Sleep is a barometer of good health in the elderly. Sleep problems in the elderly are controlled by various external and internal factors.

Sleep disturbances in the elderly can lead to changes in the physiological systems, such as a reduction in the production of appropriate hormones, like the growth hormones, and also a decline in the metabolic functioning.

Most people accept sleep difficulties as a fact of the ageing process.Most often  sleep problems in the elderly are due to disease, environment, or lifestyle and not due to the "the normal ageing" process.

Sleep disorders in the elderly involve any disruptive pattern of sleep such as problems with falling or staying asleep, excessive sleep, or abnormal behaviors associated with sleep.

• Difficulty falling asleep
• Difficulty telling the difference between night and day
• Early morning awakening
• Waking up frequently during the night

The relief of chronic pain and control of underlying medical conditions such as frequent urination may improve sleep in some people. Effective treatment of depression can also improve sleep.

Sleep-promoting interventions such as a quiet sleep environment and a glass of warm milk before bed may improve the symptoms. Other ways to promote sleep include following a healthy lifestyle and the following steps:

• Avoid large meals shortly before bedtime.
• Avoid stimulants such as caffeine.
• Get regular exercise, early in the day.
• Go to bed and wake up at the same time every day. (Don't take naps.)
• Use the bed only for sleep or sexual activity.
• If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music.

The use of sleeping pills to promote sleep on a long-term basis should be avoided, if possible. They can lead to dependence and worsening sleep problems over time if not used correctly.

• If needed, sleeping pills such as Ambien and Lunesta are relatively safe when used properly.
• It is best to NOTtake sleeping pills on consecutive days or for more than 2 - 4 days a week.
• Alcohol can make the side effects of all sleeping pills worse and should be avoided.

Sleeping problems are common in the elderly. In general, older people require less sleep, and their sleep is less deep than that experienced by the young. Some causes or contributors to sleep disturbances in older adults include:

• A need to urinate frequently at night
• Chronic pain caused by diseases such as arthritis
• Chronic diseases such as congestive heart failure
• Depression (depression is a common cause of sleep problems among people of all ages)
• Neurological conditions
• Alzheimer's disease
• Organic brain syndrome
• Prescription drugs, recreational drugs, or alcohol
• Sedentary lifestyle
• Stimulants such as caffeine

The physician will perform a physical exam to rule out medical causes. Diagnosis is also based on the patient's history of sleep disturbances and other contributing factors.

Most people see improvement in sleep with treatment or interventions. However, others may continue to have persistent sleep disruptions.

• Sleep disorders in older patients can arise from multiple and diverse factors.
• Older patients with either short or long sleep duration need thorough evaluation. A careful review of sleep history and sleep hygiene, a comprehensive history of drug use, reports from spouse, sleep logs, and education regarding age-related sleep change should be integral parts of the evaluation of sleep disturbance.
• Use hypnotics with extreme caution and only for transient sleep disturbances.
• The most common primary sleep disorders in older people are sleep apnea, periodic limb movements in sleep, or both.
• In summary, clinicians must reevaluate the approach to treating the widespread sleep complaints of the older population.

A complication is alcohol use or drug abuse with the intent of improving sleep.

Contact doctor if lack of sleep or too much sleep is interfering with daily living.