Solutions for sleeplessness

Insomnia or reduced duration of sleep affects more than 60 per cent of those above the age of 60. All healthy adults including the elderly require 7-9 hours of overnight sleep to remain physically active and intellectually productive. Common reasons for insomnia in the elderly include multiple stressors, loneliness, depression, pain due to arthritis, osteoporosis and diabetic neuropathy, frequent urination, Parkinson’s Disease, Alzheimer's Disease, etc.

The patient along with caring family members should work in unison with the family physician to identify the exact reason of sleep deprivation so that it can be rectified rather than providing symptomatic therapy with sedative pills.

There is a common myth that with advancing age, people require less sleep. This is not true. The time spent in Rapid Eye Movement Sleep (REM) may be shortened with frequent awakenings but the total normal duration of 6-9 hrs remains the same.

It is important to cultivate healthy sleep hygiene such as avoiding caffeine, nicotine and other stimulants before going to sleep. Consumption of alcohol may initially promote sleep but subsequently inhibits REM sleep and results in further fragmentation of sleep rhythm.

Prolonged day time sleeping will aggravate insomnia. Avoid exercise very close to bed time. Reduce ambient light at least one hour before going to bed. Viewing television, working with computer and mobile phone close to sleeping time will result in light stimulating the retina and worsening insomnia. Sedatives are very commonly prescribed but one needs to be cautious on development of addiction, tolerance and possibility of falls.

Insomnia can result from disorders of body, mind or both. Proper identification and treatment helps in preserving health and happiness in old age.

(The author is a consultant in geriatrics and was instrumental in starting the geriatric unit in Trivandrum Medical College)