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Persons aged 65 years or older exhibit a significantly high prevalence of insomnia compared to the younger population. In many cases, people assume that sleep disorders among the elderly are a manifestation of the aging process.
This is why most cases are undertreated or simply ignored by caregivers. Well, the truth is that aging is accompanied by a slight deterioration in sleep quality. However, it is not to be mistaken as the basis for insomnia in the elderly.
An array of factors may contribute to sleep problems in the elderly, and treatment options may vary depending on the cause. This article explains sleep medication as an intervention plan for older adults struggling with insomnia.
Common Sleep Disorders Affecting Older Adults
The American Sleep Association (AMA) reports that between 50 to 70 million adults in the U.S experience at least one type of sleep disorder. There following are established types of sleep disorders in adults:
Insomnia
Insomnia stands out as the most common sleep disorder among the older adult population. It is attributed to the changes in the sleep-wake cycle as people grow older.
Sleep Apnea
It is caused by sleep-related breathing disorders whereby the airway becomes repeatedly blocked during sleep. As a result, the victim chokes or makes loud snores. It mainly affects older people with underlying medical conditions such as obesity, alcoholism, mental disorders, chronic pain, and smoking.
Circadian Rhythm Sleep Disorders
It occurs as a result of a mismatch between a person’s circadian rhythm and their immediate surroundings. This disorder affects elderly adults more because aging diminishes the body’s ability to regulate circadian rhythm.
Restless Leg Syndrome
This is caused by a neurologic disorder that makes one move their legs when the body is at rest. The leg movements result in interrupted sleep patterns at night. It also makes the victim feel tired after waking up the next day.
REM Sleep Behavior Disorder
The REM sleep stage is where people experience dreams. This disorder causes one to demonstrate physical activities in reaction to their dreams. It is common among elderly patients in care homes. The risk factors include degenerative neurologic conditions such as dementia or Parkinson’s disease that accompany aging.
What Causes Insomnia in Old Age?
Insomnia is a condition that makes it difficult for a person to fall asleep (sleep-onset insomnia) or maintain it (sleep maintenance insomnia) once they sleep. It is one of the most common sleep complaints among older people.
Generally, sleep cycles change as people age. Seniors usually achieve less sleeping time, take longer to fall asleep (sleep latency), and experience higher sleep interruptions once they fall asleep. Aging interferes with sleep architecture resulting in sleep disturbance.
Sleep architecture explains the structural pattern of sleep, also known as the sleep cycle, which a normal person undergoes in the course of the night. Under normal circumstances, the sleep cycle consists of three stages; non-rapid eye movement (NREM) sleep, followed by a stage of “slow-wave” NREM sleep, and finally the stage of rapid eye movement (REM) sleep.
The deepest peaceful sleep occurs at the slow-wave NREM stage. Studies reveal that older people have relatively lower proportions of slow-wave sleep than younger people. This explains why seniors have difficulties maintaining sleep throughout the night and subsequently experience excessive daytime sleepiness.
Apart from the involuntary physiological changes that accompany aging, the following factors may contribute to chronic insomnia in older adults.
- Medical conditions
- Stress
- Poor sleeping habits
- Mental health disorders
- Lack of exercise
How Much Sleep Do Seniors Need?
On average, seniors need between 7 to 9 hours of uninterrupted sleep to achieve full rest at night. As a matter of fact, all adults including the elderly need the same amount of sleep every night.
However, this is not always the case as many seniors suffer from sleep disorders that greatly interfere with normal sleep. The majority of older people tend to go to bed earlier and wake up earlier. They also experience daytime naps owing to night sleep disruption.
Best Medicines for Treating Insomnia in Older Adults
The following drugs have been widely used to treat sleep problems in the elderly for quite some time. However, individualized insomnia treatment like the one you can get at Fort Worth Pharmacy is the best course of action because it addresses the specific symptoms reported by the patient while preventing adverse effects on their personal health.
Benzodiazepines
Benzodiazepines (BZDs) also referred to as “benzos” work like tranquilizers. These sleeping pills are absorbed in the central nervous system, where they cause a sedation effect and muscle relaxation. Thus, they induce sleep by slowing down the functioning of the brain and body.
Zolpidem
Zolpidem is a hypnotic drug that treats insomnia in the short term by slowing brain activity. An important component of the drug is the Ambien CR (controlled release) which works by releasing the drug in phases. In the first phase, a layer of the drug will be dissolved quickly to initiate sleep. The second phase releases the drug slowly to maintain sleep. It has a good tolerance among the elderly and comes in three forms:
- Tablet – to be taken by mouth
- Sublingual tablet – to be placed under the tongue
- Oral spray – to be sprayed into the mouth
Zaleplon
This is a relatively new hypnotic used to make people fall asleep faster. It works in the same way as other seductive drugs by making brain activity slow down. Studies have shown that the drug is safe and effective in older adults for both short- and long-term treatment of insomnia.
Eszopiclone
Eszopiclone is used for short-term insomnia treatment in the elderly. These sleeping pills help maintain good sleep hygiene by decreasing sleep latency, increasing sleep durations, and preventing early morning awakening.
Trazodone
Trazodone is mainly used to treat insomnia in elderly patients with signs of depression. It balances serotonin chemicals in the brain and in the process helps maintain healthy sleeping patterns.
MT1/MT2 Receptor Agonist
Recently approved in the U.S for insomnia treatment among older adults, this drug is a game-changer in the industry. It is used on patients with chronic primary insomnia. Patients using these sleeping pills can fall asleep faster and achieve higher total sleep time without exhibiting any withdrawal symptoms.
Non-prescription Medications
Although not recommended, the following non-prescription drugs can be used for the short-term treatment of insomnia:
Antihistaminics
Antihistaminics are primarily used to treat allergies. However, they have sedating effects that can well apply to patients with insomnia symptoms.
Melatonin
Melatonin supplements help the body produce hormones that tell the brain to respond to darkness. They can be used as sleep aids to induce sleep for people experiencing difficulty falling asleep due to a delayed sleep phase.
Herbal Medicines
Some herbal medicines are well known to treat sleep problems. For example, the Valerian root is a mild sedative that can help people with insomnia to fall asleep faster. The dried hops plant is used for treating sleep deprivation and other sleep disorders and passionflowers have been used as sleep medicine for many years to improve sleep.
What is a Safe Sleep Aid for the Elderly?
The sleep medication drugs mentioned in this article are readily available in commercial pharmacies across the U.S. Although they address sleeping problems, some may have side effects and need to be carefully considered before the prescription.
Therefore, the safest sleep aid for the elderly is compounded medication because it offers a solution to specific needs and avoids instances of allergic reactions. Compounded medicines can also be in different forms (pills, liquid, spray) and flavors to suit the specific taste and preference of the patient.
When to Talk to a Doctor About Chronic Insomnia
If your attempts to resolve insomnia do not bear fruits, you may need individualized treatment. Fort Worth Pharmacy can provide a customized prescription to address your sleeping problems.
It is important to have information that will help our pharmacists accurately diagnose your sleep symptoms. Ensure you keep a diary that illustrates your sleeping patterns, drug and medication use, and exercise routine. These are your sleep hygiene measures that will assist in finding appropriate insomnia medication for you.
For more information, talk directly to our pharmacists and get prescribed sleep medications tailored to resolve your specific problem for better sleep efficiency.