Herbie Murray
Sleep needs do change as we age, but not in the way many people think. While it's a common misconception that older people need less sleep, the amount of sleep we need stays consistent throughout our lives. However, our sleep patterns and experience do change as we age.
For example, older people tend to go to bed and wake up earlier, and their sleep is more fragmented, resulting in poorer quality sleep and less total sleep overall. They're also more likely to nap during the day.
These changes are due to a combination of factors, including lifestyle changes, medical conditions, and sleep disorders. For instance, older people are more likely to experience insomnia, sleep apnea, and restless leg syndrome. They're also more likely to have chronic pain, which can make it difficult to sleep.
Additionally, the production of certain hormones, such as melatonin, decreases with age, which can affect the sleep-wake cycle.
While sleep needs don't change as we age, it's important to prioritise sleep and maintain good sleep habits to reduce the risk of physical and mental health conditions.
| Characteristics | Values |
|---|---|
| Sleep duration | The amount of sleep needed remains consistent throughout adulthood. The recommended sleep duration for adults is 7-9 hours. |
| Sleep quality | Sleep quality tends to decrease with age. Older people spend less time in the deeper REM stages of sleep, causing an issue for consistent deep sleep. |
| Sleep patterns | Older people tend to go to sleep earlier and wake up earlier. They also experience more fragmented sleep, with frequent nighttime waking. |
| Napping | Napping is more prevalent with advancing age. |
| Sleep disorders | Advanced age is a risk factor for sleep disorders like REM Sleep Behavior Disorder and sleep apnea. |
| Circadian rhythms | Circadian rhythms change as people age, often leading to disrupted sleep patterns. |
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What You'll Learn
Sleep patterns change with age
Sleep patterns do change as we age, and it is a common misconception that older adults need less sleep. In fact, the recommended amount of sleep for adults remains at seven to nine hours a night, regardless of age. However, older adults may find it harder to fall asleep and tend to get less or worse quality sleep, which may prompt daytime napping.
Sleep patterns begin to change around age 60, but this may differ from person to person, and underlying medical conditions can also have an impact. Older adults tend to go to bed earlier and, as a result, wake up earlier. Their sleep is also more fragmented, resulting in poorer quality sleep and less total sleep overall. They are also more likely to nap during the day.
These changes may be due to a shift in the body's internal clock, which is made up of around 20,000 cells in the brain that form the suprachiasmatic nucleus (SCN). The SCN controls our 24-hour daily cycles, or circadian rhythms, which influence when we get hungry, when the body releases certain hormones, and when we feel sleepy or alert. As we age, deterioration in the function of the SCN can disrupt these circadian rhythms.
Older adults also produce less melatonin, a hormone that is usually produced in response to darkness and helps promote sleep by coordinating circadian rhythms.
In addition, medical conditions and medications can cause pain or other symptoms that disrupt sleep. Conditions that commonly affect sleep in older people include depression, anxiety, heart disease, diabetes, and conditions that cause discomfort and pain, such as arthritis. Respiratory disorders, such as sleep apnea, also become more common as people age.
Lifestyle factors can also play a role in sleep disturbances among older adults. For example, retirement may lead to a less structured sleep-wake schedule, and social isolation can impact the quality of sleep.
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Older adults may nap more frequently
Napping can be beneficial for older adults, as it can help them compensate for lost sleep and restore energy. However, excessive napping or napping too late in the day can interfere with nighttime sleep and create further sleep disruptions. It is important for older adults to optimise their naps by creating a nap schedule, limiting nap duration, and napping earlier in the day to avoid disrupting their nighttime sleep.
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Sleep disorders are more common in older people
Older adults are more likely to nap during the day. While napping may be a common lifestyle change accompanying aging, excessive napping and long daytime naps may indicate an underlying medical condition like Alzheimer's, diabetes, and cardiovascular disease.
Nocturia, or frequent urination at night, is another factor that can disrupt sleep in older people. It often leads to fragmented sleep, short sleep duration, and even sleep deprivation.
Pain, such as arthritis and chronic pain, can also make sleep difficult for older adults. This is further exacerbated by the fact that pain and poor sleep are bidirectional: pain leads to poor sleep, and poor sleep can exacerbate pain.
Insomnia is the most common sleep disturbance reported among the elderly, affecting as much as 50-70% of all people aged 65 and over. It can lead to sleep deprivation, which has been associated with more severe and chronic health issues like diabetes, heart disease, high blood pressure, stroke, and depression.
Obstructive sleep apnea (OSA) is another common sleep disorder in older adults, with prevalence estimates as high as 70% in men and 56% in women. OSA causes fragmented sleep and poor sleep quality due to pauses in breathing caused by a complete or partial airway collapse during sleep.
Other sleep disorders that are more common in older adults include Restless Legs Syndrome, which affects 7-10% of Americans and has a prevalence of 25% in those over 65, and REM Sleep Behavior Disorder, which primarily affects older adults and is characterized by a lack of muscle paralysis during REM sleep, causing sleepers to act out their dreams.
Perimenopause and menopause can also contribute to sleep issues in older women, as decreasing estrogen levels are associated with difficulty falling asleep, maintaining sleep, frequent awakenings, and poor sleep quality.
In summary, while older adults have the same sleep needs as younger adults, they often experience more sleep disturbances due to a variety of factors, including medical conditions, lifestyle choices, and hormonal changes.
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Sleep is affected by lifestyle changes
- Retirement and reduced physical activity: Retirement often leads to a less structured sleep-wake schedule, with older adults having more flexible sleep routines. Reduced physical activity can also disrupt the normal sleep-wake cycle, making it challenging to fall asleep at night.
- Social isolation: Social isolation and reduced social interactions can impact the quality of sleep. Social connections and interactions provide important cues that help regulate our sleep and wake rhythms.
- Substance use: The consumption of substances such as caffeine, nicotine, and alcohol can interfere with sleep. Caffeine and nicotine can make it difficult to fall asleep, while alcohol may cause fragmented and poor-quality sleep once it is metabolized.
- Dietary choices: Dietary choices, such as consuming caffeinated beverages late in the day or eating a large meal close to bedtime, can impact sleep. These choices may reduce total sleep time and increase the time it takes to fall asleep.
- Napping: Napping is more prevalent among older adults and can be influenced by biological and lifestyle changes. While napping can be beneficial, excessive napping or napping too late in the day can interfere with nighttime sleep, contributing to sleep deprivation or insomnia.
- Medications: The use of multiple medications is common among older adults and can impact sleep. Certain medications may cause sleepiness during the day or disrupt sleep at night, and the interactions between multiple drugs can have unanticipated effects on sleep.
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Sleep is affected by medical conditions
Sleep is affected by a variety of medical conditions. These include:
- Pregnancy, which can cause insomnia, restless leg syndrome, sleep apnea, heartburn, and frequent nighttime urination.
- Intellectual and developmental disabilities, particularly in children, are associated with sleeping problems.
- Mental health problems, such as depression, anxiety, bipolar disorder, schizophrenia, and panic disorders.
- Neurological disorders, such as Alzheimer's disease, epilepsy, and Parkinson's disease.
- Chronic physical conditions, such as heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, respiratory problems, and thyroid disease.
- Cancer and its treatments.
- Gastroesophageal reflux disorder.
- Arthritis.
- Restless leg syndrome.
- Sleep apnea.
- Headaches, including migraines and cluster headaches.
- Stroke.
- Brain tumors.
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