Insomnia and Depression in Young and Old

"It is not the need for sleep but the ability that diminishes with age."

This quote, from Harold Rubin, Rehabilitation Counselor, and himself a senior citizen, is very true for many of the elderly. Many problems hinder getting the rest they need. They may have difficulty falling asleep, they may experience frequent nighttime awakenings, or may awaken very early in the morning, unable to return to sleep.

Another cause of sleeplessness in the elderly is a tendency to develop sleep disorders, or for those disorders to worsen with age. Insomnia, of course, means the inability to sleep or the inability to get back to sleep after a nighttime awakening.

But the causes are many and varied. Add to the changes in Circadian rhythm and sleep disorders, acute and chronic medical illnesses, psychiatric disorders such as Alzheimer's and dementia and general senility and confusion. The National Sleep Foundation supplies an extensive list of medical problems that may disturb sleep.

Social changes and a loss of social support have disrupted their lives. They may have lost the mate of a lifetime, moved from their homes into senior lodges or rest homes. In some cases, these people are neglected by family and former friends.

All these problems lead to insomnia and insomnia may lead to depression. Insomnia is considered to be a symptom of depression, but modern research suggests that depression may be a separate disorder and may even predate the insomnia. Studies suggest that insomnia is a symptom of depression in some cases and a separate disorder in others.

It is essential that both the insomnia and the depression be treated. If the depression fails to respond, it may be necessary to refer the patient to a psychiatrist.

The Other Side of the Coin

Anyone may be the victim of depression and/or insomnia. From the elderly, we go, now, to young adults. Recurring insomnia in this group often leads to depression. The insomnia can increase from the occasional sleepless night to a more chronic variety where it's difficult to sleep every night. Young adults with the longer lasting insomnia may later developed major depression.

Study author Dr. Daniel J. Buysse  of the University of Pittsburgh, said that that insomnia seems to be followed by depression more consistently than the other way around. He also stated that insomnia tended to be a chronic problem that gets more persistent over time and depression was a more intermittent problem.

As in the elderly patient, both the insomnia and the depression need to be treated.