Learning > Health

Insomnia in the Elderly

Insomnia in the elderly is detrimental to their health and emotional well-being. The Department of Psychiatry at Singapore General Hospital shares some common causes of insomnia in the elderly​.

If you’re out and about very early in the morning, you might have seen seniors taking a stroll, doing tai chi or making their way to the nearby wet market. Sometimes it does seem like the elderly requires less sleep than young adults. But is this a fact? And when seniors suffer from insomnia, what are the common causes?


Consultant Dr Tan Shian Ming from the Department of Psychiatry, Singapore General Hospital (SGH), a member of the SingHealth​ group, offers insight into the sleep patterns of the elderly and what can cause sleep problems.


Sleep needs vs. sleep patterns

Though it appears like quiet time, sleep is actually a very dynamic process. It includes dreamless phases of light and deep sleep, as well as occasional periods of active dreaming (known as Rapid Eye Movement or REM sleep). The different stages combine in a cycle repeated several times throughout the night.


Sleep needs predominantly remain unchanged throughout adulthood. Adults require between 7 to 9 hours of sleep nightly. However, a person’s sleep patterns evolve with age.


Even if, on average, the total time older adults spend in sleep remains similar to when they were younger, more of it is spent in the light stages of sleep rather than deep sleep. Seniors commonly complain that they spend more time tossing and turning in bed or that they wake up frequently during the night.


“Furthermore, changes in circadian rhythms, or the body’s internal biological clock, tend to cause the elderly to wake earlier in the morning, compared to younger adults,” says Dr Tan.


Common causes of sleep problems in seniors

You may be surprised to know that about half of people aged above 65 do not have a good night’s sleep at least several times a month.


“Although ageing brings about changes in sleep patterns, sleep problems should not be taken as a part of growing old. Instead, talk to your doctor and get checked for sleep disorders,” advises Dr Tan.


Common causes that keep the elderly awake at night include:

  • Poor sleep habits: Seniors often have poor sleep habits promoting insomnia. These include irregular sleep hours, consuming alcohol before bedtime and excessive daytime napping.

  • Pain or medical illness: Chronic pain is certain to keep you awake. Also, health conditions such asthma, diabetes, osteoporosis, heartburn, Alzheimer’s disease and benign prostate enlargement can interfere with sleep.

  • Sleep disorders: Older adults are more likely to be afflicted by sleep disorders such as sleep apnoea and restless legs syndrome.

  • Medications: Certain medications commonly taken by seniors can stimulate wakefulness. These can include drugs for high blood pressure, heart failure and high cholesterol, as well as over-the-counter medications for joint pain and inflammation.

  • Stress or psychological disorders: Stress caused by life events such as the death or sickness of a loved one, or financial difficulties can contribute to insomnia.

  • Lack of physical activity: As retirement often results in a more sedentary lifestyle, it can make it harder to feel physically tired.


Why is sleep important for the elderly?

Regardless of age, sleeping well is vital for physical health and emotional well-being. For seniors, good sleep remains important as it improves concentration and memory, allows the body to repair cell damage and recharges the immune system, which in turn helps to fend off disease.


Older adults who suffer from insomnia are more likely to develop depression, attention and memory problems. As they may have difficulty staying awake, it increases the likelihood of falls. Insufficient sleep can also up the risk of serious health problems such as cardiovascular disease, diabetes, weight issues and breast cancer.


Read on to find out how to combat insomnia.


Disclaimer: All HealthXchange articles are intended for general information only and provided on the understanding that no surgical and medical advice or recommendation is being rendered. Please do not disregard the professional advice of your physician.


About HealthXchange

As Singapore's first interactive health and lifestyle resource portal developed by SingHealth, HealthXchange.sg provides comprehensive, relevant and trusted health and medical information for Singaporeans and the Asian community.

The views, material and information presented by any third party are strictly the views of such third party. Without prejudice to any third party content or materials whatsoever are provided for information purposes and convenience only. Council For The Third Age shall not be responsible or liable for any loss or damage whatsoever arising directly or indirectly howsoever in connection with or as a result of any person accessing or acting on any information contained in such content or materials. The presentation of such information by third parties on this Council For The Third Age website does not imply and shall not be construed as any representation, warranty, endorsement or verification by Council For The Third Age in respect of such content or materials.