Gary Tetz

I haven’t spent much time in a nursing home or assisted living facility late at night, but if your residents don’t sleep better than I do, it must be a rather unnerving place, filled with restless folks in a state of perpetually unsettled semi-wakefulness. 

I’m sure I’ll experience this firsthand someday soon, and I pity the caregivers who will have to put up with my lifelong nocturnal challenges and habits. Most nights, usually around 2:37 a.m., I wander around my apartment like a zombie, not really awake, not asleep, not conscious, not un. It’s a miserable limbo in which to exist, and I have reason to believe I’m not alone.  

It is estimated by alleged experts that 50-70 million U.S. adults have a sleep disorder and 10% suffer from chronic insomnia, according to the American Sleep Association. Since this organization was probably formed in the middle of the night by a group of pseudo-sentient insomniacs scribbling random numbers with bleary eyes, I’m innately distrustful of the data. But the point is that it’s a problem, and happens to a lot of us. 

Wishing for more credible information and even a cure, I turned to AARP, which is still actively and unsuccessfully campaigning for my membership. As a near-senior ingesting multiple daily prescriptions, I clicked eagerly to the article titled “Ten Types of Meds That Can Cause Insomnia.” 

Beyond reducing my daily coffee consumption, which at one point had to be administered by tanker truck, I hadn’t really considered the possibility that a medication could be the culprit. It suddenly seemed such a simple and logical solution, and I experienced the rare stirrings of an unfamiliar emotion I can only describe as hope. 

Sadly, my hunt through the medicine cabinet for a specific cause to my affliction was relatively frustrating and fruitless. For insomniacs like me, it turns out that not only could the problem be something we take, it could basically be everything we take. The AARP list includes alpha- and beta-blockers, corticosteroids, SSRI antidepressants, ACE inhibitors and statins, to name just a few. I didn’t see Vitamin C, but I’m sure it’s guilty too. 

I guess I could ignore my doctor, toss my pill box aside and hope for the best. But then I’d probably die, which seems an extreme solution, even to a condition as frustrating as insomnia. Which leaves me back where I started — wakeful, wandering, grumpy and doomed.

The whole quest has opened my groggy eyes to the vast range of medication interactions that could be causing significant sleep trouble not only for me, but for those we care for. Maybe the growing importance of consultant pharmacists under PDPM can help identify more of those, and identify adjustments to mitigate. 

If not, providers and staff are doomed to deal with the growing demands of the hordes of sleep-deprived Boomers like me, wandering facility hallways seeking snacks and companionship, or just shouting from our beds. And trust me, that’s not good for anyone. 

Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold and Silver Medal winner in the Association of Business Press Editors (ASBPE) awards program. He’s been amusing, inspiring, informing and sometimes befuddling long-term care readers worldwide since the end of a previous century. He is a multimedia consultant for Consonus Healthcare Services in Portland, OR.