News & Views

Insomnia – not what you thought

By Zach Pearl, PhD Staff


A good night’s sleep is crucial for the physical and emotional health and is especially important as it gives the body time to rest and recharge itself, while also helps the brain to learn and retain new information 1 . It is now well known that people who are sleep deprived, are at high risk of depression, memory problems and excessive daytime sleepiness, and are more likely to have nighttime falls and increased sensitivity to pain 2 .
Insomnia is the most common sleep disorder in older adults and is characterized by difficulty falling and/or staying asleep and/or non-restorative sleep and is associated with impaired daytime functioning or distress 3 .

Insomnia can be classified as transient, acute and chronic. Transient insomnia lasts only a few nights and can be triggered by many things (e.g., environmental noises, medications, jet leg) 2 , acute insomnia lasts less than 3-4 weeks and chronic insomnia lasts at least three nights a week for a month or longer. If the insomnia lasts 3 months or more it will typically not resolve spontaneously.

The prevalence of insomnia increases with age and affects almost 50% of adults 65 and older 4 . Interestingly, approximately 66% of insomniac seniors patients are women 5 .

There are several well-identified risk factors/causes for insomnia where age and gender are the most clearly identified demographic risk factors. An important factor that may contribute to the increased prevalence of insomnia in the older population is that with age there is a dramatic decline in the melatonin hormone production and secretion 6 . Since melatonin has beneficial effects on sleep and helps to synchronize the body’s biological clock, including the sleep-wake cycle in humans, the decline in melatonin levels may also contribute to the common complaint of insomnia seen amongst the elderly 7 .

Additionally, insomnia in the elderly population can have medical, psychiatric, and pharmacologic originations 8 . The gradual decline of general health with age is accompanied by higher rates of medical illness and therefore, the risk of late-life insomnia is increased by the illness itself, or by the medication used in its treatment 9 .

Untreated insomnia deteriorates cognitive and physical domains and is associated with a wide range of impaired emotional, social, and physical daytime functioning. Compared with good sleepers, people with insomnia are more prone to accidents, work absenteeism, reduced job performance, decreased quality of life and increased health care utilization 3 . Furthermore, insomnia is a high risk factor also for cardiovascular disease, hypertension, Alzheimer disease and diabetes 10 .

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