June 30, 2014

Insomnia (or sleeplessness) is often defined as difficulty falling or staying asleep.  The average adult requires between 7 ½ to 8 hours of sleep per night. As we age, we do tend to require less, but a full night’s sleep is still critical for good health.

The good news is that most insomnia is curable.  If you or someone you care for has one or more of these symptoms, you should read on:


  • Hard time falling asleep.
  • Awake 3-4 times per night.
  • Waking up not feeling rested.
  • Day/night confusion.
  • Changes in sleep patterns

Here are some causes for insomnia (remember, any one cause may or may not be a contributing factor, and a full health screening should be reviewed before any action to remedy a sleep problem is undertaken):

  • Cardiovascular Disease
  • COPD
  • Chronic pain
  • Bladder issues
  • Sleep apnea
  • Dementia/Alzheimer’s disease
  • External noise
  • Late night eating
  • Late night exercise
  • Late night TV or computer use
  • Inactive life style
  • Caffeine
  • Alcohol
  • Nicotine
  • Stimulant/anti-depressant medications
  • Stress
  • Anxiety
  • Depression

David Forman, President of Visiting Angels of Sussex DE, a home care company providing living assistance services to seniors and disabled adults says, “Insomnia is not something to ignore or give-in to.”

Forman explains, “Physically, our bodies need rest to regain strength and repair damage. Our immune system works best while we’re asleep so that cellular energy can focus more specifically where it’s needed.”

“Mentally, our ability to function depends largely on rest as well.  Think of every thought and experience as a series of electrical impulses that either travel a path between neurons (brain cells), or create new paths between them.  By the end of the day, these “electric charges” all need to be “reset.”   During sleep, these electric impulses travel back along these and nearby pathways till they obtain a state of “stasis.”   This is very likely how and why we dream,” says Forman.

Without enough deep restful sleep, we haven’t completely reached stasis.  This creates irritability, then confusion and eventually leads to various forms of psychosis including hallucinations.   Balance issues and falls may also be preventable by a good night’s sleep!

Your doctor may order any number of exams to better understand what is happening.  For example:

  • EEG sleep study
  • Overnight polysomnography
  • Mini mental exam
  • Cardiopulmonary exam
  • Upper airway exam
  • Neurologic exam
  • Blood tests

Visiting Angels offers some helpful hints to assist in creating a healthy routine to prevent or cure your insomnia:

  • Go to bed the same time every dayOur body’s circadian rhythm regulates our sleepiness over each 24-hour period regardless of external cues such as light, temperature, etc. We can “train” this sleep cycle or disrupt it.
  • Don’t eat or snack for a long while before bedOur digestive systems are very active for about three hours after meals.  While heavy meals can make us tired, energy is diverted to breaking down food and eliminating waste, rather than to repairing cellular damage and restoring brain function, and this active energy use causes a restless, light sleep.
  • Make certain the bedroom is quiet and dark enoughIf you’ve lived your whole life waking to sunlight, you may not have used blinds or curtains to darken your bedroom.  There’s a big difference between the dark of a moonlit night, and a truly dark room. A room-darkening curtain on an inexpensive (about $10), easy-to-install tension-rod creates the interior darkness your body may require.
  • Read a book or magazine before bed - If you normally read for a while before bed, do it in a chair, preferably in another room. Put down the book and transfer to your bed when you feel your eyelids getting heavy.

  • Avoid your TV and computer for a few hours before bed - Recent studies link nighttime computer use to insomnia, possibly related to how our brains process the visual information from your screen. Falling asleep to television may cause a restless sleep, as your brain is confused whether to process information or shift to its resetting mode.

  • Take a hot bathA bath relaxes your muscles and calms your thoughts.  A shower wakes you up because of temperature differences as water evaporates off your skin.
  • Avoid alcohol as a sleep aidWine and spirits may help you fall asleep, but studies show that alcohol reduces the quality and restfulness of sleep.
  • Pharmaceutical and OTC sleep aidsSome sleep aids may be fine for very short-term relief, but long-term use may cause significant health problems and mental issues.   PM pain products and antihistamines used for sleep can cause irritability and depression after just a few days. Long term they can cause or aggravate kidney and liver disease!
  • Melatonin Our bodies naturally produce melatonin, which regulates our sleep. As we age we produce less. Supplemental melatonin can work wonders.  Opt for sublingual (under the tongue) melatonin, which slowly dissolves as it helps you fall asleep.   While melatonin can help you have a restful sleep and awake refreshed, some people do report feeling groggy until that first cup of morning coffee or tea. Be sure to ask your doctor or pharmacist before using melatonin, as several medications shouldn’t be combined with it.

Just like diet and exercise, good sleep patterns take commitment to create good habits and successfully cure insomnia.

“Insomnia is just one of many reasons that seniors or their caregivers can use help from Visiting Angels,” says Forman.  “Our caregivers can provide much needed respite for sleep deprived caregivers, or closely monitor changes in the symptoms of care recipients, and let families know as difficulties arise, so that they can be properly addressed.

David Forman is president of Visiting Angels of Sussex, which provides living assistance services including hygiene assistance, meal preparation, appointments, errands, shopping, light housekeeping, medication reminders and companionship.

Call (302) 329-9475 for a free in-home assessment. More information can be found at