Insomnia in the Elderly

Insomnia is more frequent in the elderly population than in any other age group.

Overview

  • 28% report difficulty falling asleep, and 46% both falling & staying asleep.
  • Leads to deterioration in daytime alertness and functioning.
  • Sleep changes characteristic in late life include:
    • decreased total sleep time
    • frequent arousals (increased % of Stage 1 and Stage 2 sleep)
    • decreased deep sleep (3 and Stage 4 sleep)
    • decreased rapid eye movement (REM) latency & amounts
    • a tendency to exhibit redistribution of sleep (e.g., napping during the day).
  • Many of these sleep changes are similar to those that occur in depression and dementing disorders, although not as severe.
  • Older persons are also more likely to phase-advance in the sleep cycle, with a phase tendency toward “morningness.”
  • Determining underlying causes of insomnia and exploring sleep hygiene key.

Sleep disturbances leading to insomnia in the elderly

  • Primary insomnia
  • Sleep-disordered breathing (i.e., sleep apnea)
  • Nocturnal myoclonus or periodic leg movements
  • Sleep–wake schedule disorder

Secondary causes of insomnia

  • Sleep problems secondary to medication use
  • Anxiety disorders
  • Mood disorders
  • Dementing disorders
  • Comorbid physical illness (e.g., congestive heart failure, chronic obstructive pulmonary disease, nocturia)

Our geriatric psychiatrist, Dr. David Merrill, offers kind, compassionate, thorough clinical evaluations and follows depression treatment guidelines, helping the patient to stay connected with the activities and people who matter to them. Contact us at 310-582-7641 to schedule a consultation.

Depression

Anxiety