Why Mom and Dad Can't Sleep and What You Can Do to Help

Because of multiple stressors in today’s society, many Americans take sleeping medications to fall and stay asleep. But did you know it's actually the elderly population that is the most susceptible to sleep disorders?

Why?

The natural aging process causes your parent to spend less time in stages 3, 4 and REM sleep. This is important because these are the stages of sleep that are restorative and responsible for that well rested feeling. As a result, sleep for your parent tends to be lighter, causing more frequent awakenings.  Consequently, this interruptive sleep can cause excessive daytime fatigue, leading your parent to take a daytime nap.  This nap makes then makes it harder for them to then fall asleep at night, and a vicious cycle of inadequate sleep, compensated for by daytime naps occurs. But even if your parent doesn't nap, such interruptive sleep has the potential to threaten their health “leading to cognitive impairment, resulting in an increased risk for accidents, falls, and the inability to carry out daily tasks.”

What can you do? Follow these 4 steps to get your parent back on track:

1. Identify if your parent has any of the following medical conditions.

If these conditions aren’t being treated and/or are not under control, they can cause insomnia. Be sure to contact your parent’s doctor if you’re unsure if they have any of these conditions and if they are controlled or not. 

• Depression 
• Anxiety 
• Psychosis
• Parkinson’s disease 
• Dementia 
• Lung disease 
• Endocrine disorders (ex. Diabetes, Thyroid conditions)
• Arthritis
• Acute and chronic pain 
• Nocturia (waking up at night to urinate)

2. Identify medications your parent is taking that can cause insomnia.

Check and see if your parent is taking any medications on this list (note: this is not a complete list). Contact their doctor about switching to a different medication or adjusting the dose.

• Amantadine
• Bupropion
• Clonidine
• Corticosteroids
• Central Nervous System Stimulants (i.e. amphetamines)
• Decongestants (i.e. over-the-counter medications like Sudafed)
• Levodopa
• Lithium
• Methyldopa
• Propanolol
• Selegiline
• SSRI (anti-depressants)
• Diuretics (HCTZ)

3. Establish Sleep Hygiene Practices

Make sure your parent has a comfortable environment that is conducive to sleep. For example, ensure their room is dark enough, the room is at their preferred temperature, and the bed is comfortable for them.  Have them stick to a regular sleep schedule, limit day time naps, and avoid alcohol.  Be sure to restrict their intake of fluids before bedtime to lessen their use of the bathroom in the middle of the night.

4. Practice Stimulus Control as Follows:

• Go to bed only when sleepy
• Use the bed and bedroom only for sleep. This means no reading, watching TV, or worrying in bed or the bedroom during the daytime or at night
• Get out of bed and go to another room when unable to fall asleep within 15 to 20 minutes
• Repeat step 3 as often as necessary, either when trying to fall asleep or to get back to sleep
• Arise at the same time every morning, regardless of the amount of sleep obtained the previous night.

Additionally, having a Comprehensive Medication Review will identify and eliminate medication-related problems. Doing so will ensure that any medication your parent takes that has a direct or indirect impact their sleep habits (or any other medical condition) will be identified and replaced with a medication that works just as well, but doesn't negatively impact sleep quality.