Insomnia and Sleep Problems

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1. What are Insomnia and Sleep Problems?

Insomnia is a disturbance of sleep. Some people have problems falling asleep at night and others have problems staying asleep.  Some people feel they sleep well at night, but may have difficulty staying awake during the day time.

2. How common are Insomnia and Sleep Problems?

Sleep problems are very common in the elderly. It is estimated that 40% of elderly people have trouble falling asleep at night, 30% have repeated awakenings, 20% wake up too early in the morning and 20% suffer from daytime sleepiness.

3. What Causes  Insomnia and Sleep Problems?

Sleep problems are often caused and exacerbated by underlying psychiatric illness’ such as depression and dementia and can be made worse by many physical  diseases and medications.  Therefore, it is very important to have a thorough assessment by your doctor prior to starting any sleeping medications. Insomnia can also be exacerbated by caffeine, alcohol , lack of exercise or too much stimulation in the evening.

4. What can my doctor do for Insomnia and Sleep Problems?

Your doctor will do a thorough assessment of the nature of your sleep problems as well as your physical and mental health.  She or he will rule out other causes of sleep problems such as chronic pain , excessive urination, restless leg syndrome, sleep apnea or any heart, lung or neurological problem that may affect your sleep.  Your doctor will treat any underlying condition, stop any drugs that may worsen your sleep and advise you on proper sleep hygiene before treating you with sleeping pills. Sleeping pills are associated with numerous side effects in the elderly including: memory problems, falls and fractures, and addiction.  Therefore, they should only be used as a last resort for people with insomnia which is affecting their quality of life and impairing daily functioning

5. What can I do for Insomnia and Sleep Problems?

  • Eliminate caffeine- which is found in coffee, black and green tea, cola, dark chocolate and certain medications (e.g. acetaminophen with codeine). Caffeine can accumulate in older people and take much longer to excrete from their bodies. This can lead to increased arousal and poor sleep.It may take a few days to eliminate all the caffeine from your body. If you must consume caffeine, try not to take any after lunch
  • Reduce or eliminate alcohol. Although alcohol can make you drowsy, it may lead to hyper-arousal when you wake in the middle of the night as well as causing people to wake up to pass urine.
  •  Do not watch TV or read from a computer or tablet (such as an IPAD). The light from these devices can shut down the production and release of natural melatonin which signals to our brain and body that it is time to sleep
  • Exercise during the day, but avoid exercising in the evening because this may increase one’s alertness
  • Do not go to bed hungry, thirsty or cold. Make sure that your bed is physically comfortable
  • Try to do your major thinking and planning before bed time and relax when you get into bed.  Only use your bed for sleep and try not to lie in it except for this purpose
  • Avoid over the counter sleep aids such as antihistamines (eg Gravol TM).  These drugs can cause memory problems, urinary retention and constipation. They often stop working after a few weeks of continuous usage
  • Melatonin at bedtime may help some people who have significant problems falling asleep

6. Where can I find more information about Insomnia and Sleep Problems ?

More information can be found at the following sites:

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