She takes her sleeping pill on time. She lies down calmly. And at three in the morning, she gets up in the dark, still half-asleep, on her way to the bathroom, and walks through the house as if she weren't entirely herself.
She doesn't quite recognize the furniture. She misjudges distances. She bumps into the door frame, into the chair, into the usual corner. It's not that she doesn't care—it's that her brain, at that moment, isn't fully awake yet.
Why she gets up so many times at night
Before talking about the pill, we need to talk about why she gets up: most of the time, it's to go to the bathroom. And this is neither accidental nor an isolated incident.
More than 50% of people over 60 suffer from nocturia—the need to get up to urinate during the night—and the prevalence increases with age.
Source: Spanish Society of Geriatrics and Gerontology (SEGG).
And there lies the real problem: it's not an isolated, peaceful awakening. It's an awakening forced by the bladder, in the midst of sedation, several times a week—often several times a night.
It's not just fatigue: there's a real medical reason
Several meta-analyses show that the risk of falls in people over 60 taking benzodiazepines increases by 40% to 41%. A study with 378 elderly people found that 80% of those taking them had a high risk of falling, compared to 28% of those who were not.
Sources: Medicina General y de Familia and Risk of falls in elderly patients using benzodiazepines, Ocronos.
The STOPP criteria—the reference guide on inappropriate medication in older people—explicitly include benzodiazepines and Z-hypnotics (zolpidem, zopiclone) among the drugs that predictably increase the risk of falls, precisely due to the sedation, ataxia, and loss of reflexes they can produce.
Other medications that also increase this risk at night
Sleeping pills are not the only ones. The STOPP criteria indicate several families of common drugs in older people that share the same problem of sedation and loss of balance:
| Type of drug | Common examples |
|---|---|
| First-generation antihistamines | Diphenhydramine, hydroxyzine — very sedating, sometimes in over-the-counter "sleep" syrups |
| Antipsychotics / neuroleptics | Can cause stiffness and gait disturbances |
| Tricyclic antidepressants | Sedation and hypotension upon sudden standing |
| Opioids | Sedation, dizziness, and slowed reflexes |
If your family member takes any of these along with the sleeping pill, the nocturnal risk adds up, it doesn't substitute.
Why nocturnal awakening is the most dangerous time
During the day, the body compensates better for a little sedation. But at night, several things come together: the residual sedation of the drug, the darkness, the brain suddenly emerging from a chemically induced deep sleep, and the urge to go to the bathroom pushing her to get up now, without waiting to be fully awake. This combination is exactly the highest-risk profile for falls described in clinical guidelines.
What NOT to do
Don't downplay it by thinking "it's normal at her age." It's common, but that doesn't mean the risk can't be reduced.
Don't leave objects "for later" in the path to the bathroom. A box, a moved chair, slippers out of place — at night and half-asleep, any obstacle counts.
Don't suddenly turn on a very bright light. It can be more disorienting at the moment of a sudden change in light; a dim, constant light along the path is better.
Don't change or stop medication on your own. Discuss it with her doctor — there are alternatives with less residual sedation, but the adjustment must be made by a professional.
What you can do
✔ Clear path from the bed to the bathroom, without furniture or cables
✔ Avoid loose rugs or those with raised edges on that path
✔ Closed, non-slip slippers right next to the bed, not across the room
✔ A glass of water and, if necessary, a commode near the bed to reduce nocturnal trips
✔ Talk to her doctor about the dosage and type of medication — never stop it abruptly on your own, as it can have withdrawal effects
None of these measures completely eliminate the risk. The brain will still take time to fully wake up, no matter how much you clear the hallway.
That's why a protection that doesn't depend on her being fully awake, or remembering where every piece of furniture is at three in the morning, makes sense. The SafeSeniors™ Impact-Protection Helmet is light and comfortable enough to wear even at night, precisely for those awakenings where she has less control over her surroundings.
🛡️ View the Impact-Protection HelmetFrequently asked questions
How many times is it normal to get up at night? Once occasionally is usually not a cause for alarm, but getting up several times every night, consistently, is worth discussing with her doctor — it may have a solution.
Is nocturia treatable? In many cases, yes, depending on the cause (prostate, bladder, diuretic medication taken too late, etc.). It's worth consulting instead of assuming there's nothing to be done.
Do I have to take away her sleeping pill? Not on your own — many of these drugs should not be stopped abruptly. Discuss it with her doctor: sometimes the dose can be adjusted or switched to an alternative with less residual sedation.
Is it normal for her to bump into things when she gets up at night? It is a known and well-documented effect of sedatives and hypnotics in older people, not something she is doing wrong or a sign that "she is not herself anymore." But it should be taken seriously, not minimized.
What do I do if I find her fallen at night? Stay calm, check if she responds normally, and if there is loss of consciousness, confusion that does not improve, or if she takes anticoagulants, it is a reason for urgent attention. You can see the complete guide at How to Know If a Head Injury in an Older Adult Is Serious
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Discreet protection, also for night. Discover the SafeSeniors™ Impact-Protection Helmet.
View product →This article is informative and does not substitute the diagnosis or advice of a medical professional. For any questions about medication, always consult with her doctor before making changes.