Insomnia, a hallmark of aging for many, is an often overlooked risk factor for late-life depression, affecting 25 percent of men and 40 percent of women in their eighties. Changes to the integrity of the hypothalamus, which helps regulate sleep-wake cycles, as well as age-related reductions in the production of melatonin and other neurohormones, also contribute to insomnia. If you can’t get a good night’s sleep, all kinds of neural and physiological systems begin to go haywire. Practicing good sleep hygiene, as detailed in Chapter 11, is almost always more effective than medication.
