Herbie Murray
Sleep is an essential part of life, and getting a good night's rest is crucial for maintaining health and alertness. As people age, their sleep patterns and needs can change, and it is a common misconception that older adults require less sleep. In fact, adults, including older adults, are recommended to get around 7-9 hours of sleep each night. However, various factors can contribute to sleep difficulties in older individuals, such as medical conditions, medications, lifestyle changes, and mental and physical health. Understanding these factors and implementing healthy sleep habits are key to improving sleep quality and duration as we age.
| Characteristics | Values |
|---|---|
| Recommended amount of sleep | 7-9 hours |
| Sleep patterns | Older people tend to go to bed and get up earlier |
| Sleep quality | Older people experience less deep sleep and shorter periods of REM sleep |
| Sleep issues | Insomnia, sleep apnea, restless leg syndrome, hypersomnia, narcolepsy |
| Sleep and health | Lack of sleep is associated with depression, heart disease, and type 2 diabetes |
| Sleep tips | Exercise, reduce distractions, avoid substances, maintain a sleep schedule, develop a bedtime routine |
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What You'll Learn
Sleep patterns and the body's internal clock
As we age, our sleep patterns change due to our body's internal clock, known as the suprachiasmatic nucleus (SCN), which is responsible for regulating our 24-hour circadian rhythms. The deterioration of the SCN with age can disrupt these rhythms, affecting when we feel tired and alert.
Circadian rhythms are influenced by light exposure, which acts as a powerful cue for maintaining these cycles. However, older individuals often experience insufficient daylight exposure, averaging around one hour less per day than younger adults. This reduced exposure to natural light can contribute to disrupted sleep patterns in the elderly.
Additionally, hormonal changes, such as decreased melatonin production, can also impact sleep in older adults. Melatonin is a hormone that promotes sleep and its decline with age may result in shorter sleep duration and poorer sleep quality.
Age-related changes in sleep architecture also contribute to sleep disturbances. Older adults spend more time in the earlier, lighter stages of sleep and less time in the deeper stages of sleep, resulting in more frequent awakenings during the night. This shift in sleep architecture can lead to fragmented and less restful sleep.
Furthermore, older individuals may experience a phase advance in their circadian rhythms, feeling tired earlier in the afternoon and waking up earlier in the morning. They may also require a longer recovery period to adjust to changes in their sleep schedules, such as those caused by jet lag or daylight saving time changes.
While it is a common misconception that older adults need less sleep, the recommended sleep duration for adults of all ages remains relatively consistent. Adults, including older adults, should aim for at least seven hours of sleep per night. However, older people may have a harder time achieving this due to various factors, including medical conditions, medications, lifestyle changes, and mental and physical health issues.
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Health conditions and medications
Older adults may experience changes in their sleep patterns due to various health conditions and medications. Here are some common health conditions and their impact on sleep:
- Mental and physical health issues: Conditions such as depression, anxiety, heart disease, diabetes, arthritis, and other chronic illnesses can interfere with sleep. Addressing these conditions and managing symptoms is crucial for improving sleep quality.
- Circadian rhythm disruptions: Aging is associated with changes in the body's internal clock, known as the suprachiasmatic nucleus (SCN), which regulates circadian rhythms. This can result in shifts in sleep schedules, making older adults feel sleepy earlier in the evening and waking up earlier in the morning.
- Hormonal changes: The production of hormones like melatonin and cortisol decreases with age. Melatonin is crucial for promoting sleep and regulating circadian rhythms. Its decline can lead to more fragmented sleep and frequent awakenings during the night.
- Pain and discomfort: Conditions such as arthritis, asthma, diabetes, osteoporosis, nighttime heartburn, and Alzheimer's disease can cause pain and discomfort, disrupting sleep. It is important to manage these conditions and find ways to minimise their impact on sleep.
- Menopause and post-menopause: Hot flashes and night sweats during menopause can interrupt sleep. Even after menopause, sleep problems can persist, and improving daytime habits, especially diet and exercise, can help.
- Medications: Older adults tend to take multiple medications, and the combination of drugs and their side effects can impair sleep. It is essential to review medications with a doctor to identify any that may be contributing to sleep issues and explore alternative options or adjustments.
Additionally, older adults may experience sleep disturbances due to lifestyle factors such as retirement, loss of independence, social isolation, and stress. Addressing these factors and making healthy lifestyle choices can improve sleep quality.
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Lifestyle and retirement
Retirement is a significant life change that can impact your sleep. With retirement comes a less structured sleep-wake schedule, which can disrupt your body's natural sleep/wake cycle. This, in turn, can lead to difficulties falling asleep and staying asleep.
To counter this, it is important to maintain a regular sleep schedule, even during retirement. Go to bed and wake up at the same time each day, including weekends. Avoid napping during the day, especially in the late afternoon or evening, as this can interfere with your nighttime sleep.
Developing a bedtime routine can also help improve your sleep as a retiree. This might include activities such as reading a book, listening to soothing music, or taking a warm bath to help you relax and prepare for sleep. It is also recommended to avoid stimulating activities, such as watching TV or using electronic devices, before bed, as the light from these devices can interfere with your sleep.
In addition to a bedtime routine, establishing a daily exercise routine can also improve your sleep. However, it is important to avoid exercising within three hours of your bedtime, as this may make it harder to fall asleep.
Retirement can also bring about other lifestyle changes, such as increased stress and anxiety due to social isolation or other life changes. These factors can further contribute to sleep difficulties. It is important to address these issues and practice stress management techniques, such as meditation or relaxation exercises, to improve your sleep quality.
Overall, maintaining a consistent sleep schedule, establishing bedtime and daily routines, and managing stress through exercise or relaxation techniques can help improve your sleep during retirement.
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Sleep disorders and medication
Older adults need about the same amount of sleep as all other adults, between seven and nine hours each night. However, older people's sleep patterns are often impacted by medical conditions and medications. Tranquilisers, sleeping pills, muscle relaxers, and antidepressants can all change sleep architecture, causing drowsiness or insomnia.
There are several types of drugs used to treat sleep disorders. Doctors may prescribe anti-Parkinsonian drugs, benzodiazepines, non-benzodiazepine hypnotics, melatonin receptor stimulators, anticonvulsants, antinarcoleptics, antidepressants or antianxiety medications, orexin receptor antagonists, and sedative-hypnotic drugs. These medications are typically used for a short time and in combination with good sleep practices and/or behavioural treatments.
Benzodiazepines, for example, are a class of drugs called hypnotics, and they are used to treat parasomnias, bruxism (teeth grinding), and short-term insomnia. Non-benzodiazepine hypnotics, such as eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien), are also used to treat short-term insomnia. Melatonin receptor stimulators, like ramelteon (Rozerem), are used to treat insomnia, while anti-Parkinsonian drugs may be used to treat restless leg syndrome and periodic limb movement disorder.
Anticonvulsants are used to treat nocturnal eating syndrome, restless legs syndrome, periodic limb movement disorder, and insomnia related to bipolar disorder. Antinarcoleptics, such as methylphenidate (Ritalin) and modafinil (Provigil), can improve daytime wakefulness in shift workers, as well as those with narcolepsy or sleep apnea. Antidepressants or antianxiety medications may also be used for sleep since drowsiness is one of their main side effects.
Sedative-hypnotic drugs are a class of drugs used to induce and/or maintain sleep. However, the FDA has issued warnings about serious risks and even death when combining opioid pain or cough medicines with benzodiazepines.
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Improving sleep
While sleep requirements vary from person to person, most healthy adults require seven to nine hours of sleep per night. Older people tend to go to bed earlier and get up earlier than when they were younger.
Improve your sleep environment
Naturally boost your melatonin levels by minimising artificial light at night. Use low-wattage bulbs, and turn off the TV and computer at least one hour before bed. Make sure your bedroom is quiet, dark, and cool. Use a sound machine, earplugs, or a sleep mask if necessary. Ensure your bed is comfortable, and use your bedroom only for sleep and sex.
Keep a regular bedtime routine
Maintain a consistent sleep schedule. Go to bed and wake up at the same times every day, even on weekends. Develop soothing bedtime rituals, such as taking a bath, playing music, or practicing relaxation techniques such as deep breathing or meditation.
Learn the best ways to nap
Keep naps short, and in the early afternoon. Most people benefit from limiting naps to 15-45 minutes, and napping too late in the day may disrupt your nighttime sleep.
Use diet to improve sleep
Watch what you eat and drink in the hours before bedtime. Limit caffeine and alcohol late in the day, and avoid big meals or spicy foods just before bedtime. Eat a light snack such as low-sugar cereal, yogurt, or warm milk if you're hungry.
Exercise for overcoming sleep problems
Exercise, especially aerobic activity, releases chemicals in your body that promote more restful sleep. Swimming, dancing, and cycling are great options. Even if you have mobility issues, there are many activities you can do, such as water exercises or golf.
Reduce mental stress
Stress and anxiety can interfere with sleep. Keep a journal to record your worries before bed, and listen to calming music or read a relaxing book. Seek opportunities to talk about what's troubling you with a friend, family member, or therapist.
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Frequently asked questions
No, adults of all ages are recommended to get 7-9 hours of sleep each night. However, older people tend to go to sleep and wake up earlier than younger people.
Older people's bodies produce less melatonin, which is a hormone that helps promote sleep. They also tend to spend more time in the earlier, lighter stages of sleep and less time in the later, deeper stages of sleep.
Not getting enough sleep can increase older adults' risk of dementia or other memory issues. Sleep deprivation can also cause confusion and other mental changes, and is a major cause of car accidents and depression.
Older people can improve their sleep by exercising regularly, reducing exposure to bright lights and screens before bed, avoiding caffeine and alcohol, and maintaining a regular sleep schedule.
