FYI: Do seniors really need less sleep than younger people? Research suggests that’s not true. To learn more, read our guide: How Much Sleep Do Seniors Need?
If you find it increasingly difficult to sleep as you age, you’re not alone. According to the CDC, 11.9 percent of adults over the age of 65 took medication to help them sleep in 2020. That’s roughly double the amount of 18- to 44-year-olds who took similar medications.
From Lunesta to Ambien and Benadryl, many sleeping pills and aids are available with a prescription or, in some cases, over the counter. There are a variety of medications that qualify as sleep aids–benzodiazepines, nonbenzodiazepines, and melatonin-receptor agonists, to name a few–but they’re all aimed at promoting sleep.
Despite the harmless appearance of sleeping pills, studies have shown that the long-term use of these drugs can cause serious side effects that every senior should know about.
FYI: Do seniors really need less sleep than younger people? Research suggests that’s not true. To learn more, read our guide: How Much Sleep Do Seniors Need?
As a group, older adults experience over 36 million falls per year, accounting for countless injuries and roughly 32,000 deaths. It’s no overstatement to say falls are a leading risk for older people, and sleep medications can exacerbate those risks.
Even when used as directed, sedative-hypnotic medications pose a serious risk for seniors. According to the AARP, over 19,000 seniors were hospitalized in 2010 for a fall that occurred after they took Ambien or another prescription sleeping pill.
Just a single dose of prescription-strength sleeping aids can cause drowsiness, confusion, and loss of balance in anyone, regardless of age, but it’s more common in users over the age of 45.
Pro Tip: Looking to prevent falls in the home? Read our tried-and-tested guide to fall prevention.
In addition to increasing the risk of falls, sleeping pills can have a variety of side effects, as well as a high risk of interaction with other medications.
Common side effects of prescription sleeping aids include:
“Sleep behaviors” is a complex category of side effects involving the body’s disturbed natural rhythms brought on by a sedative. It often happens to people using a sleeping aid for the first time or using it again after a long break. These dangerous behaviors can include walking, eating, or even driving while not fully conscious.
Importantly, all sleeping aids, including those sold over the counter, interact with your central nervous system. Combining these medicines with others that do the same can lead to dangerous nervous system suppression, causing slow breathing or even fatal heart activity. Sleeping pills should never be mixed with antidepressants, opiates, antihistamines, or alcohol.
A popularly prescribed sleeping aid called Lunesta (and its generic form, eszopiclone) received a warning from the FDA, lowering the recommended daily dose due to so many cases of psychological impairment in the day following its use. Studies showed that activities requiring full awareness, such as driving, were significantly impaired even hours after the user had woken up.
Due to the chemical processes that are altered by sleeping pills to help the user’s nervous system calm down, regular users may find it difficult to sleep without using the pills. Dependence on sleeping aids can also cause other side effects, such as vertigo and impaired memory, in numbers significant enough to prompt Harvard Health to recommend quitting gradually to avoid withdrawal symptoms.
Many who have become dependent on sleeping pills require cognitive behavior therapy to return to normal sleep patterns. The therapy involves calming the brain using stimulus control, a rigid sleep schedule, and relaxation techniques.
Also, consider that the risk of dependence makes avoiding other potentially harmful side effects even more difficult.
Most older adults should be concerned about using sleeping pills, but certain conditions make the risks even higher. Since sleeping pills can suppress your nervous system and slow your breathing rate, people who are at risk for respiratory failure due to conditions such as asthma, COPD, or emphysema should avoid them.
Additionally, your body has to metabolize the compounds in sleeping pills to avoid a buildup that can increase the risk of side effects or cause permanent damage to your organs. That means people with diseases that affect kidney or liver function should never use sleeping pills.
Many prescription drugs interact with sleeping pills. Since 90 percent of seniors take at least one prescription medication, almost no one in this age group should use pills to fall asleep.
The reason sleeping pills are prescribed is that you need help falling asleep, a problem that affects as many as 70 percent of older adults, half of whom remain undiagnosed for their sleep impairment.
These individuals still need help getting to sleep while avoiding the many proven risks of taking sleeping pills. Here are a few natural ways to get better sleep:
Drink a sleep aid: Many drinks can release chemicals in your brain that aid with sleep. The old wives’ tale about drinking warm milk before bed has some truth to it, since warm milk stimulates tryptophan, the same brain chemical in turkey meat that knocks everyone out after Thanksgiving dinner. Other beneficial drinks include natural chamomile tea, cherry juice, ashwagandha tea, or warm drinks spiced with turmeric. Water can be a great sleep aid, as well, as long as you hydrate at least a few hours before bedtime.
Exercise: One pitfall of many seniors’ daily routines is that they don’t get enough aerobic exercise to help their bodies release endorphins, which wake you up in the short-term but prepare your body for normal sleep later. Just 30 minutes of light exercise a day is enough to help your sleep schedule.
Keep a healthy sleep schedule: People who go to bed around the same time each night maintain their body’s circadian rhythms, encouraging their brains to turn “off” and “on” at the same times and making sleep easier. Seniors should avoid taking naps later in the day. Healthy sleep includes not only a time of day, but also sleep-promoting behaviors such as turning off all light-producing screens at least an hour before bed.
Consider melatonin: Sleeping pills sometimes work by encouraging your brain to recognize the natural sleep chemical melatonin, but taking the compound in an herbal form can be a more natural way to give your brain the supply it needs. Melatonin comes as an herbal supplement, a tea, a pill, or even a gummy.
Sleeping pills may be enticing shortcuts to a good night’s sleep, but doctors can overprescribe them to older adults without adequately warning them about the dangerous, potentially fatal side effects. That said, you should always consult with your doctor before stopping or changing a prescribed medication, but realize that sleeping pills pose undue risks for seniors compared to the many more natural sleeping aids and strategies available.