What to do if you can't sleep when you are old?

This is the 4089th article of Da Yi Xiao Hu

Those who get up early at home and do morning exercises in the park are almost all elderly people. In addition to being diligent, the reason why the elderly get up early may also be that they can't sleep. As they age, the problem of poor sleep always bothers the elderly. The manifestations of insomnia can include difficulty falling asleep, difficulty maintaining sleep, waking up early, not wanting to go to bed at an appropriate time, difficulty falling asleep without care, etc. Insomnia will not only affect the elderly's daytime activities, people will feel tired, depressed, weak, dizzy, vain, forgetful, demented, etc., but also feel anxious. The more anxious they are, the more they can't sleep, forming a vicious circle. In addition, some elderly people always think that back pain and leg cramps are all caused by poor sleep, and they may ignore the timely treatment of some other physical diseases, delaying the condition.

Many people have experienced counting sheep before going to bed. The more seriously they count, the more they can’t fall asleep. This is because they have too high expectations and are nervous, so the sleep-aiding effect is not ideal. Most elderly people suffer from insomnia, but it is not always caused by diseases. When you can’t sleep well, first think about whether you go to bed on time, sleep for a fixed amount of time every day, develop a good sleep routine, and whether you sleep too much during the day; then think about whether you close the doors and windows, turn off the gas, turn off the lights, draw the curtains, and turn off the TV before going to bed? Don’t drink coffee or strong tea before going to bed, don’t smoke, don’t overeat, don’t do strenuous exercise, and don’t have wild thoughts. Keep a calm mind at ordinary times, don’t rely on drunkenness to fall asleep, keep the environment away from light, quiet and comfortable, the temperature is suitable, and you don’t feel stuffy, etc.

There are some tips to improve sleep, such as: go to bed only when you feel sleepy; do not do activities that excite the brain (eating, watching TV, thinking about things, etc.) in bed; if you really can't sleep, you can leave the bedroom for a while, do some simple and relaxing activities, and then go back to the bedroom to lie down when you feel sleepy; do appropriate exercise during the day, such as walking in the park, practicing Tai Chi, Ba Duan Jin, etc. After these conditions are improved, you can then experience whether the difficulty of falling asleep, sleep time, number of awakenings at night, sleep depth, and self-perception of daytime activities have improved. If you feel that you have improved, please maintain good living and sleeping habits. Even if you have occasional relapses, but the number of times is not large and the duration is not long, you don't need to take sleeping pills, and it may be better in a day or two.

If you have tried hard to improve your life and sleeping habits, but the results are not good, and you have poor sleep for more than 3 days a week and for more than 3 months, don't fight alone. Don't take medicine randomly, this is a taboo. Some elderly people teach each other special sleeping pills and take them without seeing a doctor. These medicines are not only ineffective, but may also cause side effects. At this time, please see a doctor. The doctor will determine whether you have insomnia based on your symptoms and related examinations, and at the same time rule out periodic limb movement disorder, restless legs syndrome, nasopharyngeal diseases leading to airway obstruction, and insomnia associated with mental disorders such as anxiety and depression, and then carry out corresponding effective and side-effect-free individualized treatment.

Finally, I wish you a good sleep and sweet dreams every day in your old age!

References: Guidelines for the diagnosis and treatment of insomnia in Chinese adults (2017 edition)

Author: Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Zuo Jingjing, attending physician of geriatrics department

Yang LingChief Physician