Trouble Sleeping? There’s Help Available

Dear Savvy Senior,

I’m 70 and have had sleep problems for years. I often wake up in the middle of the night and can’t calm my mind enough to go back to sleep. Would a sleep specialist be able to help?

–Tired Terry

Dear Terry,

Lying awake in the middle of the night with your thoughts racing can be frustrating, especially when sleep won’t return. But this is not something you simply have to endure. Persistent sleep troubles often have an underlying cause that can be found and treated.

About 40 to 50 percent of older adults deal with chronic sleep issues, yet many never bring them up with their doctor. That’s unfortunate, because untreated sleep disorders can increase 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 return to sleep after waking during the night. For many people, the problem is a busy mind — worrying about family, finances, health concerns or the next day’s tasks instead of resting.

Insomnia can 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 makes breathing repeatedly stop and start during sleep, often without the person knowing it. Warning signs include loud snoring, gasping or choking during sleep, morning headaches and excessive daytime sleepiness. If left untreated, sleep apnea can raise 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 more, or you are often tired during the day, speak with your primary care provider. You should also get medical advice 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 determine the cause of your sleep problems. If needed, you may be referred to a sleep specialist.

Seeing a sleep specialist

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

Depending on your symptoms, a sleep specialist may suggest a home sleep apnea test or an overnight sleep study that tracks your 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 with other therapies that help keep the airway open during sleep. For chronic insomnia, the first-line treatment is usually cognitive behavioral therapy for insomnia, known as CBT-I, a short-term program that helps people change the thoughts and habits that interfere with sleep. Research indicates CBT-I is often more effective than sleeping pills over the long run.

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

To locate 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.

You do not have to accept poor sleep 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 help you sleep better and improve your health, safety and quality of life.