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Night Fright

Pillows on bed
Nighttime can be very frightening for seniors, especially those who live alone.

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When the Sun Goes Down, Older Adults' Fears Often Take Over

An 86-year-old woman is suffering from dementia. During the day, it regularly sends her into states of confusion. But at night, this senior's situation worsens considerably. She's terrified in the dark, often not knowing where she is or whom she's with. Across the city, another older adult also fears nights. She wonders who might know she's alone, and if they'll break into her house and rob her, or worse.

Whether the causes are physical, psychological or related to a disease such as Alzheimer's or other dementia, the Home Instead network® has found that nighttime can be very frightening for seniors, especially those who live alone. Problems that occur at night with seniors are rooted in physical changes that result from aging, many of which are often connected to sleep disorders.

In a 2005 Gallup poll of 1,000 adults over age 50, less than half surveyed (32 percent) reported getting a good night's sleep all seven days of the week. Yet respondents ranked good sleep as more important even than interpersonal relationships.

The Gallup study revealed a number of factors – including worry – that help explain these sleep problems, according to Dr. Harrison Bloom, senior associate and director of the Clinical Education Consultation Service of the International Longevity Center - USA , in New York City. Bloom, a geriatrician, wants to help seniors and home health care providers identify solutions for sleep-related disorders in older adults. Home Instead already knows of one: elderly companionship.

"The seniors we serve often face challenges at night that disturb their sleep and peace of mind," said Jeff Huber, president and Chief Operating Officer (COO) of the Home Instead Senior Care network. "Our CAREGivers are regularly called upon to provide overnight care for seniors and assist them with the anxiety that often sets in at night."

Seniors' sleep problems can be rooted in many sources. "There are physiological changes occurring with age, such as decreased amounts of time spent in certain stages of sleep," Bloom said. "And many also have diseases that make sleep difficult. For instance, people who suffer from congestive heart failure can't rest in a flat position. For others, the pain of arthritis keeps them awake. Medications for certain diseases can affect sleep. And bladder or prostate problems prompt many people to get up for bathroom breaks. These types of interruptions can fragment sleep."

Dr. Sonia Ancoli-Israel, professor of psychiatry at the University of California at San Diego and director of the Sleep Disorders Clinic at the Veterans Affairs San Diego Healthcare System, agrees that it's not necessarily the aging process that disturbs sleep, but rather the many physiological changes that accompany getting older. "In addition to those medical illnesses and medications common in older adults, there can be psychiatric problems and changes in circadian rhythms."

These rhythms help determine when we sleep, and they change as we age. Ancoli-Israel conducted a study five years ago that exposed patients with dementia living in nursing homes to either morning or evening bright light in an effort to adjust the body's circadian rhythms. Both techniques improved nighttime sleep.

But although research is helping to identify solutions, statistics indicate that more seniors are seeking medical remedies to their sleep problems. Between 2000 and 2004, use of prescription insomnia drugs rose by 16 percent among people 65 years and older, according to an analysis by the prescription management firm Medco Health Solutions of Franklin Lakes, NJ.

While there are certainly any number of sleep aids on the market, sleep medications might not be the best answer for all older adults, according to Dr. Sharon Brangman, professor of medicine and division chief, geriatrics, at SUNY Upstate Medical University in Syracuse, NY. They may make seniors confused and disoriented – symptoms that, in particular, should not be exaggerated in seniors who already suffer from them due to Alzheimer's disease or other dementias. And those symptoms can wreak nighttime havoc in the lives of both seniors and their family caregivers.

"I have an 80-year-old Alzheimer's patient who is very anxious and nervous during the afternoon," Brangman said. "She then naps in front of a television in the evening and doesn't want to sleep at night. Her husband – her primary caregiver – is exhausted by the end of the day but he's afraid to sleep at night because she might wander. When she does go to sleep, he often lets her sleep until noon. We encourage him not to let her sleep during the day, and suggest activities for her and respite breaks for him."

While the issues of older adults with dementia-related illnesses are very different from those faced by seniors with sleep disorders and physical ailments, all of these factors contribute to psychological anxiety seniors may experience at night.

"Many seniors undoubtedly are anxious because they know it's harder to reach help at night," Ancoli-Israel said. "There's also more time to think about all of the things that might be going wrong."

This is one of the most important reasons why companionship can be such a help in dealing with these nighttime anxiety problems, according to Huber.

"The 86-year-old woman with dementia, whom we were introduced to at the beginning of the story, was promptly reassured by her overnight CAREGiver when she awoke at night," Huber said. "As for the woman who was constantly afraid of her home being broken into at night, efforts were made to secure her home, to add lighting at the front and back of her house. It's those kinds of 'extras' that can mean the difference between seniors having peace of mind, or of being afraid in their own homes."

Last revised: February 15, 2011

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Thoughts and stories from others
  1. November 12, 2020 at 6:06 pm | Posted by Gloria Todd

    My mother has always been very independent. She lives alone. She gets out of the house, catches the bus to walk around in her favorite store, Walmart, she goes to church every Sunday, catches the bus to her hair appointments, pays her bills, goes to the library, she has always loved reading books, she can catch the bus to visit with her friends but at night she is paranoid and hallucinating. She thinks people are taking naked pictures of her, cameras are all over her apartment, all of her neighbors have seen these pictures and thats why they all look at her strange. The night she left a pot on the stove, she was convinced these people are trying to kill her by attempting to set her apartment on fire. How can she be totally normal during the day but change at night. Her doctors have no clue what to do for her. I'm taking her to a specialist next week. Watching my mother suffer like this so hard.


  2. October 30, 2020 at 11:52 pm | Posted by Cathy

    I am so tired about my mom age 79 years old. Once She scared us driving at night because she didn’t see the yellow line at middle and drive on the middle of road while the truck was coming toward to us. I was scared of her driving at night and never again go with her! She did again had a accident herself broke the tires by hit on a curb and someone cut off Front of her at night again. She can’t drive now since cost money to replace a new tires. She want to go to Shopping and want to borrow my car. I am tired of her negative texting to me and she acted lonely. I wish she had a place to move at senior care.


  3. October 2, 2018 at 7:19 pm | Posted by Viola

    My mom is 89 and every morning at 3 she cried alot that she is alone in the house. She dosent want to sleep during the day


  4. August 27, 2018 at 3:59 am | Posted by Tinaj

    My mother is 90 she lives alone. She had bumped her head recently and caused a minor brain bleed. She can not be left alone now. She sleeps very little, she complains about smells and how they cause her to feel pressure on her eyes. We hace washed her clothes several times to get the smell of dryer sheets off of them. She believes that that her clothes have something on them that is getting on her. I feel that the lack of sleep is causing alot of this, but I also know that she is very lonely, her male companion/friend died just before Christmas last year and her routine of life was drastically changed. Now I do my best to be with her. We are looking into other medical aspects or probabilties also. Thanks for listening and reading my short story


  5. April 9, 2018 at 8:34 am | Posted by Tammy

    Your mom isn't doing this to upset you, your mom has mental & other old people problems. Not mental that she is crazy, but mental as in her mind/thoughts. These things tend to run in families so think about how you would want to be treated when you become that old.Take her to the doctor and have him do some tests. If she has already been tested and on drugs then ask about meds that will help her sleep better at night. Read up on things and ways to help her sleep at night. Cool room, soft bed, one of those machines that play sounds that help to relex, baths etc. At meals or another good time for you get some one on one time with her asking how she feels, and why she feels that way. Not just for at night, but her day time feelings also. When she has a bad night take a nap doing the day. Watch nice things at night time avoid scary movies, the news etc. Play music from her youth or teenage years ask her about her life doing those things to bring back memories. Sounds to me like she has "old timers" or something like that. Try to remember she is your mom, she took care of you when you were a baby. The nights of sleep she lost because you didn't feel good, when you wanted to eat, when you were scared, when you were on dates and remember not a day in your life went by she didn't love, worry and think about you. At 93 you're lucky to have her in your life. God will be taking her soon enough enjoy the time you have left. Do things together cooking, short walks, read her a book take her to the library to let her check out a book if she can't see well, they have audio books there and can send off for a list of others. Treat her the way you want and would want to be treated by your own children. Where I live they have a Community Center for older people. They enjoy being with others, playing games, watching TV. talking about their days, meds, and what scares them. They go on small trips swimming, Landmarks, they also go to the "homes" to keep those people company, play games etc Where they feel helpful. I realize she might have a hard time walking so look into a wheel chair if she doesn't have one. If she does they have bus's that can deal w/ them. Good luck.


    • September 19, 2019 at 8:38 am | Posted by Lydia

      My mom is 85 and chooses to live alone. She rejects everything we offer we tried everything you Tammy suggested and she refuses to do anyone of them. She's up down with her moods and what she wants . We all have our own homes and husbands and she wants one of us to move in with her which we can't. We all have offered to move her into our homes but she refuses too. When she stays at one of our homes all she does is worry her house will burn down. Cameras have been installed inside and out and alarms also. We show her video of the house but it only helps for a bit. Her home is a fortress very safe and she has medical alert necklace on her. She still drives a short distance and can do things on her own for her age. She is very healthy no medical issues. Just getting older. We just wish she wouldn't refuses to connect with people or her friends her age. She keeps coming up with I will but doesn't or she says every excuse to why she doesn't. Just wants her way or no way. We just don't know how to please her. Nothing works when we try and we do.


  6. September 6, 2017 at 3:00 am | Posted by Belita

    My 93 year mother lives with me. Months ago she began a pattern of being up all night and continually waking me. She roams, argues, becomes paranoid. No consideration for others - just self absorbed. I don't think companionship is the answer, as in many cases such as mine, and the comment earlier, companionship exists.


  7. July 27, 2017 at 12:07 am | Posted by Jan

    79 year old male. Many health problems. He can sleep with no problem during the day, but at night he appears to experience anxiety and does things to make noise (forcing himself to burp, clicking his jaw, blowing/simulating spitting, shifting around in bed, etc. ) acts sick/uncomfortable with no consideration for anyone who stays with him at night. Is this some type of a phobia he has developed about sleeping at night?


  8. April 30, 2016 at 3:21 pm | Posted by Marcia Mack

    My husband slept with the light on but in the last days he wanted to sleep in his chair at night. He didn't want any of the cats near him at all and he had always slept with one or two. He would get really confused in the afternoon and often did not know who I his wife was and did not know where he lived. He did not know his way around in places he had been in for years where we worked as I took him to work with me every night and we both would sleep in the day until he got real bad. He feel 12 days before he died and died in a hospital.


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