8 Tips to Help Older People Fall — and Stay — Asleep
One-third of people over age 65 take something to help them sleep, but these medications can pose real risks. What can you do?
Half of older Americans have trouble sleeping at least some of the time — and one-third are popping something in their mouths to try to get more zzz’s.
Those are two startling statistics, when you think about them. After all, sleep is one of our most fundamental needs — right up there with water and food.
Yet these new data from the National Poll on Healthy Aging show serious sleep issues among people over age 65.
This tendency to rely on medicines and supplements as sleep aids, which the poll shows 37 percent of older people take occasionally or regularly, worries poll director Preeti Malani, M.D., of the University of Michigan. Research has shown the risks of sleep medications — especially prescription ones — for older adults.
Side effects of over-the-counter drugs include confusion, urinary retention and constipation because of the diphenhydramine (an antihistamine) in many sleep aids.
And melatonin, a common “natural” sleep aid, is largely unregulated in the U.S., so the amount of melatonin can vary widely between bottles. The few available studies suggest it may lengthen sleep by only 15 minutes and may cause grogginess the next day.
Meanwhile, medical guidelines strongly warn against prescription sleep medicines for older people. They can increase the risk of confusion, dizziness and memory issues that can lead to falls, car accidents and more.
“Although sleep problems can happen at any age and for many reasons, they can’t be cured by taking a pill, either prescription, over-the-counter or herbal, no matter what the ads on TV say,” says Malani, a geriatrician and infectious disease specialist. “Some of these medications can create big concerns for older adults, from falls and memory issues to confusion and constipation.”
Among the poll respondents who reported sleep troubles three or more nights a week, 23 percent used a prescription sleep aid.
Most who use such drugs to help them sleep had been taking them for years. But manufacturers and the Food and Drug Administration say the drugs are only for short-term use by any adult.
What older adults can do
Before medication, try sleep habit changes to foster healthy sleep, Malani says.
Research backs these tips:
Keep the same sleep schedule every day, even on weekends and when you’re traveling.
Stick to a bedtime routine: Use reading, soothing music or a warm bath or face-washing to cue your body and brain that it’s time to wind down.
Keep gadgets and screens out of the bedroom: From smartphones to TVs to laptops, both what they show you and how their “blue” light influences your brain can interfere with sleep.
Limit or stop consuming caffeine in the afternoon and evening: It can interfere with your ability to get to sleep later in the day, so swear off coffee, tea or caffeinated soda at dinner.
Try not to nap during late afternoon or evening: This can throw off your sleep cycle.
Don’t use alcohol to help you get to sleep: When its effects wear off in the middle of the night, you may wake up and have a hard time getting back to dreamland.
Cut back on all liquids late in the day: A full bladder can wake you up in the night.
Talk it out: Research has shown that a form of “talk therapy” can help people with serious sleep issues. You can get insomnia-related cognitive behavioral therapy from psychologists and clinical social workers trained to provide it.
Taking steps to improve your sleep, rather than just living with sleep problems, is crucial. Poor sleep can get in the way of how you function during the daytime, and it has been linked with memory issues, depression and an increased risk of falls and accidents.
Before you turn to medication or supplements, talk to your doctor about your sleep, Malani says.
Nearly half the people in the recent poll hadn’t taken this crucial step — but many of those who did reported that they got useful advice.
If pain in particular is keeping you up, work with your doctor and other health providers to address the pain, and describe its impact on your sleep so they are aware.
Learn more about sleep
A team of U-M sleep medicine experts and researchers created a free online course on sleep deprivation strategies and solutions, open to “anyone who sleeps, ever gets too little sleep or ever wakes up wishing they could sleep more or sleep better.”
The poll is based at U-M’s Institute for Healthcare Policy and Innovation and is funded by AARP and Michigan Medicine.