Sleeping problems are common in the elderly. In general, older people require less sleep, and their sleep is less deep than that experienced by the young. Some causes of and contributors to sleep disturbances include the following:

• Sedentary lifestyle
• Depression among the elderly (depression is a common cause of sleep problems among people of all ages.)
• Chronic pain caused by diseases such as arthritis
• Chronic diseases such as congestive heart failure
• A need to urinate frequently at night
• Stimulants such as caffeine
• Prescription drugs, recreational drugs, or alcohol
• Neurological conditions
  • Alzheimer's disease
  • Organic brain syndrome

• Frequent night awakenings
• Difficulty falling asleep
• Early morning awakening
• Confusion differentiating between day and night

• History of sleep disturbances and history of contributing factors
• Physical examination to rule out medical causes

The relief of chronic pain and control of underlying medical conditions such as frequent urination may improve sleep in some people. Effective treatment of depression can also improve sleep.

Sleep-promoting interventions such as a quiet sleep environment and a glass of warm milk before bed may improve the symptoms. Other ways to promote sleep include the following:

• Have a specific bedtime and awakening time each day.
• Do not take naps during the day.
• Use the bed only for sleep or sexual activity.
• Exercise early in the day.
• Avoid large meals shortly before bedtime.
• Avoid stimulants such as caffeine.

If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music.

The use of sleeping pills, such as benzodiazepines, to promote sleep is usually not recommended on a long-term basis, as these can produce dependence and lead to worsening sleep problems over time if used inappropriately.