Getting a good night’s sleep is no small feat. It is a struggle for some. Many factors can influence sleep duration and quality, including stress, the home environment, shift work, and living with conditions such as dementia, sleep apnea, or neck pain (1-6). From medications to machines, music, and more, a variety of strategies have been promoted as potential solutions to sleep-related struggles (7-13). The question is, are they effective? Let us dive into the research to see what works, shows promise, or should be avoided. Click on the links below to learn more.
1. Music
Do, Re, Mi, Fa, Sol, La, Ti, Doze? Our mental, cognitive, and physical health can be negatively impacted by poor sleep quality (14-18). Although more research is needed, current evidence shows that music-based strategies, such as listening to music, may hold promise for helping to improve sleep quality in older adults (14). For safety purposes, work to identify any potential hazards before engaging in a music-based strategy and adjust as needed. For instance, it may be best to opt for speakers over headphones and to be mindful of volume.
2. CPAP
Obstructive sleep apnea is common in middle-aged adults, older adults, and people living with excess weight (3). Folks with this condition momentarily stop breathing when their airways become blocked. Their need for oxygen wakes them up. The pattern of blockage and waking up gasping for air occurs multiple times during the night. This prevents deep, uninterrupted sleep and results in lower energy levels, irritability, and a higher risk of accidents (1). Both invasive and non-invasive treatment options exist. These include surgery, medications, dental devices that keep the jaw in a forward position, losing weight, and wearing a mask that delivers consistent airflow through the nose. This mask is known as continuous positive airway pressure, or more commonly, CPAP. When it comes to reducing sleepiness and the number of times in an hour breathing stops or is reduced during sleep, CPAP is the most effective strategy and is considered the standard treatment for obstructive sleep apnea. Dental devices come in second, and the remaining strategies show some promise or yield inconclusive results (10). With that said, it is always best to choose a strategy that you will consistently adhere to (19).
People living with dementia are especially prone to sleep problems, such as having a hard time falling or staying asleep and waking up early or often (4;5;7). Wandering at night is also a common concern that increases the risk for injuries. These issues can significantly impact quality of life. Research shows that regularly prescribed medications or “sleeping pills”—specifically, the hormone melatonin and the sedative ramelteon—do not appear to significantly enhance sleep in people with dementia. Others like the antidepressant trazodone and hypnotic orexin antagonist may help enhance certain sleep outcomes, but additional trials are necessary to provide conclusive results. More research is needed on the benefits and harms of different types of sleep medications for people with dementia (7). Non-drug strategies that may be worth incorporating are regular exercise; limiting daytime napping; setting consistent daily routines around when to eat, sleep, and wakeup; and light therapy (8;9).
Sleep is a precious commodity! Unfortunately, sometimes we struggle to get enough sleep, particularly the good quality kind. A variety of strategies are available, each with differing degrees of effectiveness and considerations to keep in mind. If you or a loved one is having difficulty sleeping, speak with your health care team about available treatment options and sleeping aids. Together, you can determine the best course of action for your specific set of needs.
