Insomnia Can Be Especially Harmful to Older Adults

Tossing and turning throughout the night, difficulty falling asleep, and nonrestorative sleep are all hallmarks of insomnia. Studies suggest that insomnia is rather common in older adults, and the consequences of persistent lack of sleep can be dire in later decades in life.

“One of the most strongly demonstrated negative health impacts of insomnia in older adults is its association with cognitive issues and mental illness,” explains sleep specialist Joshua Roland, MD, clinical instructor, David Geffen School of Medicine at UCLA. “Many studies have shown an increased risk of depression and even dementia associated with insomnia. There also is a general notion that as we get older sleep is supposed to get worse. While there are changes in sleep that occur with age, to be at their best, older adults still generally need the same amount of sleep as they did when they were younger.”

In addition to mental-health issues, insomnia has been linked to heart disease, high blood pressure, heart attacks, issues controlling blood sugar, and even an increased cancer risk. While a few sleepless nights probably won’t cause any lingering health harms, the longer you don’t sleep well, the more havoc lack of sleep can wreak. Some daytime symptoms suggestive of insomnia include feeling fatigued, foggy-headed, irritable, drained, and unable to concentrate. Anxiety also can be a symptom or a cause of insomnia. It is difficult to untangle, but it’s logical that lack of good sleep can make a person feel anxious. Restoring sleep may abate those feelings, revive energy, increase concentration, and boost mood.

Definition and Diagnosis

The National Sleep Foundation identifies two primary categories:

Short-term (acute) insomnia lasts a few nights. This can be caused by event-related stress, such as the death of a loved one, a serious medical diagnosis, or divorce. Many people in this category do resume better sleep, though it may be difficult and may require patience and assistance from sleep specialists.

Long-term (chronic) insomnia lasts a month or longer, sometime years. This is typically caused by an underlying medical or psychological problem, another sleep disorder (e.g. restless legs syndrome), poor health habits (e.g., inconsistent sleep/wake patterns, lack of exercise, excessive caffeine or alcohol), and also may be the side effect of some medications (e.g., alpha blockers, beta blockers, statins).

The Gold Standard Treatment

Over-the-counter and prescription sleep aids may be appropriate periodically or in the short term for acute insomnia. These drugs will certainly put you to sleep, but not necessarily in the right kind of sleep. Sleep is a complex process involving several distinct cycles—all of which are needed for good health. Also, sleep medications may create dependence or cause worrisome side effects (e.g., increased fall risk, sleep walking, dementia). There is, however, a non-drug choice that is quite successful. It’s called cognitive behavioral therapy for insomnia, or CBT-I, and is considered the gold standard treatment.

“CBT-I, is a psychological and behavioral approach to treatment and the first-line therapy for insomnia in any age, including older adults,” says Dr. Roland. “Not only are there no side effects, it actually has been shown to be more effective in the long run than medications. CBT-I works on fixing insomnia at the source of the problem. It requires some work and consistency on the part of the patient, but CBT-I is highly recommended for treating chronic insomnia.”

CBT-I therapy lasts four to 12 weeks and is administered by a sleep specialist. This could be a psychologist, psychiatrist, physicians, or others trained to work in this area. The therapy includes several strategies, such as consistently practicing good sleep hygiene (e.g., sleeping in a cool, dark, and quiet room), learning techniques to reduce stress and aid muscular relaxation (e.g., deep breathing, mindfulness meditation) as well as other techniques, such as cognitive therapy and sleep restriction.

Telemedicine: CBT-I Help Online

Online CBT-I options have been found to work quite well. “Studies have shown that CBT-I can be effectively delivered via telemedicine, almost to the same extent as in-person visits,” says Dr. Roland. “There are several apps on the market that can provide CBT-I programs, such as SHUTi and Sleepio, which run somewhere in the $100-$400 range, as well as some that are free, such as CBT-I Coach. The U.S Department of Veterans Affairs also has a great free course to help with CBT-I called “Path to Better Sleep.” Find that VA course at https://tinyurl.com/VACBTI.

The post Insomnia Can Be Especially Harmful to Older Adults appeared first on University Health News.

Read Original Article: Insomnia Can Be Especially Harmful to Older Adults »