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Insomnia - helping patient to overcome it

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Insomnia brings great discomfort elderly. Age changes in sleep duration may be part of the normal aging process, but may be associated with pathological processes that are not related to the natural aging.

Without normal sleep, a person may receive a range of physical, psychological, and cognitive problems. When a person suffers from insomnia, he usually tries to understand the reasons that led to this. If a person is not able to identify the main causes of sleep disturbance, he should see a psychiatrist. Doctors carry out a medical examination the patient, take the necessary tests and examine his mental state.

Treatment of sleep disorders in older people can improve overall health, but you should be careful in the choice of drugs. Treatment of insomnia is behavioral therapy, learn relaxation techniques, improved personal hygiene, light therapy, yoga, meditation, acupuncture and acupressure.

Psychiatric disorders, such as dementia and depression often lead to insomnia. 50% of elderly patients with depressive disorders reported significant sleep disturbance.

Older people on average take 5 daily medications, some of which can disrupt sleep. Sedating antidepressants (eg, amitriptyline) and sedative antipsychotics (chlorpromazine, clozapine), can cause daytime sleepiness. But excessive use of hypnotics and sedatives usually leads to disruption of the normal phase of sleep and wakefulness. Nicotine and caffeine are powerful stimulants, and studies have shown that people who smoke and drink a lot of coffee, more likely to suffer from insomnia.

Other causes of sleep disorders in the elderly are:
- Chronic pain (osteoarthritis)
- Left ventricular failure associated with dyspnea in the supine position
- Chronic obstructive pulmonary disease (COPD)
- Diseases of the urinary tract (hypertrophy of the prostate, bladder detrusor)
- Tachyarrhythmias
- Constipation
- Gastroesophageal reflux disease

General recommendations for addressing sleep disorders in the elderly:
- Maintain a regular sleep
- Avoid naps
- Exercise daily, but not right before bedtime
- Do not read or watch TV in bed
- Avoid heavy meals before bedtime
- Limit the use of alcohol, caffeine, nicotine,
- Wear comfortable, loose pajamas
- If you can not fall asleep within 30 minutes, get up out of bed and do a calming effect; hear soft music, read, but avoid exposure to bright light.

Before you assign a drug, the physician should determine the main causes of sleep disorders, and not just engage in symptomatic treatment of insomnia. Medications used to treat insomnia in older adults: antidepressants, melatonin receptor agonists, herbal preparations (gathering herbs valerian, motherwort). Medicines should start taking a small dose, to see if their is a welcome side effect. Sedating antidepressants (trazodone, nefazodone, mirtazapine) in small doses are often prescribed at bedtime to treat insomnia.

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