Good for the elderly
As you age your body produces lower levels of growth hormone, so you’ll likely experience a decrease in slow wave or deep sleep (an especially refreshing part of the sleep cycle). When this happens you produce less melatonin, meaning you’ll often experience more fragmented sleep and wake up more often during the night.
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The choice of a hypnotic agent in the elderly is symptom-based. Ramelteon or short-acting Z-drugs can treat sleep-onset insomnia. Suvorexant or low-dose doxepin can improve sleep maintenance. Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance.
Physiologic changes of aging, environmental conditions, and chronic medical illnesses contribute to insomnia in the elderly. Sleep disturbance in the elderly is associated with decreased memory, impaired concentration, and impaired functional performance.
Tips and tricks
Temazepam is the most commonly prescribed benzodiazepine for insomnia. Therefore, based on current utilization patterns, the following section will review pertinent data on temazepam, trazodone, zolpidem, and the newest nonbenzodiazepine—zaleplon—for the treatment of insomnia in elderly patients.
In the elderly, nonbenzodiazepines such as zolpidem, eszopiclone, zaleplon, and ramelteon are safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines. Pharmacotherapy should be recommended only after sleep hygiene is addressed, however.
Get out of bed and do something relaxing that might make you feel drowsy — like reading or playing a repetitive game like Sudoku. Keep the lights low and go back to bed after 30 minutes or so (or sooner if you start feeling sleepy). Avoid technology, like phones, computers, or TV.
Magnesium Magnesium is perhaps the most important vitamin or mineral when it comes to sleep. It plays a key role in the bodily function that regulates sleep and studies have shown that sleep suffers without optimal vitamin intake.
1. Cherries. Cherries (especially sour cherries like the Montmorency variety) are one of the only (and highest) natural food sources of melatonin.
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