Insomnia and Its Non-Pharmacological Management in Older Adults

Purpose of Review: Insomnia, a sleep disorder involving difficulty falling, maintaining, or obtaining good quality sleep, is a common health complaint in older adults. The purpose of this review is to summarize the prevalence, risk factors, and consequences of insomnia, introduce available non-pharmacological interventions, provide implications for promoting sleep health in the older adult population, and provide guidance for clinical practice and future research. Recent Findings: Recent systematic reviews and meta-analyses have found that non-pharmacological interventions, such as physical exercise and music therapy, can effectively decrease insomnia severity and improve sleep health in older adults. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment but may require adaption to the older individual’s physical and cognitive conditions. Digital CBT-I is a newer modality that improves the accessibility of CBT-I and can be a valuable resource for both older adults and primary care providers in improving sleep quality. Summary: Common effective non-pharmacological interventions for insomnia in older adults include CBT-I, physical exercise, mindfulness, music therapy, light therapy, and combined interventions. For self-management, older adults are encouraged to monitor their sleep patterns, access digital CBT-I if needed, achieve recommended weekly exercise goals, strategically control light exposure throughout the day and night, and listen to music. Older adults may also discuss their insomnia symptoms and self-management strategies with their healthcare providers. Increasing primary care provider knowledge about the evaluation and management of insomnia in older adults is important in ensuring timely treatment. Digital CBT-I may be a useful tool for decreasing primary care provider burden and improving CBT-I adherence and treatment outcomes. Further research is needed to standardize and optimize non-pharmacological insomnia management in older adults.