Sleep and the ageing process

As we age, our sleep patterns change. As we get older, it becomes more difficult to fall asleep and then stay asleep for the entire night.

That being said, it’s important for older adults to get enough sleep so their bodies can rejuvenate and refresh themselves even if they are already retired and not as active. After all, the body never stops working no matter what age you’re at!

How do elderly people sleep differently?

The average person gets between 7 and 9 hours of sleep each day. They may not, however, get all of their required rest at night. Each day, around 40% of people over the age of 60 nap for at least 30 minutes and it’s thought the majority of people over the age of 80, on average, nap for more than one hour every day. At night, some older people take more than half an hour to get to sleep and this seems to be more prevalent in women. Older people also tend to sleep more lightly, wake up more frequently and get less deep, refreshing sleep than younger people.

What's the significance of age in terms of sleep?

As we age, our body clock gradually changes and the hormones that help us sleep start to get released earlier in the day. As a result, some older adults may feel sleepy earlier than they used to and they may wake up in the early hours of the morning. Melatonin is a natural hormone produced in the body at night that promotes sleep. People over the age of 60 make less melatonin, making it biologically more difficult for them to fall asleep.

There are also other age-related factors that may interfere with sleep and cause awakenings during the night. These include hot flushes in postmenopausal women and the need to get up for the toilet during the night. Discomfort, such as joint pain associated with arthritis, can also make it difficult to stay in one position for the whole night with movement interrupting deep sleep. Also, after retirement, many people find it convenient to take a short nap during the day, which can reduce their need for sleep at night.

What are the most common problems that older people have?

At least 25% of older people have sleep apnoea or periodic limb movement disorder and both of these problems often disturb the sleep of the bed partner as well. Insomnia is actually seen in an anticipated 40% of older people. One in 10 older people report having insomnia that has been a problem for more than 3 months. If folks spend too much time in bed each night, they might experience long or frequent periods of wakefulness throughout the night also.

What medical problems can affect your ability to sleep?

Sleeping difficulties can occur for a variety of reasons. Arthritis, osteoporosis, Parkinson’s disease, incontinence, indigestion, heart disease and lung diseases such as asthma or chronic obstructive pulmonary disease are all prevalent in older individuals and can impact sleep. Drugs used to treat these conditions may also mess with sleep quality and patterns. Anxiety and depression can interfere with getting off to sleep as well as cause wakefulness during the night and dementia or Alzheimer’s disease can make sleep worse too. Almost two-thirds of nursing home patients suffer from sleep problems and there’s an increase in sleep issues when there’s inadequate activity during the day coupled with early nights.

What can I do to get a better night's sleep?

There are a lot of simple things that you can do in order to help you sleep better. The most important thing is to maintain regular sleeping hours. Try for a similar bedtime and regular get up time every day to help you stay on track and this may be helped by the use of an alarm clock. Sleeping in is a bad idea, even if you feel tired after a poor night’s sleep. Spend only the amount of time in bed you actually need (8 hours, for example) and avoid going to bed too early. Getting out of bed and starting your day is the best thing to do if you wake up early. Your body clock’s sleep-wake rhythm is strengthened by regular sleep habits. Your body clock also benefits from exposure to sunlight during the morning and late afternoon. Being active during the day will also help you sleep better at night. Avoid napping too long, because while an afternoon nap may help your energy levels, it can also interfere with sleeping at night and when napping is late in the afternoon or lasts longer than 15-20 minutes, it can become a problem. Try to find a solution that works for you by experimenting. As we age and experience different circumstances, our sleep needs and sleeping patterns may change.

Can anything else cause sleep symptoms?

Age may not be the only factor contributing to poor sleep. Among the many factors that may contribute are stress, depression, anxiety, medications, pain and many others. Getting good sleep is essential for good health, and you should raise any concerns you have with your doctor.

How are sleep disorders treated?

The treatment for a sleep problem depends on its cause, so the problem has to be diagnosed before treatment can be started. Talking to a doctor about sleeping problems is an important first step and then you might need a referral to see a sleep specialist. Snoring, sleep apnoea, restless legs, insomnia, and other common sleep problems can all be treated effectively. If you have insomnia, your doctor may suggest you see a psychologist who specialises in Cognitive Behaviour Therapy for insomnia (CBT-i). Alternatively, your doctor may prescribe melatonin (a synthetic version of the hormone naturally produced by your body and sold as Circadin). On the other hand, sleeping tablets are only effective for a few weeks, and should not be used for more than four weeks. It may be difficult for you to stop taking them, and you may feel drowsy the following day. Sleeping tablets can also increase the risk of falls in some older people.

Where and when should you seek help?

If you are constantly tired during the day or your sleep is such a problem that it impacts your daytime well-being, see your local doctor. These are not normal effects of aging and something can be done about both of them. If your partner notices that something isn’t right with your breathing while you’re sleeping, seek help sooner rather than later and remember there are effective treatments for snoring, sleep apnoea and insomnia.

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