Sleep Problems

Causes

Sleep disturbances can be caused by many things: 

  • Psychological problems, such as depression, anxiety, or stress
  • Lifestyle habits, such as smoking, getting to much caffeine, napping or having irregular sleeping patterns, or using alcohol (although alcohol may cause initial drowsiness, it can interfere with sleep later in the night and can actually worsen insomnia)
  • Medical conditions such as congestive heart failure or prostate enlargement
  • Painful conditions, such as arthritis, chronic low back pain, or neuropathy (nerve damage)
  • Sleep-wake cycle disorders
  • Medication side effects
  • Chronic use of sedatives, which can cause light, broken sleep patterns
  • Sleep problems, such as sleep apnea, restless leg syndrome, periodic limb movement disorder
  • Neurological disorders, such as Alzheimer’s disease , dementia , delirium, Parkinson’s disease
  • Environment problems, such as night-time noise and lights
  • Night-time trips to the bathroom

Risk Factors

There are some specific risk factors common to older adults that can contribute to sleep problems.

Insomnia

Risk factors for insomnia include:

  • Older age
  • Female gender
  • Having certain medical or psychological conditions or diseases
  • Recent bereavement
  • Social isolation
  • Certain medications
  • Shortness of breath (from heart or lung problems)
  • Reflux disease and heartburn
  • Chronic pain
  • Having to go to the bathroom repeatedly during the night
  • Use of alcohol or nicotine
  • Having poor sleep habits
Insomnia in Long-Term Care Residents

Older adults in long-term care facilities tend to have conditions or diseases that may be uncomfortable or painful. They often take a variety of medications which may have side effects that disrupt sleep. Depression may also be an issue. 

The environment of a residence typically makes the problem worse. Environmental factors that interfere with sleep include:

  • Inadequate daytime light and exercise
  • Long periods in bed
  • Noise in hallways and rooms at night
  • Disruption of sleep to complete nursing care
  • Hallway lights that are always turned on 

Sleep Apnea

Risk factors for sleep apnea include:

  • Obesity
  • Have a family history of sleep apnea
  • Have a wide neck (large circumference)
  • Male gender
  • Tending to snore loudly
  • Having enlarged tonsils or other structural problems in your upper airways
  • Having high blood pressure, heart failure, heart rhythm problems such as atrial fibrillation, or if you have had a stroke
  • Use alcohol or sedatives (or both) to put yourself to sleep

Restless Leg Syndrome

Risk factors for restless leg syndrome include:

  • Low iron levels
  • Injury or diseases of the spinal cord nerves or nerves in the legs
  • Diabetes
  • Parkinson’s disease
  • Certain drugs (SSRI or tricyclic antidepressants, lithium, caffeine)
  • Retention of blood in your legs (venous insufficiency)

Last Updated August 2020