Evie Summers
As people age, their sleep patterns change. Older adults tend to go to bed and wake up earlier, and their sleep tends to be shorter and lighter. Many seniors experience insomnia, sleep apnea, and movement disorders such as restless leg syndrome. Various factors, including health issues, medications, and mental health conditions, can contribute to excessive sleepiness during the day. It is important to identify the underlying causes and seek appropriate treatment or management strategies. Daytime napping can be restorative for older adults, compensating for disrupted night-time sleep, but excessive sleepiness could indicate underlying health concerns and should be discussed with a doctor.
| Characteristics | Values |
|---|---|
| Sleep pattern | Older adults tend to go to bed and wake up earlier than younger adults. |
| Sleep duration | Elderly people rarely sleep through the night and about 4 in 10 older people take at least one nap during the day. |
| Sleep quality | Sleep tends to be shorter and lighter, and older adults may wake up more often during the night. |
| Sleep disorders | Sleep disorders become more common with age, including insomnia, sleep apnea, and movement disorders such as restless legs syndrome. |
| Medication | Older adults are more likely to take medications that can affect sleep and cause excessive sleepiness. |
| Health conditions | Various health issues, such as arthritis, chronic pain, and vitamin deficiencies, can impact sleep quality and duration. |
| Mental health | Depression, anxiety, and dementia can interfere with sleep and cause insomnia or excessive sleepiness. |
| Lifestyle | Boredom, lack of stimulation, and changes in routine can contribute to excessive daytime sleepiness. |
| Age-related changes | Older adults may experience age-related changes that affect their sleep, such as decreased melatonin production and changes in circadian rhythms. |
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What You'll Learn
- Sleep disorders: insomnia, sleep apnea, and restless legs syndrome are common in older adults
- Medication: prescription drugs and over-the-counter medications can cause excessive sleepiness
- Health issues: arthritis, vitamin deficiencies, and chronic pain can disrupt sleep patterns
- Mental health: depression, anxiety, and boredom can lead to increased sleep
- Age-related changes: older adults tend to sleep more lightly and wake up more frequently
Sleep disorders: insomnia, sleep apnea, and restless legs syndrome are common in older adults
As people age, their sleep patterns change. Older adults tend to go to bed and wake up earlier, and their sleep tends to be shorter and lighter. Many older adults experience sleep disturbances due to various factors, including underlying medical and psychiatric conditions, medication use, mental health issues, and pain. Sleep disorders such as insomnia, sleep apnea, and restless legs syndrome become more prevalent with age and can significantly impact an older adult's quality of sleep and overall well-being.
Insomnia, characterised by difficulty falling or staying asleep, is the most common sleep problem in adults aged 60 and above. It can be short-term, caused by stress or changes in routine, or long-term, lasting more than three months without a clear medical explanation. Insomnia in older adults can lead to excess disability and declining health, including an increased risk of comorbid medical, psychiatric, and cognitive disorders.
Sleep apnea is another common sleep disorder in older adults, affecting up to 20% of this population. It occurs when the throat muscles relax and block the airway during sleep, causing pauses in breathing. Obstructive sleep apnea is the most common form, caused by the collapse of soft tissue in the back of the throat. Older adults are also at risk for central sleep apnea, which is due to a dysfunction in the central nervous system or heart. Sleep apnea can lead to excessive daytime sleepiness and, if left untreated, may result in serious health consequences, including an increased risk of death.
Restless legs syndrome (RLS) is a movement disorder that causes a strong urge to move the legs while resting, often accompanied by uncomfortable sensations. It can interfere with sleep, causing sleep disruptions, difficulty falling or staying asleep, and fatigue or daytime sleepiness. RLS becomes more common with age, affecting 7-10% of the US population, and symptoms tend to worsen as individuals get older.
It is important for older adults experiencing sleep disturbances to seek help. Practicing healthy sleep habits, keeping a sleep diary, and consulting a healthcare provider can aid in diagnosing and managing sleep disorders. Cognitive-behavioural therapy (CBT-I) is a non-pharmacological, evidence-based treatment for insomnia in older adults, proven effective even in those with comorbid medical, psychiatric, and cognitive disorders. Sleep medicines may provide short-term relief for insomnia but carry risks and are not recommended for long-term use. Treatment options are also available for sleep apnea, including continuous positive airway pressure (CPAP) devices, dental devices, and surgery.
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Medication: prescription drugs and over-the-counter medications can cause excessive sleepiness
As people age, their sleep patterns change. Older adults tend to go to bed earlier and wake up earlier, and their sleep tends to be shorter and lighter. Many older adults experience insomnia, the most common sleep problem in adults over 60. Sleep disorders, such as sleep apnea and restless leg syndrome, also become more prevalent with age.
In addition to these age-related changes, certain medications can also contribute to excessive sleepiness in older adults. Older adults are more likely to take multiple medications, and these can sometimes interact in undesirable ways or cause side effects, such as increased sleepiness. It is important to be aware of potential side effects and to consult a doctor or pharmacist if you have any concerns.
Prescription Drugs
Prescription medications that can cause fatigue and drowsiness include:
- Antihistamines used for allergy relief, such as brompheniramine (Bromfed, Dimetapp), diphenhydramine, hydroxyzine (Vistaril, Atarax), meclizine (Antivert), and Benadryl.
- Antidepressants, particularly tricyclics like amitriptyline (Elavil, Vanatrip), doxepin (Silenor, Sinequan), imipramine (Tofranil, Tofranil PM), and trimipramine (Surmontil).
- Muscle relaxants, including carisoprodol (Soma) and cyclobenzaprine (Flexeril).
- Opioid pain medications, such as fentanyl (Actiq, Duragesic, Fentora), oxycodone and aspirin (Percodan), oxycodone and acetaminophen (Percocet, Roxicet), morphine, oxymorphone (Opana, Opana ER), oxycodone (OxyContin, OxyIR), and hydrocodone and acetaminophen (Lorcet, Lortab, Vicodin).
- Seizure or epilepsy medications, also known as anticonvulsants.
- Sleeping pills, including Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta).
- Benzodiazepines (benzos).
Over-the-Counter Medications
Over-the-counter drugs that can cause sleepiness include:
- Allergy medications (antihistamines) like Benadryl and Xyzal.
- Sleeping pills and sleep aids, which often contain antihistamines.
- Gut medications that control nausea, vomiting, or treat diarrhea.
If you or your loved one is experiencing excessive sleepiness, it is important to consult a doctor to rule out any underlying health issues and to review medications. Adjustments to dosage, timing, or alternative medications may be considered to alleviate excessive sleepiness.
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Health issues: arthritis, vitamin deficiencies, and chronic pain can disrupt sleep patterns
Older adults tend to go to bed earlier and wake up earlier, and their sleep tends to be shorter and lighter, with more frequent awakenings during the night. Several factors can contribute to these changes in sleep patterns, including medical conditions such as arthritis, vitamin deficiencies, and chronic pain.
Arthritis is a common condition in older adults that can significantly impact sleep quality. The pain and stiffness associated with arthritis can make it difficult to get comfortable and fall asleep. Additionally, certain medications used to treat arthritis, such as steroid tablets, can affect the body clock and disrupt sleep. To improve sleep with arthritis, it is recommended to consult a healthcare professional, such as a rheumatology consultant or physiotherapist, who can advise on medication timing, lifestyle changes, and exercises to reduce joint pain and improve sleep.
Vitamin deficiencies, such as low levels of vitamin D, magnesium, or calcium, can also disrupt sleep patterns in older adults. Vitamin D plays a role in sleep regulation, and deficiencies have been linked to disrupted sleep. Magnesium is essential for muscle relaxation and promoting calmness, and deficiencies can lead to insomnia and restless nights. Calcium is crucial for the production of melatonin, the hormone that regulates sleep. Addressing these vitamin deficiencies through dietary adjustments or supplementation can help improve sleep quality.
Chronic pain is another common issue among older adults that can interfere with sleep. The bidirectional relationship between sleep and pain means that a good night's sleep can alleviate painful symptoms, while chronic pain can lead to long-term sleep deprivation. The cycle of sleep stages, including light sleep, slow-wave sleep, and rapid eye movement (REM) sleep, can be disrupted by chronic pain, resulting in less restful sleep and next-day tiredness. Prioritizing sleep and managing pain through medication, physiotherapy, exercise, or mattress and pillow adjustments may help improve sleep quality for individuals with chronic pain.
Overall, addressing health issues such as arthritis, vitamin deficiencies, and chronic pain can be crucial in improving sleep patterns and promoting overall well-being in older adults. Consulting healthcare professionals and making appropriate lifestyle changes can help mitigate the impact of these conditions on sleep quality.
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Mental health: depression, anxiety, and boredom can lead to increased sleep
As people age, their sleep patterns change. Older adults tend to go to bed and wake up earlier, and their sleep is often shorter and lighter. Many older adults struggle with sleep due to illnesses, medications, mental health issues, and pain. Sleep disorders, such as insomnia, sleep apnea, and movement disorders, become more common with age.
Mental health conditions, such as depression and anxiety, are prevalent among older adults and can contribute to excessive sleepiness. Depression can cause fatigue and a loss of interest in activities, leading to increased sleep. It is often triggered by boredom, loneliness, loss of purpose, medication changes, bereavement, or health issues. Social isolation and loneliness are risk factors for depression in later life, and older adults are more susceptible to these factors due to retirement, bereavement, and ageism. Abuse of older people is also, unfortunately, a risk factor for depression and anxiety.
Anxiety disorders are another common mental health concern for older adults. They may experience anxiety due to adverse life events, financial insecurity, or age-related health issues. These anxieties can interfere with sleep, causing or exacerbating sleep disorders.
Boredom is a significant factor contributing to excessive sleep in older adults. Retirement often leaves older adults with fewer activities to occupy their days, leading to boredom and napping. This boredom can also contribute to depression, further increasing sleepiness.
If you notice an older loved one sleeping more than usual, it is important to encourage them to seek professional help to address any underlying mental health or medical issues. Lifestyle changes, establishing a consistent sleep schedule, and improving sleep habits can also help promote healthier sleep patterns in older adults.
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Age-related changes: older adults tend to sleep more lightly and wake up more frequently
Older adults tend to experience disrupted sleep patterns due to various age-related changes. One notable change is the tendency to sleep more lightly and wake up more frequently during the night. This phenomenon can be attributed to several factors, which we will explore in detail below.
Firstly, older adults often go to bed and wake up earlier compared to younger adults. This shift in sleep schedule can be influenced by factors such as changes in circadian rhythms and a decrease in social engagements or activities that occupy their time during the day. As a result, they may compensate for lost sleep by taking restorative naps during the day, which is a common and healthy practice.
However, disrupted sleep in older adults can also be attributed to more frequent health issues and the medications used to manage them. Conditions such as arthritis, chronic pain, and urinary incontinence can cause discomfort and interrupt sleep. Additionally, older adults are more likely to experience sleep disorders like insomnia, sleep apnea, and restless legs syndrome, which can further contribute to fragmented sleep.
Medications play a significant role in sleep patterns as well. Older adults are more likely to take multiple medications to manage various health conditions, and certain drugs can have side effects that promote sleepiness or disrupt sleep cycles. This polypharmacy, or use of multiple medications, can complicate sleep patterns and make it challenging to maintain consistent and restful sleep.
Lastly, mental health conditions, such as depression, anxiety, and dementia, can also impact sleep in older adults. Depression, for instance, can cause excessive fatigue, making it difficult to stay awake during the day. Anxiety can interfere with sleep, leading to insomnia or fragmented sleep. Dementia, including Alzheimer's disease, can impair sleep quality due to increased confusion and disturbances in circadian rhythms.
While age-related changes can contribute to lighter sleep and frequent awakenings in older adults, it is important to address any underlying health or mental health concerns and ensure that sleep patterns do not significantly interfere with their overall well-being and daily functioning. Seeking medical advice and adopting healthy sleep habits can help improve sleep quality in older adults.
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Frequently asked questions
Older people tend to sleep more lightly than when they were younger and wake up more frequently during the night. Seniors compensate for this lost sleep by taking restorative naps during the day.
Excessive sleep in older people can lead to problems with thinking and memory. Research also suggests that excessive sleep may accelerate brain ageing, making it difficult to perform simple daily tasks.
Excessive sleepiness in older people can be caused by problems sleeping at night, health issues, mood disorders, or side effects of medication.
Specific health issues that cause excessive sleepiness in older people include sleep apnea, depression, vitamin deficiencies, chronic pain, and dementia.
If an older person is sleeping a lot, it is important to ensure they are getting the necessary personal care, nutrition, hydration, and medications. It is also recommended to consult a doctor to identify any underlying health issues and determine an appropriate treatment plan.
