Sleep Hygiene Plan for Adults Aged 65 and Older

Introduction

For most adults, seven to eight hours of sleep is sufficient for a good rest. This also applies to older adults aged 65 years or more. As one gets older, changes in sleeping patterns may emerge. These changes can result in insomnia, whereby a person experiences trouble sleeping. Moreover, a 65-year-old may experience additional changes that include waking up early in the morning, difficulty falling back to sleep after waking in the middle of the night, and early tiredness in the evening. Other psychiatric and medical issues can also affect nighttime sleep for adults aged 65 and older. Nonetheless, individuals without major illnesses are more likely to enjoy better sleep. Designing a sleep hygiene plan is critical for addressing the changing sleep patterns in a 65-year-old person and, consequently, promoting overall body wellness.

Sleep Hygiene Plan

A study among adults aged 65 years and over established that 36 percent of women and 13 percent of men needed thirty minutes or more to fall asleep (Yaffe et al., 2014). Possible explanations for changing sleep patterns include the secretion of less melatonin — the sleep-promoting hormone — as well as increased sensitivity to environmental changes such as noise. Common sleep disorders that affect older adults include sleep apnea, periodic limb movement disorder, and restless legs syndrome. The following elements are critical to a sleep health plan for a 65-year-old client.

1. Set the same bedtime each day throughout the week to regulate the sleep-wake cycle.
2. Limit naps to a maximum of twenty minutes.
3. Refrain from consuming caffeine within eight hours of bedtime.
4. Use the bedroom for sleeping purposes only; avoid watching television, eating, or reading in bed.
5. Avoid smoking cigarettes or drinking alcohol as a strategy for falling asleep. Both approaches can make it harder to fall asleep. Smoking poses a safety risk if one falls asleep with a lit cigarette, and nicotine in cigarettes acts as a stimulant.
6. If you have not fallen asleep within thirty minutes of going to bed, get up and do something quiet — such as listening to music in a different room — before returning to bed.
7. Stay fit and active during the day to promote better sleep at night. Suitable forms of exercise include swimming, walking, stretching, yoga, and strength training. End any workout at least three hours before bedtime.
8. Refrain from worrying about sleep. Staying relaxed and stress-free creates a more favorable environment for sleep.
9. Expose the older adult to natural light in the afternoon when possible.
10. Create a comfortable and safe sleeping environment. Ensure all doors are locked and that each floor has a functioning smoke alarm. The bedroom should also be well ventilated, dark, and quiet.
11. Consult a doctor if current medications — such as cardiovascular drugs or antidepressants — may be contributing to sleeplessness.
12. See a doctor if you feel exhausted during the day for a period exceeding two to three weeks, especially when it interferes with normal functioning.

Pharmacological Options

Several pharmacological treatments are available for addressing sleep disorders in older adults:

1. Dopamine agonists such as Parlodel and Mirapex can treat disorders such as periodic limb movement disorder and restless legs syndrome.
2. Melatonin receptor stimulators are used to treat insomnia.
3. Nonbenzodiazepine hypnotics such as Lunesta are used in cases of short-term insomnia.
4. Anticonvulsants including Neurontin and Lyrica are used to counter restless legs syndrome and insomnia (Ralevski et al., 2014).
5. Orexin receptor antagonists are used to regulate an individual's sleep-wake cycle.
6. Opiates such as methadone may be engaged in treating restless legs syndrome.

Conclusion

For older adults, sleep-wake cycle changes may occur as a result of health conditions or lifestyle factors. The melatonin hormone plays a significant role in reducing the ability to fall and stay asleep. Lifestyle habits such as consuming caffeine or alcohol and smoking can further disrupt an individual's sleeping patterns. It is therefore important to avoid these stimulants, as they make it harder to fall asleep. Additionally, consulting a doctor is essential to ensure that underlying health problems are not responsible for sleeping difficulties. The application of both pharmacological and nonpharmacological options in addressing sleep disorders is critical to improving the health and wellness of older adults.

References

Field, T., Diego, M., Delgado, J., & Medina, L. (2013). Tai chi/yoga reduces prenatal depression, anxiety, and sleep disturbances. Complementary Therapies in Clinical Practice, 19(1), 6–10.

Ho, F. Y. Y., Chan, C. S., & Tang, K. N. S. (2016). Cognitive-behavioral therapy for sleep disturbances in treating posttraumatic stress disorder symptoms: A meta-analysis of randomized controlled trials. Clinical Psychology Review, 43, 90–102.

Ralevski, E., Olivera-Figueroa, L. A., & Petrakis, I. (2014). PTSD and comorbid AUD: A review of pharmacological and alternative treatment options. Substance Abuse and Rehabilitation, 5, 25.

Yaffe, K., Falvey, C. M., & Hoang, T. (2014). Connections between sleep and cognition in older adults. The Lancet Neurology, 13(10), 1017–1028.