Why Do the Elderly Have Trouble Sleeping at Night?

5 causes of sleep problems in the elderly

1. Sleep disorders

• Circadian rhythm disorder: Periodic irregularities in your circadian rhythm, the “internal body clock” that keeps your biological processes in sync, are known as circadian rhythm disorders. These sleep disorders are characterized by trouble falling asleep, waking up throughout the sleep cycle or waking up too early, and being unable to go back asleep.
• Sleep apnea: Sleep apnea is a potentially dangerous sleep problem in which your breathing regularly stops during sleep. If you snore loudly and wake up feeling fatigued in the morning, you may have sleep apnea.
• Periodic limb movement disorder: Periodic limb movement disorder is a disease that affects the muscles of the lower extremities. It involves repeated limb movements that occur during sleep and cause sleep disturbances.
• REM sleep behavior disorder: REM sleep behavior disorder, also known as dream-enacting behavior, is a sleep disorder in which you respond to vivid dreams during REM sleep by making noises and violent arm and leg movements.

2. Neurological diseases

• Parkinson’s disease: The incidence of Parkinson’s disease increases with age. It is estimated that up to 40% of people with Parkinson’s disease experience sleep problems.
• Alzheimer’s disease: Alzheimer’s disease can make you feel tired during the day and have trouble falling asleep at night.

3. Underlying medical conditions

4. Mental health disorders

Mental health disorders become more common with age, and can lead to trouble sleeping at night:

5. Medications

Medications used to treat age-related health conditions can also lead to trouble sleeping at night:

• Anticholinergics
• Antihypertensive agents
• Corticosteroids
• Histamine H2 blockers
• Diuretics
• Sympathomimetics
• Levodopa
• Herbal medicines

How to reduce sleep problems in the elderly

• Reduce screen time. Artificial lights at night can stop the body from making melatonin, which is crucial for sleep. Turning off TVs, computers, and other digital devices at least an hour before going to bed may help.
• Establish a sleep schedule. Even on the weekends and holidays, go to bed and wake up at the same time every day.
• Exercise on a regular basis. Engage in frequent physical activity. Getting regular exercise can help you fall asleep faster and stay asleep longer.
• Avoid drinking fluids before bedtime. Limit fluid intake before going to bed to reduce the amount of times you have to get up to pee in the middle of the night.
• Avoid caffeine before bedtime. Caffeine before bedtime can cause sleep disturbances. Stop having coffee, tea, and other caffeinated items at least 4hours before sleep.
• Limit alcohol before bedtime. Alcohol may initially help induce sleep but can make your sleep less deep and cause nighttime awakenings. 
• Avoid smoking at night. Nicotine is a stimulant that disrupts sleep.
• Limit sedatives and sleep aids. These have adverse effects and are not recommended for long-term use. Sleep medications don’t treat the root cause of insomnia and may possibly worsen it.