Insomnia in Elderly




Worried Senior Woman Sits On Bed Whilst Husband Sleeps


 Transient insomnia usually afflicts those with no history of sleep disorder. It is commonly due to temporary stress, jet lag, or the sleeping environment. This form of insomnia generally is short-term (resolving within a few days)


The normal aging process frequently leads to insomnia in the elderly. The initial evaluation should address medical conditions, medications, or sleep habits. Once a pharmacologic agent is deemed necessary, it should be initiated at the lowest dose, taking into consideration underlying medical and psychiatric conditions, pharmacokinetic parameters, and the side-effect profile of the drug.


A reaction to change or stress is one of the most common causes of short-term and transient insomnia. This condition is sometimes referred to as adjustment sleep disorder.

The trigger could be a major or traumatic event such as:

  • An acute illness
  • Injury or surgery
  • The loss of a loved one
  • Job loss

Temporary insomnia could also develop after a relatively minor event, including:

    • Extremes in weather
    • An exam
    • Travelling
    • Trouble at work

In most cases, normal sleep almost always returns when the condition resolves, the individual recovers from the event, or the person becomes used to the new situation. Treatment is needed if sleepiness interferes with functioning or if it continues for more than a few weeks. Individual responses to stress vary and some people may not experience insomnia at all, even during very stressful situations while others may suffer from insomnia in response to very mild stressors.


Insomnia that usually lasts less than a week and does not recur. If it recurs from time to time, the insomnia is considered intermittent. If the insomnia affects most nights and lasts a month or more, it is considered chronic insomnia.

Transient insomnia may not require treatment. For example, if it is due to jet lag, the biological clock will return to normal on its own. Short-acting sleeping pills may improve sleep and next-day alertness but, as with all drugs, there are potential side effects. The use of over-the-counter sleep medicines is not usually recommended for insomnia.


Insomnia, intermittent: Insomnia that occurs from time to time and each time lasts less than a week or two.

Intermittent insomnia may not require treatment since the episodes of insomnia usually only last a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the biological clock will often get back to normal on its own.

For some people, however, who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and next-day alertness. As with all drugs, there are potential side effects. The use of over-the-counter sleep medicines is not usually recommended for the treatment of insomnia

Intermittent Insomnia — Is Occasional Sleeplessness Leading You Toward the Chronic Path?
The pattern begins…

insomniac woman needs to sleep. The problem with intermittent insomnia is not the frequency. That’s usually nothing to worry about. Everyone experiences an occasional sleepless night now and then. It’s easy to make up for the lost sleep and the fatigue disappears with a couple of good nights. There are no serious health effects other than feeling tired the day after an episode.

No, the problem with intermittent insomnia goes much deeper than frequency. It’s the cause and correlation that you have to deal with. And what does that mean?

Well, if you have this condition, it’s quite likely that you can detect a definite pattern in it.

You might find, for example, that it’s associated with an event that gives you a lot of anxiety, such as an exam, starting a new job, starting school in the fall, attending a social event, getting a promotion at work, and so on.

The anxiety connection can be pretty strong in intermittent insomnia. I even heard about someone, a friend of a friend, who could not pass the bar exam because he could not sleep the night before.

The lack of sleep seriously affected this person’s cognitive ability. And as any lawyer knows, the bar exam is not a time when you can bluff your way through or “call it in,” so to speak. You have to be in good mental shape to pass.

Now, to me, this sounds like the perfect scenario for a sleeping pill. If the insomnia was so specifically related to a relatively rare event, why not just take medication and be done with it?

As it turned out, sleeping pills didn’t work, because while they did provide the sleep, they too caused mental sluggishness. No improvement.

The Connection Between Sleep and Mental Health

Short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks and should be investigated by a physician with a potential referral to a sleep disorder specialist, which includes psychiatrists, neurologists and pulmonologists who have expertise in sleep disorders.