Gina Johnson
It is a common misconception that older people need less sleep than younger people. While older adults may find it harder to sleep, this does not mean they need less sleep. In general, adults should aim to get at least seven hours of sleep each night. Older adults often experience changes in the quality and duration of their sleep, which can be caused by a variety of factors, including changes in their body's internal clock, medications, and health conditions. Poor sleep in older adults can lead to various health issues, including cognitive decline, depression, and cardiovascular problems. Therefore, it is important for older adults to prioritize good sleep hygiene and maintain consistent sleep schedules to improve their sleep quality.
| Characteristics | Values |
|---|---|
| Circadian rhythms | Older people's circadian rhythms change, causing them to wake up earlier and go to bed earlier. |
| Sleep duration | Older people sleep for fewer hours than younger people, but this does not necessarily mean they need less sleep. |
| Sleep quality | Older people's sleep tends to become lighter and more fragmented, with more awakenings during the night. |
| Sleep disturbances | Common sleep disturbances in older adults include insomnia, daytime sleepiness, and sleep apnea. |
| Sleep hygiene | Maintaining good sleep hygiene, such as consistent sleep schedules and a calming bedtime routine, can improve sleep quality for older adults. |
| Health risks | Poor sleep in older adults is linked to increased risks of cognitive decline, depression, and poorer cardiometabolic health. |
| Medical conditions | Medical conditions such as arthritis, sleep apnea, and bladder disorders can contribute to sleep disturbances in older adults. |
| Medication | Medications for medical conditions and sleep aids can disrupt sleep or cause side effects that affect sleep quality. |
| Lifestyle changes | Lifestyle changes, such as retirement and social isolation, can impact sleep patterns and increase stress and anxiety. |
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What You'll Learn
Circadian rhythms and ageing
Circadian rhythms change as people age, often leading to disrupted sleep patterns. The body's internal clock, located in the hypothalamus, is made up of around 20,000 cells that form the suprachiasmatic nucleus (SCN). The SCN controls 24-hour daily cycles or circadian rhythms, which influence when people feel sleepy or alert.
As people age, their sleep patterns change due to the effects of an ageing SCN. A deterioration in the function of the SCN can disrupt circadian rhythms, directly influencing when people feel tired and alert. Older people's body clocks may prevent them from sleeping during the day, even if they want to.
Research has shown that older adults' body clocks shift forward in time, known as a phase advance. This shift causes older adults to feel tired earlier in the afternoon and wake up earlier in the morning. They might still need sleep, but they can't get it, and when they do fall asleep, the quality of sleep is not as good as when they were younger.
Ageing also causes a decline in the production of the hormone melatonin, which normally promotes sleep by coordinating circadian rhythms. This decline can affect body temperature regulation and further disrupt the sleep-wake cycle. Changes in body temperature and melatonin release are two mechanisms suggested to be responsible for the decrease in sleep time as people age.
Additionally, older adults often face sleep barriers, such as disabilities and chronic illnesses, which can further disrupt their sleep. Furthermore, certain medications and health conditions like arthritis or sleep apnea can also impact sleep quality.
While sleep patterns and needs may change with ageing, it is a myth that older adults require less sleep. Adults aged 65 and older are still recommended to get seven to nine hours of sleep per night, similar to younger adults. However, older adults may experience lighter and more fragmented sleep, waking up more frequently throughout the night.
To improve sleep quality, older adults can maintain good sleep hygiene practices, such as consistent sleep schedules, calming bedtime routines, and limiting caffeine and alcohol intake.
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Sleep disorders in older people
Causes of sleep disturbances in older adults
Sleep disturbances in older adults can be caused by a variety of factors, including:
- Changes in the body's natural internal clock, causing some people to fall asleep earlier in the evening
- Long-term (chronic) diseases, such as heart failure
- Certain medications, herbs, supplements, and recreational drugs
- Depression, which is a common cause of sleep problems in people of all ages
- 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 disturbances in older adults
Symptoms of sleep disturbances in older adults can include:
- Difficulty falling asleep
- Difficulty telling the difference between night and day
- Early morning awakening
- Waking up often during the night (for example, due to nocturia)
Managing sleep disturbances in older adults
To manage sleep disturbances, older adults should consult a healthcare provider, who will take a history and perform a physical exam to determine the underlying causes. The provider may recommend creating a sleep diary or undergoing a sleep study (polysomnography).
Relieving chronic pain, controlling medical conditions such as nocturia, and treating depression can help improve sleep. Additionally, older adults should practise good sleep hygiene, such as sleeping in a quiet, comfortable room and having a relaxing bedtime routine. Other tips include:
- Avoiding large meals, caffeine, and alcohol shortly before bedtime
- Exercising regularly, but not too close to bedtime
- Maintaining a consistent sleep and wake schedule
- Avoiding screen time in the bedroom
- Avoiding tobacco products, especially before sleep
- Using the bed only for sleep or sexual activity
- Engaging in quiet activities if unable to fall asleep
- Avoiding sleeping pills if possible, as they can lead to dependence and worsen sleep problems over time
In some cases, older adults may benefit from cognitive behavioural therapy or short-term use of sleep medications under the supervision of a healthcare provider.
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Sleep and physical health
Sleep is vital for our physical health, and this remains true as we get older. However, older people often experience changes in their sleep patterns, with many reporting sleep disturbances. These changes are often due to alterations in the body's internal clock, known as the suprachiasmatic nucleus (SCN), located in the hypothalamus region of the brain. The SCN controls our circadian rhythms, which dictate when we feel sleepy or alert. As we age, the SCN deteriorates, disrupting circadian rhythms and causing older adults to feel tired earlier in the afternoon and wake up earlier in the morning.
Older adults still require 7-9 hours of sleep per night, similar to younger adults. However, their sleep tends to become lighter and more fragmented, with more frequent awakenings during the night. This disruption can be attributed to various factors, including natural changes in the internal body clock, medications, and health conditions common in older adults, such as arthritis or sleep apnea.
The quality and quantity of sleep can have a significant impact on physical health. Poor sleep in older adults is associated with an increased risk of cognitive decline, depression, and poorer cardiometabolic health. Additionally, a lack of sleep can affect the immune system, leading to potential health issues such as high blood pressure, obesity, heart disease, and depression.
To maintain optimal physical health, older adults should aim for consistent sleep schedules, calming bedtime routines, and limit caffeine and alcohol consumption. These practices can improve sleep quality and enhance overall physical, mental, and emotional well-being.
While sleep patterns may shift with age, it is important to recognize and address sleep disturbances. Seeking medical advice and adopting good sleep hygiene practices can help older adults improve their sleep quality and overall health.
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Sleep and mental health
Sleep is an integral part of mental health. As we age, our sleep patterns change, and we may experience more fragmented sleep. This can be due to shifts in our internal body clock, medications, or health conditions. Maintaining good sleep hygiene, such as consistent sleep schedules and a calming bedtime routine, can significantly improve sleep quality.
Older adults who experience poor sleep are at an increased risk of cognitive decline, depression, and poorer cardiometabolic health. Sleep helps regulate mood, improve cognitive function, and enhance emotional resilience. It supports heart health, boosts the immune system, and keeps energy levels steady.
The quality and duration of sleep can be impacted by various factors, including medical or psychiatric illnesses, pain, depression, and lifestyle changes. It is important to distinguish between normal age-related changes and sleep disorders. Seeking professional help for sleep problems is essential, especially if they persist for a month or longer and interfere with daily activities.
Additionally, the use of prescription and over-the-counter medications to aid sleep in older adults is a concern. As we age, our bodies break down drugs less efficiently, and the effects may last longer. It is crucial to consult a healthcare professional before taking any sleep aids to avoid potential side effects and dependency.
While the idea that older people need less sleep is a common misconception, the truth is more complex. Older adults still require similar sleep durations as younger adults, but their sleep tends to become lighter and more interrupted. The decrease in sleep quality and quantity can have a significant impact on overall health and well-being.
To address sleep issues, older adults can adopt good sleep hygiene practices, such as regular exercise, limiting caffeine and alcohol intake, and maintaining a consistent sleep schedule. Cognitive behavioural interventions have also been found to be effective in some cases, offering an alternative to sleeping pills.
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Sleep tips for older adults
Older adults still need 7–9 hours of sleep per night, similar to younger adults, but their sleep often becomes lighter and more fragmented. Here are some tips to help you get a good night's sleep.
Maintain a regular sleep schedule
Go to bed and get up at the same time every day, even on weekends or when you are travelling. Avoid sudden changes in your sleep schedule.
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.
Improve your sleep environment
Keep your bedroom dark, cool, and quiet. Use low-wattage bulbs and turn off the TV and computer at least one hour before bed. Make sure your bed is comfortable and use your bedroom only for sleep and sex.
Avoid substances that discourage sleep
Substances like alcohol, tobacco, and caffeine can make sleep more challenging. Consider quitting smoking, reducing caffeine intake, and eating dinner at least four hours before bedtime.
Exercise regularly
Older people who exercise regularly fall asleep faster, sleep longer, and report better quality sleep. Even if you have mobility issues, there are countless activities you can do, such as swimming, dancing, and cycling.
Reduce mental stress
Stress and anxiety built up during the day can interfere with sleep at night. Learn how to let go of thoughts and worries when it's time to sleep. Keep a journal, listen to calming music, or get a massage from a friend or partner.
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Frequently asked questions
No, adults over 65 still need 7-9 hours of sleep per night. However, their sleep often becomes lighter and more fragmented.
According to the National Institutes of Health, more than half of all people aged 65 or over experience disturbed sleep. Insomnia is the most common complaint, which can be caused or worsened by chronic illnesses, certain medications, or lifestyle factors such as caffeine consumption or lack of physical activity.
Aging is associated with changes in the body's internal clock, also known as circadian rhythms, which can cause older adults to fall asleep and wake up earlier. Additionally, the production of hormones like melatonin and cortisol may decrease with age, further disrupting sleep patterns.
Older adults may find it more difficult to fall asleep or stay asleep throughout the night. They may also experience more frequent awakenings and have trouble falling back asleep. These are normal age-related changes, but repeated sleep problems are not normal at any age and could indicate an underlying sleep disorder.
Maintaining good sleep hygiene practices, such as consistent sleep schedules, a calming bedtime routine, limiting caffeine and alcohol intake, and regular physical activity, can help enhance sleep quality and overall well-being.
