Which sleep strategy is recommended for older adults with insomnia?

• A. Exercising vigorously at night.
• B. Take a sedative every night.
• C. Maintain a regular sleep schedule and optimize the sleep environment.
• D. Napping in the evening.

Answer: (C)

Regular sleep schedule and a well-optimized sleep environment help regulate the body's internal clock and improve both falling asleep and staying asleep. For older adults, circadian changes and more fragmented sleep make consistency and a conducive sleeping space especially important. A steady bedtime and wake time cue the body when to wind down, while a cool, dark, quiet, and comfortable room minimizes awakenings and disruptions. This approach is nonpharmacologic and considered first-line because it builds healthier sleep habits without the risks that can come with medications.

Exercising vigorously at night can increase arousal and body temperature, delaying sleep. Taking a sedative every night raises concerns about dependence, side effects, and falls. Napping in the evening can reduce sleep pressure and make it harder to fall asleep at night. So, keeping a regular schedule and optimizing the sleep environment best supports insomniac sleep without those downsides.