Seniors and Insomnia
This article was updated on: 09/15/2018
If you have trouble falling or staying asleep, you may have insomnia. According to National Institute of Health (NIH), insomnia affects almost half of adults age 60 and older. Insomnia can result in serious health concerns. Specifically, the NIH study showed that seniors with insomnia:
- Have an increased risk for falls
- Are more likely to be fatigued during the day
- Are at increased risk for nursing home placement
- Have higher mortality and disease rates
The NIH says insomnia is “underrecognized, underdiagnosed, and undertreated,” leading to health consequences among the 65 and older population.
What is insomnia?
According to the National Institutes of Health, insomnia refers to a number of sleep disturbances, but usually involves one or more of the following conditions:
- Difficulty initiating sleep at night (taking longer than 30 to 45 minutes to fall sleep)
- Difficulty maintaining sleep (waking many times during the night)
- Waking too early in the morning and being unable to fall back to sleep
What Insomnia symptoms often include
The Mayo Clinic lists several insomnia symptoms, including:
- Daytime sleepiness
- Irritability, anxiety, depression
- Memory problems, inability to focus on tasks
- Increased errors or accidents
Insomnia symptoms can be acute and/or short-term, usually as a result of a specific event such as an illness, medication change, or mental or emotional stress. On the other hand, these symptoms can be ongoing or chronic, lasting for months and even years.
What causes insomnia symptoms?
Insomnia can be primary, such as in the case of sleep apnea, for example, or it can be secondary, a side effect or another medical problem or condition, or even medication. According the NIH, some common causes of insomnia symptoms include:
- Having to wake up too much to go to the bathroom
- Too much caffeine, nicotine, or certain over-the-counter medications and prescription drugs
- Chronic, often painful diseases, such as arthritis, heartburn, menopause and cancer
- Neurological disorders such as Parkinson’s disease
How is insomnia treated?
According to the National Sleep Foundation, there are two main approaches to managing insomnia symptoms: cognitive and behavioral (non-medical) and prescription drug therapy (medical).
Non-medical insomnia treatment
While some people might be successful teaching themselves techniques to manage insomnia at home, you may want to consult a sleep therapist or psychologist. Some common non-medical approaches from the National Sleep Foundation include:
- Relaxation training,which might help you relax your muscles and ease yourself into sleep.
- Stimulation control, which is meant to help you learn to associate your bed with sleeping and not with the frustration of being unable to fall asleep. This method might involve keeping a strict sleep schedule, for example, and only using your bedroom for sleeping.
- Cognitive behavioral therapy (CBT), which is meant to teach you new thinking pathways for falling asleep and maintaining good “sleep hygiene.”
Medical insomnia treatment
In some cases, your health-care provider may recommend either over-the-counter or prescription medications to help you fall asleep and stay asleep at night. According to the National Sleep Foundation, classes of prescription medications for insomnia include benzodiazepine hypnotics, non-benzodiazepine hypnotics, and melatonin receptor agonists. You also might benefit from alternative medicines.
Does Medicare cover treatment for insomnia and insomnia symptoms?
If your doctor believes that your insomnia is caused by sleep apnea and you are covered by Original Medicare (Part A and Part B), you may be eligible for Part B coverage of sleep tests if they are performed in a sleep lab facility. You pay 20% of the allowable charge plus any Part B deductible amount. If your doctor orders treatment with a continuous positive airway pressure (CPAP) machine, Medicare may also pay 80% of allowable charges to rent the device. Note that CPAP machines may be affected by Medicare’s Competitive Bidding Program, which means you must use a Medicare –contracted supplier in order to be covered. Original Medicare doesn’t typically cover prescription drug therapy to treat insomnia. However, if you are enrolled in a stand-alone Medicare Part D Prescription Drug Plan, or a Medicare Advantage Prescription Drug Plan, your plan may cover your medication. As of 2013, Medicare has authorized payment for certain benzodiazepines to treat insomnia symptoms; check your plan formulary (list of approved prescription drugs) to see if your medication is covered. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
It’s important to see a doctor if you suffer from insomnia symptoms. I’m happy to help you understand your coverage options under Medicare. You can schedule a telephone call or request an email at your convenience by clicking one of the links below. To view a list of plans in your area you may qualify for, click the “Compare Plans” button.