Savvy Senior: When to seek help for sleep problems

Dear Savvy Senior: I’m 70 and have struggled with sleep for years. I often wake up in the middle of the night and can’t quiet my mind enough to fall back asleep. Would seeing a sleep specialist help? —Tired Terry

Dear Tired Terry: Waking up at 2 a.m. and lying there with your mind racing can be maddening, especially when you can’t seem to fall back asleep. But you don’t have to just live with it. Ongoing sleep problems often have an underlying cause that can be identified and treated.

An estimated 40 to 50 percent of older adults struggle with chronic sleep problems, yet many never mention them to their doctor. That’s unfortunate because untreated sleep disorders can raise the risk of falls, memory problems, depression, high blood pressure, heart disease and diabetes.

Common causes

Insomnia is the most common sleep complaint among older adults. It can make it hard to fall asleep, stay asleep or fall back asleep after waking during the night. For many people, the problem is a racing mind — worrying about family, finances, health issues or tomorrow’s to-do list instead of sleeping.

Insomnia might also stem from pain, medications, anxiety, depression, arthritis, frequent nighttime urination, acid reflux or too much caffeine or alcohol.

Another common, and often overlooked, cause of poor sleep is obstructive sleep apnea. This condition causes breathing to repeatedly stop and start during sleep, often without a person realizing it. Warning signs include loud snoring, gasping or choking during sleep, morning headaches and excessive daytime sleepiness. Untreated sleep apnea can increase the risk of heart disease, stroke and other serious health problems.

Restless legs syndrome, which causes an uncomfortable urge to move the legs while resting, is another condition that can make it difficult to fall asleep.

When to seek help

If you have trouble sleeping at least three nights a week for three months or longer, or you’re frequently tired during the day, talk with your primary care provider. You should also seek medical advice if you snore loudly, stop breathing during sleep, wake up gasping for air or find yourself nodding off while reading, watching TV or driving.

Your doctor can review your symptoms, medications and medical history to help identify what’s causing your sleep problems. If needed, you might be referred to a sleep specialist.

Seeing a specialist

Sleep specialists are physicians trained to diagnose and treat sleep disorders, including insomnia, sleep apnea and restless legs syndrome.

Depending on your symptoms, a sleep specialist may recommend a home sleep apnea test or an overnight sleep study that monitors your breathing, brain activity, heart rate and oxygen levels while you sleep.

Treatment depends on the cause. Sleep apnea is often treated with a continuous positive airway pressure, or CPAP, machine or other therapies that help keep the airway open during sleep. For chronic insomnia, the first-line treatment is usually cognitive behavioral therapy for insomnia, known as CBT-I, a short-term program that helps people change the thoughts and habits that interfere with sleep. Research shows CBT-I is often more effective than sleeping pills over the long term.

Medicare generally covers sleep specialist visits and medically necessary sleep tests when ordered by a doctor. People with Medicare Advantage plans might have different costs and network rules.

To find an accredited sleep center, ask your doctor for a referral or visit SleepEducation.org, the public education website of the American Academy of Sleep Medicine.

You don’t have to accept poor sleep as a normal part of aging. If you’ve been struggling for months, or even years, talk with your doctor. The right diagnosis and treatment can help you sleep better and improve your health, safety and quality of life.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.