that your doctor can help is by offering a referral to a mental health counselor. Or if you already have a counselor that you work with, be sure to let them know about your sleep problems.
In some cases, the underlying conditions that are affecting sleep are psychological. Issues like depression and anxiety, even if they are mild, can play a role in sleeplessness. A type of talk therapy called cognitive behavioral therapy for insomnia, which is abbreviated CBT-I, can involve a number of types of discussion and reflection. Studies support the effectiveness of CBT-I led by a trained professional. It can help to work through underlying issues and pave the way for more consistent and restful sleep.
Be Wary of Sleep Medications
Many people suffering from sleep difficulties immediately think about medications as a way to help them sleep. Taking drugs to help with sleep problems is referred to as pharmacotherapy, and this includes both prescription and over-the-counter sleep aids. Remember that medications like these, even when they bring some relief, are not a cure for insomnia. Pharmacotherapy typically is not the best way to deal with sleep problems for a few reasons.
First, even though drugs may have strong effects at the outset, they usually become less and less effective over time. The amount of time this may take can vary based on the person and the medication, but diminishing returns are common. Second, sleep medications can be habit-forming. Relying on a medication to get to sleep can create dependencies that make it harder to ever get back to falling asleep naturally. Third, as with most medications, there are side effects, some of which can be serious. One of the most common is a grogginess or fogginess that can persist after having woken up. This can slow reaction times and raise the risk of falls or car accidents. Fourth, detailed research studies are not available for many pharmacotherapies. While broad studies may have been conducted, those studies usually do not provide specific guidance about the drug in terms of its interactions with other drugs, about its effects on people with coexisting medical conditions, about how it influences sleep architecture, or about its safety and efficacy in this particular demographic group.
If you do decide to use a sleep medication, whether it be prescription or over-the-counter, talk to your doctor first. Your doctor is in the best position to address any potential concerns or instructions for using these medications in your situation.
Improving Your Sleep Without Medications
Besides treating any underlying medical issues that can contribute to insomnia, there are a handful of other steps that you can take to improve your ability to get good sleep.
Physical activity: studies have indicated that adding regular exercise to your day may help with sleep problems. You want to make sure to exercise at least 3 or more hours before bedtime, and it is also helpful to consult with a health professional before beginning a new exercise routine. This can help to ensure that your exercises are appropriate given your overall health and any coexisting medical conditions.