SIOUX CITY | When counting sheep, reading a boring book or downing a glass of warm milk doesn't cure your insomnia, you might be tempted to reach for a bottle of prescription or over-the-counter sleeping pills.
That could be a dangerous choice, especially if you're getting up there in years.
According to Mayo Clinic, sleeping pill use may increase the risk of nighttime falls and injury in older adults. Some sleep aids are also known to interact with other medications and taking them long-term could lead to dependence.
A national poll on healthy aging conducted by the University of Michigan, revealed that more than half of older adults said they have sleep problems. Although they know there are risks associated with taking sleep medication, a third of respondents said they take pills to help them sleep anyway.
"Most people will try an over-the-counter sleep aid before they go to their doctor and report a sleep disorder," said James Case, a neurologist at CNOS in Dakota Dunes with expertise in sleep medicine.
Case said over-the-counter sleeping pills are nearly all diphenhydramine-based. Diphenhydramine is the active ingredient in Benadryl, which is primarily used to treat allergy or hay fever symptoms.
"Benadryl is discouraged. Tylenol PM, I would discourage," said Case, who noted that adults also turn to alcohol, which fragments sleep, and herbal supplements to try to get some shut eye. "Tylenol, if you also drink, increases your risk of liver injury. Diphenhydramine can cause hangover effects, dizziness, drowsiness, upset stomach and dry eyes."
According to the National Sleep Foundation, our sleep patterns change as we age. Older people tend to have a harder time falling asleep and more trouble staying asleep, the foundation says.
"I think we've seen, at least with our aging parents, the tendency of our body clock to shift," Case said. "Instead of being the night owls that we were in our 20s, the tendency as the sun goes down is for us to feel sleepy and sometimes go to bed at 6 or 7 o'clock."
Research shows that it takes older adults longer to fall asleep. They also encounter a decline in rapid eye movement sleep (REM) sleep -- the deepest stage of sleep in which dreaming occurs -- and experience more sleep disorders than their younger counterparts. Sleep apnea is a common sleep disorder that causes a person to stop breathing or have very shallow breathing.
"As we age, we develop medical problems and those do include sleep apnea, which is a very common cause of disturbed sleep," Case said. "In fact, that's the primary reason I would discourage someone who snores or whose spouse suspects that they're having breathing difficulties from using any type of sleeping pill until or unless they've had their sleep apnea diagnosed and treated."
If you can't sleep, Case recommends getting out of bed and doing something relaxing, such as reading a book. If your problem is falling asleep too early, he said you might want to ask your doctor about bright light exposure therapy to help reset your body clock.
Case said keeping a sleep diary might help some patients identify why they're having trouble sleeping. Drinking coffee and energy drinks too late in the day, he said, will keep people up at night. He tells patients not to consume caffeine, which can persist in some people for up to 14 hours, after noon.
"Smokers are going to have more trouble with sleep. (Nicotine) is a stimulant that will impair the efficiency and restorative quality of sleep," he said.
Case said overactive bladder, chronic joint pain and/or restless leg syndrome are other medical issues that can disturb sleep. Before turning to sleep aids to try to cure a sleeping problem, he urges patients to see a medical professional to rule out sleep apnea or another sleep disorder.
Medical professionals who staff UnityPoint Health -- St. Luke's sleep lab can conduct a nighttime sleep study or polysomnography, which is used to diagnose sleep disorders like sleep apnea. Polysomnography measures brain waves, heart rate, breathing, the level of oxygen in the blood and movements made during sleep. The data is then analyzed and interpreted.
"Most people fall asleep as if they're in a hotel," Case said of the sleep lab. "If you are detected to have breathing difficulties, in many cases, the path toward treatment would be started that night. The treatment is generally a machine called (continuous positive airway pressure)."