What do old people do when they can't sleep? Practical tips & solutions

According to the National Institute on Aging, insomnia is the most common sleep problem among adults aged 60 and older. Addressing the underlying causes and adopting new strategies is key to improving sleep quality. This guide explores the most effective ways to cope with sleeplessness, answering the question: what do old people do when they can't sleep?

Quick Summary

Older adults who can't sleep often turn to improved sleep hygiene practices, such as maintaining a consistent schedule, creating a relaxing bedtime routine, and optimizing their sleep environment. They also utilize behavioral strategies like cognitive behavioral therapy and consult with healthcare providers to address underlying issues like pain, medication side effects, or sleep disorders.

Key Points

• Get Out of Bed When Awake: After 20 minutes of lying awake, move to a different room to do a quiet activity like reading to break the cycle of anxiety.

• Maintain a Consistent Schedule: Going to bed and waking up at the same time each day helps regulate the body's natural sleep-wake cycle.

• Optimize the Environment: A dark, quiet, and cool bedroom, free of screens, is essential for promoting deeper, more restful sleep.

• Review Diet and Habits: Avoid caffeine, alcohol, and large meals close to bedtime, and limit afternoon napping to improve nighttime sleep quality.

• Consider Cognitive Behavioral Therapy (CBT-I): For chronic insomnia, CBT-I is a highly effective, non-drug treatment that addresses the root causes of sleeplessness.

• Consult a Doctor for Underlying Issues: Medical conditions like sleep apnea or medication side effects can cause insomnia and require professional diagnosis and treatment.

Understanding Sleep Changes in Older Adults

It's a common misconception that less sleep is a normal part of aging. While sleep patterns do shift—leading to lighter, more fragmented sleep—the need for 7 to 9 hours of rest per night remains consistent. Understanding the root causes of sleeplessness is the first step toward finding effective solutions.

Why Sleeplessness Increases with Age

Several factors contribute to age-related sleep disturbances:

• Circadian Rhythm Shifts: The body's internal clock changes, causing some seniors to feel tired earlier and wake up earlier.
• Health Conditions: Chronic pain from arthritis, heart disease, or restless legs syndrome can disrupt sleep.
• Medications: Many common prescription drugs, including diuretics, antidepressants, and beta-blockers, can interfere with sleep.
• Lifestyle Factors: Lack of physical activity, social engagement, and sunlight exposure can disrupt the sleep-wake cycle.
• Psychological Impact: Depression, anxiety, and grief can severely impact sleep patterns.

Practical Strategies for When You Can't Sleep

When lying awake, older adults can take proactive steps to either wind down or get back to sleep. These are often non-medicated approaches recommended by experts as the first line of defense.

Get Out of Bed for a Quiet Activity

If you've been awake for more than 20 minutes, don't stay in bed and worry. Get up and go to another room. Engage in a calm, non-stimulating activity until you feel sleepy. This trains your brain to associate the bedroom only with sleep.

• Read a book: Choose a physical book or an e-reader without a backlit screen. Avoid stimulating or suspenseful topics.
• Listen to soothing music: Put on some relaxing, quiet music or a podcast. Use headphones if a partner is sleeping.
• Practice a relaxation technique: Gentle stretching, deep breathing exercises, or meditation can calm your mind and body.

Optimize Your Sleep Hygiene

Good sleep hygiene is a set of healthy habits that can significantly improve sleep quality. While simple, these practices are often overlooked.

• Maintain a consistent schedule: Go to bed and wake up at the same time every day, even on weekends. This reinforces your body's sleep-wake cycle.
• Limit naps: If you must nap, keep it short (under 30 minutes) and take it earlier in the day to avoid disrupting nighttime sleep.
• Create a relaxing bedtime routine: Establish a nightly ritual to signal to your body that it's time to wind down. This could include a warm bath, reading, or listening to music.

Adjust Diet and Environment

What and when you consume food and drink, along with your bedroom environment, plays a crucial role in restful sleep.

• Limit stimulants and alcohol: Avoid caffeine and alcohol in the afternoon and evening. Both can interfere with falling and staying asleep.
• Eat wisely: Avoid large or spicy meals close to bedtime, which can cause indigestion. A light, healthy snack, like a small bowl of cereal, may be fine.
• Manage fluids: Reduce liquid intake later in the day to prevent nighttime bathroom trips.
• Make your bedroom a sanctuary: Keep the room dark, quiet, and cool. Consider blackout curtains, earplugs, or a white noise machine.

Addressing Underlying Issues with a Professional

Sometimes, sleeplessness is a symptom of a deeper issue. It's essential to consult with a doctor to rule out or treat underlying medical or psychological causes.

Medical and Psychological Solutions

Your doctor may suggest various treatments, depending on the diagnosis.

• Cognitive Behavioral Therapy for Insomnia (CBT-I): A highly effective, non-drug therapy that targets the thoughts and behaviors preventing good sleep. It can have lasting results. For more information on this evidence-based approach, see the American Academy of Sleep Medicine's guide on CBT-I.
• Medication Review: A doctor can review your current medications to see if side effects are contributing to sleeplessness and suggest adjustments.
• Treatment for Underlying Conditions: Addressing conditions like sleep apnea or restless legs syndrome can significantly improve sleep.

Comparison of Sleep Improvement Strategies

Strategy	Description	Best for...
Get Out of Bed	Leaving the bedroom after 20 minutes and doing a quiet activity to reset sleep association.	People who toss and turn or feel anxious about not sleeping.
Good Sleep Hygiene	Establishing consistent routines and optimizing the bedroom environment.	Proactive, daily management of sleep patterns.
Dietary Changes	Limiting caffeine, alcohol, large meals, and fluids before bed.	Controlling external factors that disrupt sleep.
CBT-I	Therapy focused on changing thoughts and behaviors related to sleep.	Long-term, chronic insomnia sufferers seeking non-drug solutions.
Medical Review	Consulting a doctor to check for underlying health or medication issues.	Diagnosing and treating medical causes of sleeplessness.

Conclusion: Taking Control of Sleepless Nights

Sleeplessness is a frustrating experience, but for older adults, it doesn't have to be a permanent reality. By combining proactive, at-home strategies like maintaining a consistent sleep schedule and optimizing the bedroom environment with professional medical consultation, it is possible to regain restful nights. The key is to be consistent with good habits and seek help when needed. Focusing on non-drug interventions first and treating any underlying conditions can lead to sustainable improvements, allowing seniors to enjoy the healthy, restorative sleep they need for overall well-being. The simple act of creating a peaceful, sleep-conducive routine can make all the difference in turning a frustrating night into a calm, restful one.

Frequently Asked Questions

What is the 20-minute rule for insomnia?

The 20-minute rule advises that if you haven't fallen asleep after 20 minutes of getting into bed, you should get up and do a quiet, non-stimulating activity in another room. The goal is to break the association between your bed and being awake and stressed.

How do older adults naturally increase melatonin?

Older adults can naturally boost melatonin by increasing their exposure to bright daylight during the day and reducing exposure to artificial blue light from screens in the evening. Some individuals also find supplements helpful, but this should be discussed with a doctor.

Are daytime naps bad for senior sleep?

Long or late afternoon naps can disrupt nighttime sleep patterns. Keeping naps short (under 30 minutes) and early in the day helps maintain a healthy sleep-wake cycle. Some seniors may find that avoiding naps entirely improves their nighttime rest.

Can exercise help older people sleep better?

Yes, regular physical activity can significantly improve sleep quality. However, it's best to avoid exercising within three hours of bedtime, as it can be too stimulating. A brisk walk in the afternoon is often ideal.

What kind of drinks should older people avoid before bed?

Older adults should avoid caffeine, alcohol, and excessive fluids in the hours leading up to bedtime. While alcohol may initially cause drowsiness, it disrupts sleep later in the night. Limiting fluids reduces the need for nighttime bathroom trips.

When should an older adult with sleep problems see a doctor?

If you consistently struggle to fall or stay asleep, or if daytime fatigue affects your daily activities, it's time to see a doctor. A healthcare provider can rule out underlying medical conditions or review medications that may be causing the problem.

How does sleep apnea affect older adults?

Sleep apnea, where a person repeatedly stops breathing during sleep, is more common in older adults and can severely disrupt sleep. Signs include loud snoring and gasping sounds. It is a serious condition that requires medical attention to treat.