Insomnia in Older People

Originally written in 2012

It's 4:30 AM as I started this article and I've already been up for an hour. Insomnia has hit me frequently through my adult life and I wonder if it's going to get worse as I continue to get older. I've often heard that older people don't sleep as well. I have one friend, well into his seventies, who has described ways of passing the time while tossing and turning in his bed. One is to recite the names of New York's Finger Lakes going west to east, and then he will reverse the order, east to west. I'm not sure if he does this truly to pass the time, or if it's a way to lull himself to sleep, similar to counting sheep.

My issues of insomnia go back to the days when our first daughter, Kristi was born. Mary and I tried to share overnight duties at first, taking turns handling Kristi when she was up crying at night. The problem I ran into is that I could never get back to sleep again once Kristi was settled, whereas Mary would fall asleep rather quickly. In addition to my sleep issues, Mary realized that she was usually awake the whole time I was taking care of Kristi just because, as a new mom, she wanted to know what was going on. We finally came to the conclusion that she might as well be the one to take care of Kristi at night. I was the one who had to get up for work and she was on maternity leave, so she could easily sleep into the day or take naps if necessary.

That did not put an end to my insomnia. For about 15 years I worked a very early morning shift and had to be up anywhere from 3:30 to 5:00 AM. Bedtime was a reasonable 8:30 PM or so. I would go through cycles where I'd wake up around 1:30 AM and not be able to get back to sleep. A pattern arose: After trying for an hour or so to get back to sleep, I'd know it's fruitless so I might as well get up and do something. There's not a whole lot you can do in the middle of the night without waking other people in the house, so I'd often watch TV, play on the computer or read. Often around a half hour or so before I'd need to be up for work, my body would feel ready to sleep again. Then it became a struggle to fight the urge to stay asleep when the alarm rang. I'd get ready for work, go to work and get an hour-long nap in during my lunch break at 9:00 AM. Yes, lunch at 9:00 AM. That's the life of working crazy hours in the TV business. The day would end at 1:30 or 2:30 PM. I tried all sorts of ways to get into a reliable sleep schedule, including regularly staying up until 10:30 or 11:00 PM, sleeping solidly until the alarm rang, but then taking a one- or two-hour nap in the afternoon. It didn't work very well; it usually left me feeling extremely "spacey" through the evening.

Then I switched to the evening shift, which usually started around 2:30 or 3:00 PM. This shift was much more compatible for me. Getting home from work around midnight, I never felt like going to bed right away so I usually watched TV for an hour or two first. I did have insomnia while on the evening shift; I might sleep four or five hours and then wake up. The difference was I could take a long nap in the late morning, then wake up and feel refreshed rather than "spacey."

Why would this matter? It all has to do with the circadian rhythm. I went to a sleep specialist and did a lot of research on circadian rhythms. According to the National Institutes of Health, circadian rhythms "are produced by natural factors within the body, but they are also affected by signals from the environment. Light is the main cue influencing circadian rhythms, turning on or turning off genes that control an organism’s internal clocks." They change sleep-wake cycles, hormone release, body temperature, and other functions. Light and dark are primary factors in determining the body's internal clock. More melatonin is released at night, helping you get to sleep and affects the various stages of sleep.

According to the National Sleep Foundation, insomnia is the most common sleep complaint among Americans. Their website lists many causes and reasons for insomnia with a long list of suggestions for getting over insomnia. In reading it, I have to conclude that I'm not very consistent in my bedtimes even today, when I work a "normal" shift of 7 AM to 4 PM. I can't help but wonder if it's just that I need to work hard at being consistent.

Back to the question of whether insomnia gets worse as we age, as I scan various websites on aging and insomnia, the general consensus seems to be that yes, insomnia can get worse. The reasons include medicinal side effects, other health problems, and taking overly long naps during the day that affect our circadian rhythms.