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Suggest Treatment For Insomnia In An Elderly Person
Question: Is there no hormone therapy, as opposed to the plethora of non-hormonal sleep aid drugs, for age-related male (I am 73 and have had this problem for at least 20 years.) awakening wide awake 1-3 hours after falling asleep normally (retiring at 9-1030) every night? I do not day time nap, but if I do not use the drugs, I have a 3 day cycle of Day 1 of total of about 4 hours sleep, Day 2 of about 6 hours sleep and Day 3 of 9-11 hours sleep, beginning the cycle again with no daytime napping and falling asleep without drugs upon retiring. My BMI is 25 and no blood pressure problems and excellent sleeping environment. I have measured cortisol - 50 per cent above human average normal during the nocturnal awakening hours and 50 per cent below average during mid-day. Endocrinologists claim their is no hormonal intervention (replacement) therapy, but given the role of hormones in sleep when everything else seems to be correct, I find this hard to believe. Meanwhile, I have been through a witches brew of drugs, mostly settling on zolpidem tartrate, alprazolam, quetiapine, mirtazapine, clonidine, etc., all at the low end of dosage scales, but generally serviceable for consumption, but only upon nocturnal awakening, not upon retirement where they do nothing more than extend my first cycle of sleep by 1-2 hours.
Brief Answer:
I suggets to consult a sleep specialists who are trained in sleep medicine.
Detailed Answer:
Hello
I read carefully your question and understood tour concern.
A lot of people experience trouble sleeping at one time or another. This is normal and usually temporary, due to stress or other outside factors. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder.
According to the National Commission on Sleep Disorders Research, at least 40 million Americans suffer from chronic, long-term sleep disorders.
So this is a common problem.
It is very important to identify the causes of your sleeping problem and find ways to improve your sleep and quality of life.
We all have an internal biological clock that regulates our 24-hour sleep-wake cycle, also known as our circadian rhythms.Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, including insomnia, jet lag, and shift work sleep difficulties.
About the role of hormones in sleep, Melatonin is a hormone produced in the pineal gland of the brain that is responsible for regulating sleep cycles.
To adjust the body’s internal clock and fall asleep more easily, many people take melatonin supplements in pill form. This is especially common among; shift workers (people with irregular hours), when experiencing jetlag, insomniacs and blind people.
At the other side it is very important to regulat your sleep schedule and trying to go to bed and wake up at the same time. Melatonin levels begin to increase approximately two hours before a person goes to sleep, so keeping a rigid sleep schedule will aid in the regularity of melatonin secretion.
Cortisol, a stress hormone operates on the opposite cycle, decreasing just before bed and increasing as a person wakes up. If a person is experiencing higher levels of stress, these two hormones will become misaligned causing a noticeable decline in sleep quality.
The nocturnal awakening are a stress for you body and this explain your levels of cortisol during the nocturnal awakening.
I don't think your problem has a hormonal basis,so i suggest to consult a sleep specialist to find the cause of your problem.
Hope this information is helpful.
If you have other doubts,feel free and to ask.
Thank you for using HCM.
Wish you good health.
I suggets to consult a sleep specialists who are trained in sleep medicine.
Detailed Answer:
Hello
I read carefully your question and understood tour concern.
A lot of people experience trouble sleeping at one time or another. This is normal and usually temporary, due to stress or other outside factors. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder.
According to the National Commission on Sleep Disorders Research, at least 40 million Americans suffer from chronic, long-term sleep disorders.
So this is a common problem.
It is very important to identify the causes of your sleeping problem and find ways to improve your sleep and quality of life.
We all have an internal biological clock that regulates our 24-hour sleep-wake cycle, also known as our circadian rhythms.Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, including insomnia, jet lag, and shift work sleep difficulties.
About the role of hormones in sleep, Melatonin is a hormone produced in the pineal gland of the brain that is responsible for regulating sleep cycles.
To adjust the body’s internal clock and fall asleep more easily, many people take melatonin supplements in pill form. This is especially common among; shift workers (people with irregular hours), when experiencing jetlag, insomniacs and blind people.
At the other side it is very important to regulat your sleep schedule and trying to go to bed and wake up at the same time. Melatonin levels begin to increase approximately two hours before a person goes to sleep, so keeping a rigid sleep schedule will aid in the regularity of melatonin secretion.
Cortisol, a stress hormone operates on the opposite cycle, decreasing just before bed and increasing as a person wakes up. If a person is experiencing higher levels of stress, these two hormones will become misaligned causing a noticeable decline in sleep quality.
The nocturnal awakening are a stress for you body and this explain your levels of cortisol during the nocturnal awakening.
I don't think your problem has a hormonal basis,so i suggest to consult a sleep specialist to find the cause of your problem.
Hope this information is helpful.
If you have other doubts,feel free and to ask.
Thank you for using HCM.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
I have had three full night sleep studies, very little perceptible sleep in each study; reports of much movement, etc. No obstructive sleep apnea and numerous consults with ''sleep professionals'', all of whom just shrug and cash my checks.
Other than age, there have been no changes in my lifestyle, diet, health, etc. since the onset of this problem over a 12-18 month period of my life in the early 1990's.
40 million Americans chronically suffer from a version of what I suffer from and there has not been some creditable reasonably generic therapy evolve, just a bunch of psycho-babble, anti-hypnotics, etc. and keep the lights dim? The neuro-chemical precursors to initiating and sustaining sleep that are malfunctioning in 15 per cent of the US population and the resulting health effects are appalling.
I know all about cortisol. I strongly suspect my cortisol before onset of the sleep problem was in the proper cycle and that it is an indicator of a causative underlying dysfunction of my neuro-chemistry (i. e., endocrine).
Yes, I am suffering from a sleep disorder. Your response seems to indicate you like all the MD's (about a dozen) who have had a touchy-feely contact with me over the last couple of decades do not have a clue. In behalf of the 40 million other Americans ''shame on you''. But I suppose I have gotten my $35 worth.
Other than age, there have been no changes in my lifestyle, diet, health, etc. since the onset of this problem over a 12-18 month period of my life in the early 1990's.
40 million Americans chronically suffer from a version of what I suffer from and there has not been some creditable reasonably generic therapy evolve, just a bunch of psycho-babble, anti-hypnotics, etc. and keep the lights dim? The neuro-chemical precursors to initiating and sustaining sleep that are malfunctioning in 15 per cent of the US population and the resulting health effects are appalling.
I know all about cortisol. I strongly suspect my cortisol before onset of the sleep problem was in the proper cycle and that it is an indicator of a causative underlying dysfunction of my neuro-chemistry (i. e., endocrine).
Yes, I am suffering from a sleep disorder. Your response seems to indicate you like all the MD's (about a dozen) who have had a touchy-feely contact with me over the last couple of decades do not have a clue. In behalf of the 40 million other Americans ''shame on you''. But I suppose I have gotten my $35 worth.
Brief Answer:
I can understand yur emotional response.
Detailed Answer:
Hello
I can understand your emotional response,because sleep is a vital necessity and not a luxury.
About the role of cortisol in sleep disorders,it is true that dysfunctional HPA axis activity may play a role in some sleep disorders.
HPA axis hyperactivity can have a negative impact on sleep, leading to sleep fragmentation, decreased deep slow-wave sleep, and shortened sleep time.
In turn, sleep problems including insomnia and obstructive sleep apnea can further propagate HPA axis dysfunction.
In this cases interventions to normalize HPA axis abnormalities, decrease nocturnal CRH hyperactivity, and decrease cortisol may be beneficial in treating insomnia and other sleep disorders.
Anyway in your case you have a measured cortisol production that is slightly irregular,if the levels are within the normal range.
The circadian rhythm of cortisol secretion has a waveform pattern with the XXXXXXX for cortisol occurring at about midnight. Cortisol levels start to rise approximately 2-3 hours after sleep onset and continue to rise into the early morning and early waking hours. The peak in cortisol is about 9 a.m.; as the day continues, levels decline gradually. With the onset of sleep, cortisol continues to decline until the XXXXXXX
For this reason my opinion is that your problem has not hormonal basis.
Anyway i need to know exactly your cortisol levels during the night and day(several measurements are necessary for the diagnose of nocturnal CRH hyperactivity).
Best regards.
I can understand yur emotional response.
Detailed Answer:
Hello
I can understand your emotional response,because sleep is a vital necessity and not a luxury.
About the role of cortisol in sleep disorders,it is true that dysfunctional HPA axis activity may play a role in some sleep disorders.
HPA axis hyperactivity can have a negative impact on sleep, leading to sleep fragmentation, decreased deep slow-wave sleep, and shortened sleep time.
In turn, sleep problems including insomnia and obstructive sleep apnea can further propagate HPA axis dysfunction.
In this cases interventions to normalize HPA axis abnormalities, decrease nocturnal CRH hyperactivity, and decrease cortisol may be beneficial in treating insomnia and other sleep disorders.
Anyway in your case you have a measured cortisol production that is slightly irregular,if the levels are within the normal range.
The circadian rhythm of cortisol secretion has a waveform pattern with the XXXXXXX for cortisol occurring at about midnight. Cortisol levels start to rise approximately 2-3 hours after sleep onset and continue to rise into the early morning and early waking hours. The peak in cortisol is about 9 a.m.; as the day continues, levels decline gradually. With the onset of sleep, cortisol continues to decline until the XXXXXXX
For this reason my opinion is that your problem has not hormonal basis.
Anyway i need to know exactly your cortisol levels during the night and day(several measurements are necessary for the diagnose of nocturnal CRH hyperactivity).
Best regards.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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