Insomnia is a serious medical condition that is under recognized, under diagnosed, and under treated in America. Despite being a common complaint among elderly people (aged 65 years and older), sleep disorders are rarely systematically diagnosed and treated, even by doctors who specialize in treating older patients.
The Condition- Insomnia
Insomnia is an especially serious problem among older individuals because of its widespread prevalence and because poor sleep can have detrimental consequences for many of the aspects of vitality and resilience required for successful aging. Sleep disturbances among the elderly are associated with significant increases in disease and mortality and increased nursing home placements. Insomnia is also correlated with risk for falls. Sleep maintenance, rather than sleep initiation, is the most commonly reported problem among older people with sleep disturbance, which can have serious consequences. However, while a range of treatment options exists, there is currently a lack of prescription drugs that provide an optimal balance of safety and efficacy. Ideal health outcomes would include improved sleep initiation, sleep maintenance without next-day residual effects, and, ideally, improved next-day functioning.
The Rx Sleep Aid Approach
Older people tend to take a lot more pills than younger people; and they have much higher rates of insomnia. This is often the result of secondary insomnia, a condition whereby the insomnia is a symptom of other health problems, which are very common in older people, as well as the side effects of drugs they might be taking for other medical conditions.
Medical experts are cautious about prescribing drugs for insomnia, but they are often prescribed anyway; and hopefully harmful side effects are carefully monitored. The most common insomnia drugs are classified as sedatives, minor tranquilizers, and antianxiety medications. These drugs are risky for older folks and folks with breathing problems because they suppress the areas of the brain that control breathing.
Rx drugs for insomnia are often very habit forming. This is made worse in older people because of all the other drugs they take, which can easily result in complicated drug interactions and more harmful side effects. Seniors experience the same side effects as younger people, but their bodies are less able to cope with the effects.
All drugs can easily become a crutch. This is unfortunately true in nursing homes where Rx drugs are used a lot to manage patients. It’s understandable in a way because nursing home staff have to manage a large group of people; and it’s easier to have everybody awake or asleep at the same time. Nursing homes are also great places for causing insomnia because they keep the lights on all night, there’s always a lot of noise, and those old folks are much too sedentary, exercising very little. Long-acting benzodiazepine hypnotics are the drugs of choice in nursing homes.
The chronic use of the Rx sleeping pills in the elderly, however, can produce undesirable side effects, such as impaired memory and alertness, incontinence, daytime sleepiness, and imbalance, which are already problems for many old people
The Natural Sleep Aid Approach
The safety and efficacy profile of dietary supplements containing melatonin and ashwagandha has been studied extensively. Melatonin is an important hormone in sleep physiology; it is produced in the brain and levels rise and fall through the circadian cycle. Older people’s bodies don’t produce as much of the hormone. Natural sleep supplements contain synthetic melatonin, and it functions in the body the same way natural melatonin does. Ashwagandha is an Ayurvedic herb from the roots and leaves of Withania somnifera, a plant in the nightshade family, commonly called Indian ginseng. It has long been prized for its ability to help the body deal with stress. Ashwagandha is especially recommended when stress is a contributing factor with insomnia. (Standardized and highly purified ashwagandha extracts containing high levels of withanolides are best.)