Evie Summers
Do adults need less sleep? The answer is no, but they may need a different kind of sleep. While the number of hours of sleep needed per night varies from person to person, the average adult needs between 7.5 and 8 hours of sleep per night. However, many older adults get much less sleep than they need, due to factors such as insomnia, sleep apnea, restless leg syndrome, and advanced sleep phase syndrome.
| Characteristics | Values |
|---|---|
| Recommended sleep for adults aged 18-64 | 7 or more hours a night |
| Recommended sleep for adults aged 65+ | 7 to 8 hours a night |
| Average sleep for adults | 7.5 to 8 hours a night |
| Average sleep in the 1960s and 1970s | 8-8.5 hours a night |
| Average sleep in the 2000s | 7-7.5 hours or less a night |
| Sleep problems in adults over 65 | 40-70% |
| Sleep problems in adults over 65 that are undiagnosed | up to 50% |
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What You'll Learn
Older people may need a different type of sleep
While older people need the same amount of sleep as younger adults, they may need a different type of sleep. The amount of sleep an adult needs varies from person to person, but on average, an adult needs between 7 and 9 hours of sleep per night. However, older people tend to go to sleep and wake up earlier than younger adults.
Older people experience changes in the quality and duration of their sleep due to changes in the body's internal clock. The body's internal clock is made up of around 20,000 cells in the hypothalamus region of the brain, which control 24-hour daily cycles called circadian rhythms. Circadian rhythms influence when people get hungry, when the body releases certain hormones, and when a person feels sleepy or alert. As people age, their sleep changes due to the effects of an ageing internal clock, which can disrupt circadian rhythms and directly influence when people feel tired and alert.
Older people also produce less melatonin, a hormone that is usually produced in response to darkness and helps promote sleep by coordinating circadian rhythms. This can further disrupt sleep patterns in older adults.
In addition, older people may experience more sleep disturbances due to medical conditions or medications. Medical conditions can cause pain or other symptoms that disrupt sleep, and medications can make people very sleepy during the day, making it hard for them to sleep at night.
To improve sleep quality, older adults can try improving their sleep hygiene by adhering to routines, such as going to bed and waking up at the same time every day. They should also consider how substances like alcohol, caffeine, and nicotine may be impacting their sleep. Finally, physical activity and social interactions can help maintain a normal sleep/wake cycle.
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Sleep problems in seniors
Sleep problems are common in older adults. While older adults need about the same amount of sleep as all other adults (7 to 9 hours each night), their sleep is usually less deep and more fragmented. Older people also tend to go to sleep and wake up earlier than they did when they were younger.
Causes of Sleep Problems in Seniors
There are many reasons why older people may not get enough sleep at night. Here are some common causes:
- Changes in the body's natural internal clock, causing some people to fall asleep earlier in the evening and wake up earlier in the morning.
- Long-term (chronic) diseases, such as heart failure.
- Certain medications, herbs, supplements, and recreational drugs.
- Depression, which is a common cause of sleep problems at any age.
- Brain and nervous system conditions.
- Lack of physical activity.
- Pain caused by diseases such as arthritis.
- Stimulants such as caffeine and nicotine.
- Frequent urination at night (nocturia).
Symptoms of Sleep Problems in Seniors
Sleep disturbances in older adults can lead to the following symptoms:
- Difficulty falling asleep.
- Difficulty telling the difference between night and day.
- Early morning awakening.
- Waking up often during the night, sometimes due to nocturia.
Treatment of Sleep Problems in Seniors
If you are experiencing sleep problems, it is important to consult a healthcare provider. They may recommend creating a sleep diary or undergoing a sleep study (polysomnography) to identify the underlying causes. Here are some general tips to improve sleep:
- Avoid large meals shortly before bedtime, but a light bedtime snack may be helpful. Warm milk may increase sleepiness due to its natural, sedative-like amino acid content.
- Avoid stimulants such as caffeine for at least 3 to 4 hours before bed.
- Exercise regularly, but not within 3 hours of bedtime.
- Maintain a consistent sleep schedule by going to bed and waking up at the same time every day.
- Avoid watching television or using electronic devices in the bedroom.
- Avoid tobacco products, especially before sleep.
- Use the bed only for sleep or sexual activity.
- If you can't fall asleep after 20 minutes, get out of bed and engage in a quiet activity like reading or listening to music.
- Avoid sleeping pills if possible, as they can lead to dependence and worsen sleep problems over time if not used properly.
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Tips for getting more sleep
- Exercise regularly: Regular exercise helps older people fall asleep faster, sleep longer, and report better quality sleep.
- Reduce bedroom distractions: Televisions, smartphones, and bright lights can make it harder to fall asleep. Keep the television in another room and avoid falling asleep with it on. Move electronics out of the bedroom and reserve the bedroom for sleeping and sex.
- Avoid substances that discourage sleep: Alcohol, tobacco, caffeine, and large meals late in the day can make sleep more challenging. Consider quitting smoking, reducing caffeine intake, and eating dinner at least four hours before bedtime.
- Keep a regular sleep schedule: Go to bed and wake up at the same time every day, even on weekends. Avoid napping in the late afternoon or evening, as naps may keep you awake at night.
- Develop a bedtime routine: Take time to relax before bedtime each night. Some people read a book, listen to soothing music, or soak in a warm bath.
- Optimise your bedroom environment: Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible. Use low lighting in the evenings and as you prepare for bed.
- Get a comfortable bed, mattress, and pillow: Having the best mattress for your needs is vital to making sure that you are comfortable enough to relax. Investing in a supportive mattress and pillow helps ensure that your spine gets proper support to avoid aches and pains.
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Seniors and advanced sleep phase syndrome
Advanced sleep phase syndrome (ASPS) is a rare genetic neurological disorder characterised by very early sleep onset and offset. The sleep-wake cycle is generally shortened, and those with the syndrome may also experience migraines with or without aura and seasonal affective disorder. ASPS is caused by genetic mutations, which can be hereditary or occur randomly when cells are dividing.
In terms of sleep, ASPS is a type of circadian rhythm sleep-wake disorder, which includes jet lag, delayed sleep phase disorder, and non-24-hour sleep-wake disorder. The circadian rhythm is an internal biological clock that regulates sleep-wake cycles, as well as the release of hormones related to sleep, appetite, and core body temperature. The circadian rhythm of a person with ASPS operates on an earlier schedule, so melatonin, the sleep hormone, is released earlier.
Older people are more likely to have ASPS, and the syndrome can be challenging to live with. It can affect many aspects of a person's life beyond when they go to bed and when they wake up. For example, people with ASPS may have difficulty staying awake when attending social activities that are scheduled during the late afternoon or early evening. They may fall asleep during a nighttime social or family event, which can damage their social relationships.
People with ASPS may feel obligated to attend social events or engage in other activities that keep them up past their natural bedtime. Even if they manage to push their bedtime later, they may still wake up very early in the morning, causing them to miss out on sleep. Over time, this can lead to sleep deprivation, which includes symptoms like sleepiness, lack of focus or concentration, or slower reaction times.
To help themselves stay awake, people with ASPS may use caffeine or other stimulants in the afternoon or early evening. In the morning, they may use alcohol, sedatives, or sleeping pills to help them sleep in. However, using these substances will only further disrupt their sleep, leading to increased sleep deprivation and other adverse side effects.
Bright light therapy is used to treat ASPS. At specific times of day, people sit in front of a specialised light device with a brightness designed to mimic the power of the sun. To help reset their circadian rhythm, people with ASPS may use the device in the evening between 7 p.m. and 9 p.m.
Following good sleep hygiene, like keeping a regular sleep schedule, can help improve sleep quality. Doctors may also recommend avoiding caffeine, stimulants, alcohol, or other drugs.
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Medical conditions and medications that impact sleep
Sleep is an essential part of what makes our bodies function. While the amount of sleep needed varies from person to person, experts recommend that adults get seven to nine hours of sleep per night. However, various medical conditions and medications can impact sleep, disrupting this crucial aspect of our lives.
Circadian Rhythm Disturbances
Circadian rhythms are 24-hour daily cycles controlled by the body's internal clock, which is located in the hypothalamus. As people age, their circadian rhythms tend to shift forward in time, resulting in a phase advance. This shift can cause older adults to feel tired earlier in the afternoon and wake up earlier in the morning. Additionally, older individuals may not get sufficient exposure to daylight, which is a crucial cue for maintaining circadian rhythms.
Mental and Physical Health Conditions
Mental and physical health issues can significantly interfere with sleep. Conditions such as depression, anxiety, heart disease, diabetes, arthritis, and other painful conditions can disrupt sleep patterns. The relationship between physical health and sleep is further complicated by the fact that many older adults have multiple health conditions, increasing the likelihood of sleep disturbances.
Medications
The use of certain medications can also impact sleep. Almost 40% of adults over the age of 65 take five or more medications, and many of these can contribute to sleep issues. For example, the use of sedatives and hypnotics to induce sleep can lead to tolerance, dependence, and diminished sleep quality. Additionally, the interactions of multiple medications can cause unanticipated effects on sleep. It is always important to consult a doctor before starting or stopping any medication to understand its potential impact on sleep.
Sleep Disorders
Sleep disorders are conditions that affect the quality, amount, and timing of sleep. Common sleep disorders include insomnia, restless legs syndrome, narcolepsy, and sleep apnea. These disorders can be caused by various factors, including medical conditions, mental health issues, genetic factors, medications, substance use, and more. Sleep disorders can have a significant impact on overall health and well-being, affecting mental and physical health and increasing the risk of accidents and falls.
Lifestyle Factors
Lifestyle changes that come with aging can also impact sleep. For example, retirement may lead to a less structured sleep-wake schedule, and social isolation can increase stress and anxiety, disrupting sleep. Additionally, older adults may be more susceptible to the effects of substances like alcohol, caffeine, and tobacco, which can interfere with sleep.
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