“Sweet dreams are made of these?” 3 strategies that aim to improve sleep

The Bottom Line

  • Good sleep and good sleep quality are key for our mental, cognitive, and physical health.
  • Music-based strategies may improve sleep-quality in older adults.
  • Continuous positive airway pressure (CPAP) and dental devices can help treat obstructive sleep apnea.
  • Two common sleeping pills do not appear to improve sleep in people with dementia, while two others may show some benefits but require more research. 
  • Struggling to sleep? Speak with your health care team about the pros and cons of available treatment options and sleeping aids.   

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.


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).

3. Sleeping pills

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.   

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  1. McMaster Optimal Aging Portal. Sleep and aging: How many zzz's are optimal to stay healthy?
  2. Vyas MV, Garg AX, Iansavichus AV, et al. Shift work and vascular events: Systematic review and meta-analysis. BMJ. 2012; 345:e4800.
  3. Punjabi NM. The epidemiology of obstructive sleep apnea. Proc Am Thorac Soc. 2008; 5(2):136-143.
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  6. McMaster Optimal Aging Portal. A pain in the neck! Does a specialized pillow really help?
  7. McCleery J, Sharpley AL. Pharmacotherapies for sleep disturbances in dementia. Cochrane Database Syst Rev. 2020; 11:CD009178. doi: 10.1002/14651858.CD009178.pub4. 
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  9. Mayo Clinic. Sleep tips: 6 steps to better sleep. [Internet] 2022. [cited December 2022]. Available from http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379?pg=1
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  11. Qaseem A, Holty JE, Owens DK, et al. Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159:471-483.
  12. Wang C, Li G, Zheng L, et al. Effects of music intervention on sleep quality of older adults: A systematic review and meta-analysis. Complement Ther Med. 2021; 59:102719. doi: 10.1016/j.ctim.2021.102719.
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  14. Santaguida PL, Gross A, Goldsmith C, et al. Orthoses for neck pain. Cochrane Collaboration. 2014; In press.
  15. Wang C, Li G, Zheng L, et al. Effects of music intervention on sleep quality of older adults: A systematic review and meta-analysis. Complement. Ther Med. 2021; 59:102719. doi: 10.1016/j.ctim.2021.102719.
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  18. Nadorff MR, Drapeau CW, Pigeon WR. Psychiatric illness and sleep in older adults: Comorbidity and opportunities for intervention. Sleep Med Clin. 2018; 13:81-91. doi: 10.1016/j.jsmc.2017.09.008.
  19. Krause AJ, Simon EB, Mander BA, et al. The sleep-deprived human brain. Nat Rev Neurosci. 2017; 18:404-418. doi: 10.1038/nrn.2017.55. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.