Ian McDonald

As we age, sleeping can become more difficult and new challenges can arise. Insomnia and obstructive sleep apnea most commonly affect adults over age 65 due to age-related diseases, medication, arthritis pain and bladder issues. Disturbed sleep, waking tired everyday and other sleep loss related symptoms are not a normal part of aging. Sleep is important to your well-being no matter your age.

Older adults are recommended 7-9 hours of sleep each night. An adequate amount of sleep is crucial for older adults because sleep helps maintain memory, cognitive functions and overall physical well-being.

Adults that do not receive an adequate amount of healthy sleep may suffer a variety of
short- and long-term effects. Some sleep disorder symptoms that older adults may experience include:

  • Difficulty concentrating
  • Memory problems
  • Daytime fatigue
  • Increased daytime and/or nighttime falls
  • Anxiety
  • Depression

Trouble Sleeping

Sleep is essential for overall mind and body health, which is why it’s so important that potential sleep disorders are promptly diagnosed and treated. Common sleep disorders among older adults include:

  • Insomnia
  • Obstructive sleep apnea (OSA)
  • Restless leg syndrome (RLS)

Insomnia is described as trouble falling or staying asleep. It can usually be harder for those aged 65 and older to stay asleep throughout the night because of a lower production of melatonin and the use of some medications. Restless sleep can occur as a result of repeated awakening and difficulty going back to sleep.

Obstructive sleep apnea is characterized by repeated involuntary pauses in breathing during sleep. It may occur hundreds of times throughout the night due to the partial closure of the airway. Symptoms include loud snoring, abrupt awakenings caused by gasping or choking, fatigue, and observed episodes of stopped breathing during sleep. OSA can cause a variety of health issues such as stroke, heart disease or high blood pressure. Excessive daytime sleepiness is one of the leading side effects of untreated sleep apnea.

Restless leg syndrome occurs from unpleasant sensations in the legs and uncontrollable urges to move. More than 80 percent of people with restless leg syndrome also experience a more common condition known as periodic limb movement disorder (PLMD). The risk of PLMD increases with age and medication use, causing it to occur in up to 34 percent of people over 60. Symptoms include repetitive leg movements in one or both legs, restless sleep and waking up in the middle of the night.

Medications that Affect Sleep

Older adults have typically prescribed medications such as antidepressants, beta-blockers, diuretics and corticosteroids that can negatively impact sleep. Side effects such as frequent awakening, unpleasant dreams, tremors, achy joints and muscles, nausea and changes in heart rhythm should be discussed with a physician when they impact normal daily functioning. Doctors may prescribe new medications or change dosage levels to improve the quality of sleep.

Diagnosing Sleep Disorders

The Sleep Disorders Center at MemorialCare Long Beach Medical Center performs sleep studies to help people identify their sleep challenges. In order to properly diagnose sleep disorders, a physician must conduct a sleep study in a sleep lab, usually overnight. A sleep study monitors activity during sleep such as measuring brain waves, heart rate and rhythm, breathing patterns and oxygen levels.

A polysomnogram, otherwise known as a sleep study, is the most accurate test used to diagnose a sleep disorder. During a sleep study, a patient’s brain waves, heart rate, breathing patterns, oxygen levels in the blood, as well as eye and leg movement, are recorded. 

Better Sleep for Older Adults

Older adults can achieve better sleep with some simple lifestyle changes. Tips for healthy sleep include:

  • Exercising more
  • Assessing medication ingredients
  • Monitoring fluid intake to prevent frequent bathroom visits
  • Removing bedroom distractions, such as televisions and other electronic devices

If symptoms of a sleep disorder persist, a variety of medical treatment options are available. Older adults can visit a doctor and undergo a sleep study to determine which treatment is best. Common treatment options include:

  • Continuous positive airway pressure (CPAP)
  • Bi-level positive airway pressure (BiPAP)
  • Behavioral therapy
  • Medication or supplements

CPAP is the primary treatment for obstructive sleep apnea. It is a small mask or nasal cannula that is applied to the nose and connected by tubing. Air pressure that enters the body is controlled by a generator and prevents the airway from collapsing. Treatment is typically effective immediately.

BiPAP is a variation of CPAP and includes high pressure air being delivered when a patient breathes. It is often recommended when lung disease is present but can also be a treatment option for obstructive sleep apnea.

Behavioral therapies involve structured routines that help identify and replace behaviors that may disrupt sleep. It includes education on proper sleep hygiene and personalized care.

Medications are not usually recommended as long-term treatment options. Patients should talk with their physician to determine if this option is necessary.

If you think you or a loved one is suffering from sleep disorder symptoms, talk to your doctor immediately. Find a primary care physician who can help.