Herbie Murray
Sleep is an essential part of maintaining physical and psychological health, improving memory, and slowing down the aging process. Older adults may require more sleep, ranging from 7 to 14 hours per night, compared to younger adults. However, excessive daytime sleepiness in the elderly can be concerning and may indicate underlying health issues. Various factors contribute to increased sleep in 95-year-old seniors, including age-related changes in sleep architecture, medication side effects, chronic health conditions, depression, and dementia. It is important to monitor their condition and consult with healthcare professionals to address any concerns and improve their sleep patterns.
| Characteristics | Values |
|---|---|
| Ageing | The body slows down, requiring more rest for effective functioning. |
| Sleep-wake cycle issues | Deterioration of the brain causes seniors to feel tired during the day and awake at night. |
| Medication | Seniors are more susceptible to adverse effects like drowsiness from medications. |
| Depression | Depression is characterised by fatigue and loss of interest in activities. |
| Dementia | Sleep issues are common, especially in the later stages of the disease. |
| Chronic health conditions | Conditions like arthritis, chronic pain, diabetes, and cardiac issues can cause sleep disturbances. |
| Sleep deprivation | Seniors may nap during the day to compensate for lost sleep at night. |
| Lifestyle | Staying up late and not maintaining a consistent sleep schedule can contribute to excessive daytime sleepiness. |
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What You'll Learn
Sleep-wake cycles are affected by brain deterioration
Sleep-wake cycles are regulated by the body's internal clock, which is controlled by an area of the brain called the suprachiasmatic nucleus (SCN). The SCN is located in the hypothalamus, a peanut-sized structure deep inside the brain. The SCN receives information about light exposure through the optic nerve in the eyes and controls our behavioural rhythm, also known as our circadian rhythm.
When it is dark, the SCN sends messages to the pineal gland, which triggers the release of the hormone melatonin. Melatonin makes us feel sleepy and ready for bed. As we sleep, our bodies produce another chemical called adenosine, which also promotes sleepiness. Caffeine blocks the receptors for adenosine, which is why it has a wakefulness effect.
As we age, our bodies produce less melatonin, which may be due to the gradual deterioration of the hypothalamic nuclei that drive our circadian rhythms. This can result in a disrupted sleep-wake cycle, with older adults experiencing insomnia and earlier wake times. They may also experience a continuous increase in sleep latency, or the time it takes to fall asleep, and more frequent nighttime awakenings.
Additionally, older adults are more likely to experience medical conditions that can impact sleep, such as arthritis, chronic pain, cardiac and pulmonary disease, and depression. The medications used to treat these conditions can also cause sleep disturbances.
In the case of a 95-year-old senior sleeping all the time, it is important to consider the possibility of underlying health conditions, such as dementia, which is known to cause increased sleep in its later stages. Other factors, such as sleep apnea, the use of certain medications, and changes in brain function due to aging, could also contribute to excessive sleepiness in older adults.
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Seniors may sleep more due to medication side effects
Seniors may experience changes in their sleep patterns due to various factors, and one of the contributing factors can be the side effects of medication. It is quite common for older adults to take sleeping pills or other medications that may impact their sleep. While these medications can aid in falling asleep, they can also lead to excessive sleepiness during the day.
Sleeping pills and sedatives are often prescribed to older adults to address sleep disturbances or insomnia. While these medications can be effective in the short term, they may have adverse side effects, especially with prolonged use. It is important for seniors to follow the instructions provided by their doctors and pharmacists to minimize the risk of negative consequences.
Over-the-counter (OTC) sleep aids and medications containing diphenhydramine (Benadryl) or doxylamine are easily accessible and often used by seniors. However, when combined with prescription sleep drugs, these OTC medications can lead to central nervous system depression. Additionally, excessive use of diphenhydramine can have severe consequences, including seizures, coma, cardiovascular problems, and even death.
The use of certain medications to treat underlying medical conditions can also contribute to changes in sleep patterns among seniors. For example, β-blockers, bronchodilators, corticosteroids, decongestants, diuretics, and other cardiovascular, neurologic, psychiatric, and gastrointestinal medications are known to cause sleep disturbances. Polypharmacy, or the use of multiple medications, is common among older adults, and the combination of these drugs may further disrupt their sleep.
Additionally, seniors with dementia, especially in the later stages, often experience increased sleepiness. As the disease progresses, the damage to the brain becomes more extensive, and individuals may find even simple tasks exhausting. This can result in longer sleep durations and frequent napping throughout the day.
It is important for seniors and their caregivers to be aware of the potential side effects of medications and their impact on sleep. Consulting with a healthcare professional is crucial to ensure proper medication management and to explore non-pharmacological treatment options for improving sleep quality.
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Ageing bodies and brains need more rest
As people age, their bodies slow down, and they experience a decline in their energy levels. This means that their bodies need more rest to function effectively. Seniors may also take longer to complete tasks, leaving them with less time for activities and socialising. Sleep is essential for the body to make quick repairs, and it is theorised that the increased amount of time spent sleeping as we age speeds up cellular repair throughout the body.
Older people may need 12 to 14 hours of sleep per night for optimal performance, compared to eight hours for younger adults. Beyond age 65, the amount of time spent sleeping increases by one hour every five years. This is because, as we age, our brains change, and issues arise with our sleep-wake cycles, or circadian rhythms, and temporal awareness. This can make it difficult for older people to sleep through the night and keep a normal schedule.
The aging process can be hard on the body, and older people often experience excess fatigue due to the physical decline of their bodies. They may also find it difficult to get comfortable due to aches and pains, or need to get up in the night to use the bathroom. This can result in a lack of sleep, which is compensated for by napping during the day. While daytime napping is normal, it becomes a problem when a person spends most of their time sleeping instead of engaging in daily life.
Seniors are also more susceptible to adverse effects from medication, such as drowsiness and dizziness. Drugs used to treat conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson's disease, nausea, and allergies can all cause excessive sleepiness. Polypharmacy is increasingly common among older adults, and the average senior takes between four and five separate medications. The interaction of these drugs can have unintended consequences on sleep.
Additionally, depression is a common issue among older people, and it can cause excessive fatigue and a loss of interest in activities. Other health issues such as arthritis, diabetes, cardiac and pulmonary disease, and chronic pain can also lead to fatigue and excessive sleeping.
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Seniors may experience depression and fatigue
Another factor contributing to depression in seniors is the potential presence of chronic illnesses or pain. Older adults commonly experience physical health issues, such as arthritis, chronic pain, or neurological conditions like dementia. These conditions can impact their daily functioning and lead to feelings of helplessness and hopelessness. The challenges associated with managing chronic illnesses can further contribute to depressive symptoms.
Furthermore, medications used to treat various medical conditions in seniors can also cause disruptions in sleep and contribute to fatigue. Polypharmacy, or the use of multiple medications concurrently, is common among older adults and can lead to unintended consequences, including sleep disturbances. Additionally, seniors may experience sleep disorders, such as snoring and excessive daytime sleepiness (EDS), which can impact their overall energy levels and contribute to fatigue.
It's important to recognize that depression in older adults may manifest differently than in younger individuals. While sadness may be a factor, many depressed seniors complain of low motivation, lack of energy, or physical problems. They may also experience cognitive deficits, such as difficulties with concentration, attention, and short-term memory loss. These symptoms can further contribute to feelings of fatigue and exhaustion.
Additionally, seniors may have grown up in a time when mental illness was highly stigmatized and misunderstood. As a result, they may be reluctant to seek help for depression, feeling ashamed or fearful of becoming a burden to their families. This reluctance can delay treatment and exacerbate the condition.
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Sleep deprivation can worsen dementia symptoms
Sleep is essential for good brain health, just like eating right and exercising. Studies have shown that individuals who slept fewer than five hours per night were twice as likely to develop dementia and twice as likely to die compared to those who slept six to eight hours per night.
Sleep disturbances are associated with many kinds of dementia, most notably Alzheimer's disease. People with dementia, especially in the later stages, can often spend a lot of time sleeping. This can be distressing for family and friends, who may worry that something is wrong. However, this increased sleep is likely due to the exhaustive nature of simple tasks for people with dementia, such as communicating or eating.
The link between sleep and dementia is complicated. Experts are unsure whether poor sleep causes dementia or if early dementia symptoms cause poor sleep. It is possible that both are true and that the relationship is circular. Some studies have shown that short sleep (less than seven hours) raises levels of beta-amyloid and tau, proteins linked to Alzheimer's disease. Insomnia also disrupts slow-wave sleep, which is important for learning and memory.
Additionally, sleep apnea, a common issue among the elderly, can further disrupt sleep and increase the risk of dementia. Other medical conditions, such as cardiac and pulmonary disease and depression, can also cause sleep disturbances. Medications used to treat these conditions can also impact sleep.
While the exact relationship between sleep and dementia is still being studied, it is clear that sleep deprivation can worsen dementia symptoms and increase the risk of developing dementia.
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Frequently asked questions
There are many reasons why older people sleep more than younger people. One reason could be that they are taking medication for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson’s disease, nausea, and allergies, which can cause excessive sleepiness. Another reason could be that they are experiencing depression or dementia. It is important to remain in contact with a doctor to rule out any underlying health issues.
Depression in seniors can manifest as a loss of interest in activities they once enjoyed. Other signs include feelings of sadness, worthlessness, and fatigue, leading to changes in sleeping patterns.
Seniors with dementia often experience a wide array of sleep problems, especially in the later stages of the disease. They may sleep during the day and be awake and restless during the night. They may also become disoriented in the dark, not be able to tell the difference between night and day, and experience agitation.
