Strategies to tackle insomnia


Sleepless nights are common, especially as we grow older, but there are effective treatments.

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  • Read Time: 4 mins

Insomnia is a common and often frustrating sleep disorder, marked by difficulty falling asleep, staying asleep, or waking too early and being unable to drift back off.

It affects more than one in 10 Australians at any given time and becomes increasingly prevalent with age, with older people more likely to experience disrupted sleep or chronic sleeplessness. 

For many, the condition doesn’t just disturb nights; it spills into the day, bringing low energy, irritability, poor concentration, and a general sense of not feeling refreshed. 

As we grow older, the architecture of sleep naturally changes. Sleep becomes lighter, awakenings more frequent, and the internal body clock may shift, making restful nights harder to achieve. 

Research suggests that up to half of older adults have trouble initiating or maintaining sleep, and as many as one in five meet the criteria for an insomnia disorder. 

Despite these challenges, the need for restorative sleep does not diminish with age; adults over 65 still require around seven to eight hours each night for optimal health. 

The reasons behind insomnia can be complex. Sometimes the cause is obvious, be it stress, illness, or environmental disturbances. In other cases, underlying medical conditions, chronic pain, medication side effects, or mental health concerns play a significant role. 

In older adults especially, insomnia often appears alongside other health conditions such as cardiovascular disease, depression, or cognitive changes, which can worsen or perpetuate sleep problems. 

Fortunately, effective treatments are available, and one stands out above all: Cognitive Behavioural Therapy for Insomnia (CBT‑I). 

Widely endorsed by Australian and international sleep guidelines, CBT‑I is considered the first-line treatment for insomnia because it addresses the behavioural and thought patterns that keep people awake long after the lights are out. 

Unlike sleep medications, which often work only in the short term, CBT‑I has lasting benefits, and its improvements can persist well beyond the end of treatment.  

Alongside CBT‑I, adopting good sleep habits can make a meaningful difference. 

The Australian Government website, Healthdirect, emphasises the value of maintaining a regular bedtime routine, limiting caffeine and alcohol, reducing screen time before bed, and creating a dark, quiet, comfortable sleep environment. 

Small adjustments to daily behaviour can help reset the sleep cycle and improve overall restfulness.  

Medication does have a place, but it must be approached with care. This is especially true for older adults, who are more vulnerable to side effects such as falls, confusion, and interactions with other medicines. 

Safer options include low-dose doxepin, melatonin, ramelteon, and dual orexin receptor antagonists, which are generally considered preferable to benzodiazepines or “Z‑drugs”. These are typically recommended only when non‑drug therapies haven’t provided sufficient relief.  

If sleeplessness persists for more than a few months or begins to affect daily functioning, it’s important to seek medical advice. 

Persistent insomnia may indicate an underlying condition that deserves attention, and effective treatment is more accessible than ever. 

Related reading: Healthdirect, Cleveland Clinic, RACGP 

Compiled by

Brett Debritz

Brett Debritz

Communications Specialist, National Seniors Australia

Disclaimer: This article is for information purposes only and should not be considered medical advice. Consult a healthcare professional about any health concerns or before making any changes to your medication, diet, or exercise routine. 

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