Miya Pearson
Sleep patterns tend to change as we age. While older adults need about seven to nine hours of sleep, the same amount as all other adults, they tend to go to sleep earlier and get up earlier. Older people may find it harder to fall asleep and may wake up more frequently, leading to a disrupted sleep cycle and a lighter sleep overall. Various factors can contribute to these changes, including lifestyle changes, medical conditions, medications, and changes in hormone production. Sleep issues in older adults can also be related to the side effects of medications, with many over-the-counter and prescription drugs impacting sleep.
| Characteristics | Values |
|---|---|
| Recommended sleep hours for 65+ | 7-8 hours |
| Sleep patterns | Older people tend to go to bed earlier and wake up earlier. |
| Sleep quality | Older people tend to wake up more often and spend less time in deep sleep. |
| Sleep disorders | Insomnia, restless legs syndrome, narcolepsy, hypersomnia, sleep apnea, sleep-disordered breathing, snoring, excessive daytime sleepiness, nocturnal confusion, and daytime cognitive impairment are common in older adults. |
| Sleep issues | Caused by medications, lifestyle changes, mental and physical health conditions, substance use, and lack of physical activity. |
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What You'll Learn
- Sleep disorders, such as insomnia, restless legs syndrome, and sleep apnea, are common in older adults
- Medical conditions like arthritis, diabetes, and heart disease can cause discomfort and disrupt sleep
- Medications for multiple health issues can cause or worsen sleep issues in older adults
- Lifestyle changes, such as retirement and reduced physical activity, can impact sleep patterns
- Hormonal changes, particularly a decrease in melatonin, can contribute to sleep disturbances
Sleep disorders, such as insomnia, restless legs syndrome, and sleep apnea, are common in older adults
Sleep is a complex process that involves multiple parts of the brain working together to prepare the body for sleep. While older adults need the same amount of sleep as younger adults (seven to nine hours each night), older people tend to go to bed earlier and wake up earlier. Many older adults experience insomnia, restless legs syndrome, and sleep apnea, which can disrupt their sleep patterns and impact their overall health and well-being.
Insomnia is a sleep disorder characterized by dissatisfaction with sleep quality or quantity, leading to difficulty falling asleep, maintaining sleep, or waking up earlier than desired. It can persist for at least three months, occurring at least three nights per week, and causing distress or impairment during the day. Insomnia in older adults can lead to excess disability and declining health, often coinciding with other medical, psychiatric, and cognitive disorders. Cognitive-behavioral therapy for insomnia (CBT-I) is a non-pharmacological intervention that has been successful in treating insomnia in older adults, even those with comorbid conditions.
Restless legs syndrome (RLS) is another common sleep disorder in older adults, affecting an estimated 10 to 35% of individuals over 65. RLS is characterized by unpleasant sensations in the legs, typically in the evening, resulting in motor restlessness. Movement temporarily relieves the symptoms. RLS can lead to insomnia and depression if left untreated. Treatment options for RLS include medication and non-pharmacological approaches such as gentle yoga programs, which have been shown to improve sleep, mood, and blood pressure in older women with RLS.
Sleep apnea is a serious sleep disorder affecting up to 20% of older adults. The most common form is obstructive sleep apnea, caused by the collapse of soft tissue in the back of the throat, blocking the upper airway during sleep. Older adults are also at risk for central sleep apnea, which is caused by a dysfunction in the central nervous system or heart. Sleep apnea can lead to excessive daytime sleepiness, and when left untreated, significantly increases the risk of death in older adults. Treatment for sleep apnea is available at sleep disorder centers, and seeking help is crucial to improving sleep quality and overall health.
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Medical conditions like arthritis, diabetes, and heart disease can cause discomfort and disrupt sleep
While older adults need about seven to nine hours of sleep each night, just like all other adults, many older people don't sleep well. Sleep is a complex process involving multiple parts of the brain that work together to prepare the body for sleep. Sleep-wake homeostasis, or the body's drive to sleep, increases the longer one is awake. Certain signals in the body, such as melatonin and adenosine, also lead to sleep.
It is important to note that not everyone with diabetes will experience sleep disturbances, but the relationship between diabetes and sleep is bidirectional. Well-managed diabetes may lead to improved sleep quality, and sufficient sleep supports better diabetes management. Similarly, maintaining a healthy sleep schedule and addressing sleep disruptions can positively impact heart health and overall well-being.
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Medications for multiple health issues can cause or worsen sleep issues in older adults
Older adults need around seven to nine hours of sleep each night, which is about the same amount of sleep as all adults. However, older people tend to go to bed earlier and wake up earlier than they did when they were younger. Sleep patterns tend to change as people age, and many older people don't sleep well.
Medications such as beta-blockers, glucocorticoids, non-steroidal anti-inflammatory drugs, decongestants, and antiandrogens may be one of the factors contributing to insomnia. Additionally, many antidepressants, antihypertensives, sedatives, antihistamines, and steroids can interfere with sleep. Benzodiazepines are the most commonly prescribed agents for sleep, but users tend to report poorer sleep quality than non-users. They can increase the risk of cognitive and psychomotor impairments, falls, fractures, and motor vehicle accidents. Therefore, they should be limited to specific indications such as seizure disorders, REM sleep disorders, benzodiazepine or alcohol withdrawal, and severe generalized anxiety disorder.
Older adults with respiratory symptoms, physical disabilities, and fair to poor perceived health are at increased risk of insomnia. Lifestyle changes that come with ageing, such as retirement, loss of independence, and social isolation, can also increase stress and anxiety, contributing to sleep issues.
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Lifestyle changes, such as retirement and reduced physical activity, can impact sleep patterns
Lifestyle changes, such as retirement and reduced physical activity, can significantly impact the sleep patterns of 65-year-olds. Firstly, retirement often leads to a less structured sleep-wake schedule. Without the routine of a work schedule, retirees may experience a shift in their body's circadian rhythms, known as a "phase advance". This can result in them feeling tired earlier in the afternoon and waking up earlier in the morning. Retirement also brings more leisure time, which can lead to increased sleep duration, especially for those who previously slept less or had busy work schedules.
Additionally, reduced physical activity can influence sleep patterns. Regular physical activity can improve sleep quality, reduce sleep latency, and enhance overall sleep duration. Moderate-intensity physical activities are particularly beneficial in improving sleep quality by decreasing sleep latency, increasing total sleep time, and reducing pre-sleep anxiety. However, high-intensity physical activities, especially close to bedtime, may negatively impact sleep quality and make it difficult to fall asleep. Short-term interventions of physical exercise, lasting three months or less, have been found to be more effective in improving sleep quality than longer interventions.
It is important to note that the impact of physical activity on sleep can vary among individuals, and future studies should consider providing detailed exercise suggestions tailored to specific age groups. Nonetheless, engaging in regular moderate-intensity physical activities can be a natural way to improve sleep quality and address sleep disturbances in older adults.
Furthermore, other lifestyle changes associated with aging, such as loss of independence and social isolation, can increase stress and anxiety, further contributing to sleep issues. Aging is associated with various mental and physical health conditions that may also interfere with sleep. Conditions like depression, anxiety, heart disease, diabetes, and arthritis are commonly linked to sleep disturbances in older adults. Therefore, addressing these lifestyle changes and health conditions is crucial for improving sleep patterns in 65-year-olds.
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Hormonal changes, particularly a decrease in melatonin, can contribute to sleep disturbances
Sleep patterns tend to change as we age. Older people tend to go to bed and wake up earlier than they did when they were younger. They also tend to wake up more frequently during the night and in the early morning, and spend less time in deep sleep. This can make older people feel sleep-deprived, even if their total sleep time has not changed.
Hormonal changes, particularly a decrease in melatonin, can contribute to these sleep disturbances. Melatonin is a hormone that the body releases in response to darkness, making us feel sleepy. As people age, the body secretes less melatonin, which can make it harder to fall asleep and stay asleep. This reduction in melatonin secretion may be associated with physiological ageing and neurodegenerative diseases.
The decrease in melatonin can also affect the sleep-wake cycle, or circadian rhythm. Melatonin levels typically rise as light fades in the evening, signalling to the body that it's time to wind down and prepare for sleep. However, if melatonin levels are already low, taking melatonin supplements too early or too late may interfere with the sleep-wake cycle.
Melatonin supplements have been shown to be effective in treating insomnia in older adults. Clinical studies have found that melatonin improves sleep quality and depth, reducing the time it takes to fall asleep and increasing total sleep time. It is considered a safer alternative to other sleep aids, as it does not cause withdrawal or dependence symptoms. However, it is recommended that adults over 65 consult a doctor before taking melatonin supplements, as there may be additional risks for this age group that are not yet fully understood.
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Frequently asked questions
The recommended sleep guidelines suggest that people over 65 years old should get seven to eight hours of sleep per night. However, older people tend to go to bed earlier and wake up earlier. They also tend to experience more sleep disruptions, which can make it difficult to get a full night's rest.
Older people may sleep more due to changes in hormone production, such as decreased melatonin, which regulates sleep. They may also be taking medications that cause sleepiness during the day or disrupt sleep at night. Additionally, older people may experience more pain or discomfort from chronic illnesses, making it harder to sleep through the night.
Sleep issues in older adults can manifest as insomnia, hypersomnia, or narcolepsy. They may also experience restless leg syndrome, sleep apnea, or confusion and cognitive impairment during the day. Other signs include frequent nighttime awakenings, early morning awakenings, and difficulty falling or staying asleep.
Older adults experiencing sleep issues should consult a healthcare provider to determine if any medical conditions or medications are affecting their sleep. Reducing alcohol, caffeine, and nicotine intake can also improve sleep quality. Maintaining a consistent sleep schedule, engaging in physical activity during the day, and socializing can all contribute to a better sleep-wake cycle.
