Sleep and Aging

Many people assume older adults simply need less sleep than young adults. However, the National Institute on Aging reports that both age groups need between 7 to 9 hours of sleep each night.  Unfortunately, many seniors find it difficult to get adequate rest. They may struggle with daytime fatigue, feelings of depression, difficulty focusing or remembering, a higher risk of falling at night, and may purchase more sleep medications as a result of their restlessness. While sleeping patterns do change with age, several conditions and lifestyle habits can complicate getting a good night’s rest.  Here we’ll look at how sleep changes, what factors can disrupt sleep, and tips for sleeping more soundly as you age.

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By Katherine Ladny MitchelliStock_000021305362_Large

How Sleep Changes with Age

Sleep can be divided into two primary types: REM (rapid eye movement) sleep, which is the sleep when people typically dream, and light and deep stages of non-REM sleep. People rest best during the deep stages of non-REM sleep. But as people age, their non-REM sleep pattern includes less deep sleep and more light sleep. As lighter sleepers, older adults may be more alert to disruptions in their environment and experience abrupt transitions between sleep and wakefulness. As a result, some may feel less rested even if their total amount of sleep stays the same.

Older adults also tend to go to bed earlier at night and wake up earlier in the morning, a sleep pattern shift known as “advanced sleep phase syndrome.” Many may have more difficulty falling asleep and more sleep interruptions, often due to the need to use the restroom, pain from chronic conditions, anxiety, and side effects from certain medications.

Michael Crowe, DO Life Care Center of Collegedale

Michael Crowe, DO
Life Care Center of Collegedale

Why Sleep Patterns Change

Researchers are still studying possible explanations for these sleep pattern shifts. One explanation concerns changes in the circadian biological clock – the body’s 24-hour rhythm which responds to sunlight and governs our temperature and hormone levels (including those affecting sleep). As a person ages, this circadian biologic clock can start acting differently. According to Dr. Michael Crowe, the on-site physician at Life Care Center of Collegedale, lack of sunshine and fresh air could be where the problem lies. “A lot of people don’t get outside enough. The pineal gland makes melatonin, which resets our 24-hour cycle. If you don’t get outside, your pineal gland doesn’t know what time of day it is, and that can cause trouble getting to sleep at night.”

Sleep pattern changes often occur in women who are going through or who have experienced menopause, as they have lower levels of the sleep-inducing hormones progesterone and estrogen than premenopausal women. Some researchers believe older adults also produce less melatonin, a sleep-inducing hormone that is typically released at night. This decrease in melatonin may cause sleep problems, but other researchers think there is little significant difference in melatonin levels. Stacy Hill, a registered nurse and the executive director of The Lantern at Morning Pointe of Collegedale, explains that a lack of cognitive stimulation could be the cause of many older adults’ restless nights. “If you don’t exercise the brain during the day, then it’s not tired when it’s time to go to sleep. We encourage seniors to stay stimulated throughout the day.” Dr. Crowe agrees. “The best thing to do is physical exercise to wear yourself out a little bit,” he says.

Underlying Problems

As people age, they may develop chronic medical problems, and these, in turn, can interfere with sleep. Here are some of the most common underlying sleep problems.

Insomnia is a widespread sleeping problem among older adults, keeping people from both falling asleep and sleeping soundly. According to a National Sleep Foundation poll, 44% of older adults deal with symptoms of nighttime insomnia more than once a week. Certain medications, sickness, anxiety, consuming alcohol and caffeine, and even smoking can contribute to insomnia.

Snoring is also a disruptive sleep problem affecting about 90 million Americans. Snoring is more prevalent among overweight persons and can become more of a problem with age. Snoring loudly may also indicate a more serious problem – sleep apnea.

Sleep Apnea is a condition in which a person stops breathing for several seconds while sleeping. The body then awakens slightly to draw breath, thus disrupting sleep cycles and making rest more elusive. People with untreated sleep

Stacy Hill, RN Executive Director, The Lantern at Morning Pointe, Collegedale

Stacy Hill, RN
Executive Director, The Lantern at Morning Pointe, Collegedale

apnea have a higher risk of high blood pressure, memory problems, and stroke. According to Dr. Crowe, excessive tiredness during the daytime could be an indicator of sleep apnea.


Movement Disorders

According to the National Sleep Foundation, approximately 10% of North Americans and Europeans experience restless legs syndrome (RLS). A neurological disorder, RLS causes people to experience an unpleasant, tingly sensation that makes them want to move or kick their legs. Many with RLS also have a similar condition called periodic limb movement disorder (PLMD). PLMD makes people jerk their legs frequently – sometimes hundreds of times – while sleeping.

Mood Issues

Hill believes that depression could be an underlying problem for many older adults. “I think an overlooked issue for older adults with sleeping problems is depression. They’re oftentimes suffering from the loss of identity, a spouse, or their role in life. These traumatic life events can lead to depression and can upset their sleep-wake patterns.”


How to Sleep Better as you Age

While sleep pattern shifts and various conditions can make getting a good night’s rest more challenging as people mature, there are several tips that can help older adults sleep more soundly.

  • Develop a regular sleep routine with the same bedtime each night and time to get up each morning.
  • Dr. Crowe suggests staying away from stimulants such as nicotine, alcohol, and caffeine in the hours before you sleep.
  • Hill recommends keeping a journal of sleep disturbances or times you awake in the middle of the night, as this can help your doctor determine how to help.
  • Avoid taking naps more than 20 minutes long.
  • Moderately exercise during the afternoon hours. “Make sure exercise is done early in the day so that you don’t wire your brain back up before sleep,” recommends Dr. Crowe.
  • Make your sleeping environment comfortable, quiet, and dark.
  • Drink less before bed to keep nighttime bathroom trips to a minimum.
  • Consider having a light snack (such as warm milk) before bedtime.
  • Leave your bedroom if you cannot fall asleep after 20 minutes, as your bedroom is your sleeping room. Return when you feel drowsy.

Talk to your doctor to see if any underlying problems may be interfering with your rest if your typical night’s sleep is not satisfactory. According to Dr. Crowe, medications are often found to be a contributing factor to sleepless nights. “Consult your doctor for a medication review if you’re having insomnia,” he recommends. While aging can affect sleep patterns, a good night’s rest is never too far out of reach.