Gina Johnson
Sleep is an essential part of life, and as we age, our sleep patterns and habits change. Older adults, aged 60 and above, tend to go to bed and wake up earlier, and their sleep tends to be lighter with frequent awakenings. While the recommended sleep requirement for older adults is seven to nine hours, many experience difficulty sleeping and may require more sleep. This can be attributed to various factors, including health conditions, medications, mental health, pain, and sleep disorders such as insomnia, sleep apnea, and restless leg syndrome. Additionally, boredom and a lack of engagement in activities can contribute to excessive sleepiness in the elderly. It is important to address sleep issues as they can impact an older adult's quality of life and overall health, increasing the risk of depression, cognitive issues, and other health problems.
| Characteristics | Values |
|---|---|
| Amount of sleep needed | 7 to 9 hours each night |
| Sleep patterns | Go to bed and wake up earlier than younger adults |
| Sleep quality | Shorter and lighter sleep; more disruptions |
| Sleep disorders | REM sleep behaviour disorder, insomnia, sleep apnea, restless legs syndrome |
| Factors affecting sleep | Illness, medications, mental health, pain, stress, lack of exercise, diet, menopause, depression |
| Ways to improve sleep | Regular exercise, reduce distractions in the bedroom, establish a bedtime routine, improve sleep hygiene, social engagement |
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What You'll Learn
- Sleep disorders, including insomnia, sleep apnea, and RBD, become more common with age
- Medication side effects: older individuals may experience drowsiness from multiple drug interactions
- Depression: older adults with depressive symptoms may experience sleep issues and fatigue
- Lifestyle factors: boredom, lack of exercise, and limited social engagement can contribute to excessive sleep
- Sleep environment: reducing distractions and hazards in the bedroom can improve sleep quality
Sleep disorders, including insomnia, sleep apnea, and RBD, become more common with age
Sleep disorders are more common among older people, with insomnia being the most prevalent sleep problem in adults aged 60 and above. People with insomnia struggle to fall asleep or stay asleep at least three nights a week. This condition can be caused by stress, medications, poor sleep habits, changes in sleep environments, or other existing medical, psychiatric, sleep, or neurological disorders. Seniors are more susceptible to insomnia due to their higher risk of developing these coexisting conditions.
Sleep apnea, characterised by pauses in breathing during sleep, also becomes more prevalent with age. It is often associated with other health issues such as obesity, cardiovascular disease, and neurological conditions. For instance, up to 40% of people with Parkinson's disease experience sleep apnea. Additionally, older adults may develop REM sleep behaviour disorder (RBD), which causes them to physically act out their dreams, sometimes violently. RBD is particularly common in elderly men.
The risk of developing restless legs syndrome, a neurologic disorder characterised by an overwhelming urge to move the legs during rest, also increases with age. This condition can lead to nighttime arousals, causing individuals to wake up frequently and experience tiredness during the day. Furthermore, older adults may experience chronic pain, such as arthritis, which can contribute to inadequate rest and sleeplessness. This can create a vicious cycle where pain intensifies due to a lack of sleep.
Age-related changes in circadian rhythms and sleep-wake cycles can further contribute to sleep disorders in older adults. Advanced sleep-wake phase disorder, for instance, causes individuals to feel tired in the early evening and wake up between 3 am and 5 am. This disorder is common among older adults due to the forward shift in their body's circadian rhythms. These changes in sleep patterns can disrupt older adults' daily activities and negatively impact their quality of life.
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Medication side effects: older individuals may experience drowsiness from multiple drug interactions
Older adults require about seven to nine hours of sleep each night, which is similar to the amount of sleep needed across all adults. However, older people tend to go to bed and wake up earlier than younger adults, and their sleep patterns may be disrupted by various factors, such as illness, medications, mental health issues, and pain. As a result, many older individuals experience sleep disorders, including insomnia, sleep apnea, and movement disorders like restless leg syndrome.
The use of multiple medications, known as polypharmacy, in adults over 60 can lead to an increased risk of oversedation, causing drowsiness and confusion. This risk is heightened for older adults who are frail. Opioid painkillers, benzodiazepines (used for anxiety and agitation), and antihistamines are among the drugs that can contribute to oversedation. Additionally, alcohol consumption while taking these medications can further increase the risk of oversedation.
Older adults often manage multiple chronic health conditions and are more susceptible to experiencing unwanted drug side effects. They may also be more sensitive to certain medications. It is recommended that older individuals exercise caution when using specific medications, including some over-the-counter drugs. For instance, over-the-counter treatments for heartburn, indigestion, and ulcers can cause confusion even when taken at regular doses.
To make informed decisions about their medications and reduce the chances of overmedication and adverse reactions, older adults should consult with their healthcare providers or pharmacists. A health advocate or caregiver can also assist in reviewing the patient's medications, identifying potential drug interactions, and ensuring the medications remain beneficial to the patient's health.
Practicing good sleep habits can help older adults improve their sleep quality. This includes maintaining a regular sleep schedule, establishing a bedtime routine, and creating a comfortable sleep environment. Regular exercise and reducing distractions in the bedroom, such as removing televisions and smartphones, can also promote better sleep.
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Depression: older adults with depressive symptoms may experience sleep issues and fatigue
While older adults need around seven to nine hours of sleep per night, just like all other adults, many struggle to get quality sleep. Sleep issues are common among older adults due to factors such as illness, medications, mental health issues, and pain. One of the mental health issues that can affect sleep in older adults is depression.
Depression is a serious mood disorder that can affect anyone at any age and is not an inevitable part of ageing. It can impact older adults' energy levels, appetite, sleep, and interest in activities, work, hobbies, and relationships. Symptoms of depression in older adults may manifest differently and can include feelings of emotional numbness, a lack of interest in activities, sadness, despair, aches and pains, weight loss, hopelessness, and helplessness.
Older adults with depressive symptoms often experience fatigue, which can be a symptom of underlying depression. The association between fatigue and depression in older adults has been explored in studies, indicating a complex relationship that warrants further investigation. While the studies did not find a significant link between depression and fatigue, anecdotal reports and clinical observations suggest that fatigue may be a common presentation of depression in older adults.
Older adults with depression may benefit from various treatments, including counselling and medication. Counselling, such as cognitive behavioural therapy, can help address the underlying causes of depression and improve mental well-being. Additionally, adjusting dietary habits by minimising sugar and refined carbs while focusing on quality protein, complex carbs, and healthy fats can promote emotional balance and stabilise energy levels.
To improve sleep quality, older adults can practice good sleep hygiene. This includes maintaining a regular sleep schedule, having a bedtime routine, and creating a comfortable sleep environment that is dark, quiet, and cool. Regular exercise, reducing bedroom distractions, and avoiding caffeine and alcohol close to bedtime can also enhance sleep quality.
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Lifestyle factors: boredom, lack of exercise, and limited social engagement can contribute to excessive sleep
As people age, they may experience boredom due to factors such as limited mobility, poor eyesight, or a lack of engaging activities. This boredom can lead to excessive daytime napping, disrupting their sleep at night. To combat boredom, elders can be encouraged to participate in activities that stimulate their interests and engage their minds. This may include reading, puzzles, social outings, or volunteering.
Lack of exercise is another factor that can contribute to excessive sleep in older adults. Exercise helps promote good sleep by releasing chemicals in the body that facilitate rest. Additionally, exercising during the day can help regulate body temperature, triggering sleep onset at night. Older adults who exercise regularly tend to fall asleep faster, sleep longer, and report better sleep quality. However, it is important for elders to consult their doctors before starting a new fitness program, especially if they have mobility issues. Recommended exercises for older adults include swimming, water exercises, dancing, and gentle ball games like lawn bowling.
Social engagement also plays a crucial role in maintaining healthy sleep patterns. Social activities, family interactions, and work can keep older adults active and prepare their bodies for a good night's sleep. Retirement can be a significant life change that leads to reduced social interaction and subsequent sleep disturbances. To counteract this, retired individuals can consider volunteering, joining senior groups, or taking adult education classes to increase their social engagement and improve their sleep patterns.
In summary, boredom, lack of exercise, and limited social engagement are lifestyle factors that can contribute to excessive sleep in older adults, particularly those over 80 years old. By addressing these factors through stimulation, physical activity, and social interaction, older adults can improve their sleep patterns and overall well-being.
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Sleep environment: reducing distractions and hazards in the bedroom can improve sleep quality
Older adults need around seven to nine hours of sleep each night, which is similar to the amount of sleep recommended for all adults. However, older people tend to go to bed and wake up earlier than younger adults, and their sleep tends to be lighter and more disrupted. Factors such as illness, medications, mental health, and pain can impact sleep quality. Additionally, sleep disorders like insomnia, sleep apnea, and REM sleep behaviour disorder become more common with age.
To improve sleep quality, it is important to focus on the sleep environment and reduce distractions and hazards in the bedroom. Here are some ways to do this:
- Reduce bedroom distractions: Televisions, smartphones, and bright lights can disrupt sleep. Keep the bedroom reserved for sleeping and sex, and move electronics to another room.
- Keep a phone nearby: While it is important to limit distractions, it is also crucial for older adults to be able to call for help if needed. Keep a phone on the nightstand, but be mindful of excessive notifications or the temptation to look at the bright screen.
- Ensure adequate lighting: Have a light within easy reach to reduce the risk of tripping or falling when getting out of bed. Consider motion-sensor lights in hallways or bathrooms, and use nightlights or low-wattage string lights to illuminate paths to the kitchen or bathroom.
- Reduce tripping hazards: Remove rugs, throw pillows, and any clutter, such as laundry, clothing, or towels, from the floor. Securely tuck away cords and cables to prevent tripping.
- Create a clear path: Ensure there is a clear path from the bed to the door. Remove any bulky furniture that may obstruct movement.
- Address pet-related hazards: Consider relocating pet beds, crates, and toys to another area to prevent tripping over them in the middle of the night.
- Organise the bedroom: Clear out large items and create better walkways. Sentimental items, paperwork, and clothing clutter can make it difficult to navigate the space.
- Modify the flooring: Smooth or slippery floors can increase the risk of falling. Consider replacing rugs and carpets with soft wood or wood-like flooring. Apply non-slip wax to hard floors or opt for non-slip vinyl floors.
- Use appropriate footwear: Encourage the use of non-slip socks or slippers with tread to improve grip and reduce the risk of slipping.
- Follow a sleep schedule and routine: Consistency is key. Go to bed and wake up at the same time each day, even on weekends. Develop a bedtime routine, such as reading a book or listening to soothing music, to signal to your body that it's time to wind down.
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