Savvy Senior: When It’s Time to Get Help for Sleep Trouble

Untreated sleep disorders can increase the risk of falls, memory issues, depression, high blood pressure, heart disease and diabetes.

Dear Savvy Senior: I’m 70 and have struggled with sleep for years. I often wake up in the middle of the night and can’t quiet my mind enough to fall back asleep. Would seeing a sleep specialist help? —Tired Terry

Dear Tired Terry: Waking up in the middle of the night and lying there with your mind racing can be frustrating, especially when sleep won’t return. But chronic sleep trouble doesn’t have to be accepted as inevitable. In many cases, there is an underlying cause that can be identified and treated.

An estimated 40 to 50 percent of older adults deal with ongoing sleep problems, yet many never bring them up with a doctor. That matters, because untreated sleep disorders can raise the risk of falls, memory problems, depression, high blood pressure, heart disease and diabetes.

Common causes

Insomnia is the most common sleep complaint among older adults. It can make it difficult to fall asleep, stay asleep or go back to sleep after waking during the night. For many people, the problem is a busy mind — worrying about family, money, health concerns or the next day’s tasks instead of drifting off.

Insomnia may also be linked to pain, medications, anxiety, depression, arthritis, frequent nighttime urination, acid reflux or too much caffeine or alcohol.

Another frequent but often missed cause of poor sleep is obstructive sleep apnea. This condition causes breathing to repeatedly stop and start during sleep, often without the person realizing it. Warning signs include loud snoring, gasping or choking during sleep, morning headaches and excessive daytime sleepiness. If left untreated, sleep apnea can increase the risk of heart disease, stroke and other serious health problems.

Restless legs syndrome, which creates an uncomfortable urge to move the legs while resting, can also make it hard to fall asleep.

When to seek help

If you have trouble sleeping at least three nights a week for three months or longer, or if you are often tired during the day, speak with your primary care provider. Medical advice is also warranted if you snore loudly, stop breathing during sleep, wake up gasping for air or find yourself nodding off while reading, watching TV or driving.

Your doctor can review your symptoms, medications and medical history to help pinpoint the cause of your sleep trouble. If necessary, you may be referred to a sleep specialist.

Seeing a specialist

Sleep specialists are physicians trained to diagnose and treat sleep disorders, including insomnia, sleep apnea and restless legs syndrome.

Based on your symptoms, a sleep specialist may suggest a home sleep apnea test or an overnight sleep study that tracks breathing, brain activity, heart rate and oxygen levels while you sleep.

Treatment depends on the cause. Sleep apnea is often treated with a continuous positive airway pressure, or CPAP, machine or other therapies that help keep the airway open during sleep. For chronic insomnia, the usual first step is cognitive behavioral therapy for insomnia, or CBT-I, a short-term program that helps people change the thoughts and habits that interfere with sleep. Research shows CBT-I is often more effective than sleeping pills over the long term.

Medicare generally covers sleep specialist visits and medically necessary sleep tests when ordered by a doctor. People with Medicare Advantage plans may face different costs and network rules.

To find an accredited sleep center, ask your doctor for a referral or visit SleepEducation.org, the public education website of the American Academy of Sleep Medicine.

Poor sleep does not have to be accepted as a normal part of aging. If you have been struggling for months or even years, talk with your doctor. The right diagnosis and treatment can improve sleep and strengthen your health, safety and quality of life.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.