More than half of men and women over the age of 65 years complain of at least one sleep problem. Many older people experience insomnia and other sleep difficulties on a regular basis. As we get older, our sleep patterns change. However, good restorative sleep is essential to our physical health and emotional well-being. General changes in sleep patterns caused by aging include:
- More time spent in light sleep
- More disrupted night-time sleep
- A higher number of health conditions that negatively affect sleep quality and quantity
- More daytime naps that can lead to an irregular sleep-wake schedule
- A tendency to sleep early and wake up early
In general, older people sleep less, experience more fragmented sleep, and spend less time in stage 3 (deep sleep), and REM sleep, than younger people.
What are the common causes of sleep problems in older people?
Several factors might contribute to our inability to sleep well as we get older. Some of the common causes include:
Poor sleep habits
Irregular sleep-wake patterns can affect an individual’s circadian rhythm and make it hard to maintain a regular sleep schedule. Other sleep issues — such as consumption of alcohol before bedtime, increased wakeful time in bed, consuming caffeine before bedtime or daytime napping — will also affect a person’s ability to sleep.
Medical illness
Certain chronic medical conditions are common in older people. Some of these conditions —including heart failure, arthritis, heartburn, menopause, and Alzheimer’s disease — affect sleep. These conditions can make it hard to fall sleep or might cause the person to awaken frequently, ultimately affecting the quantity and the quality of sleep.
Medicines
Some medicines might impair a person’s ability to fall asleep or stay asleep, and might even stimulate wakefulness at night.
Psychological distress or psychiatric disorders
Old age is characterized by many life events, some positive and some negative. Some older individuals experience psychological difficulties or psychiatric disorders that will affect the quality and quantity of sleep. Depression is twice as common in old age compared to young adults and this can significantly affect the quality and the quantity of sleep. Also, life changes such as the death of a loved one, moving from a family home, or physical limitations due to illness, can cause significant stress and sleep difficulties.
Sleep disorders
Sleep disorders such as sleep apnea, restless leg syndrome (RLS), periodic limb movement disorder (PLMD), and REM behavior disorder, are associated with aging. All of these conditions can affect sleep and can subsequently have daytime effects. The risk of sleep apnea increases in old age (particularly in women) and affects not just sleep but also the heart and brain. These disorders can be treated effectively and thus can improve sleep.
Retirement
Retirement often leads to a lot of downtime with no specific plans. This often leads to an irregular sleep-wake schedule and chronic sleep problems.
Are you getting enough sleep?
In order to determine whether you have a problem with sleep, it is necessary to ask yourself about the quality of your time awake. If you are getting less sleep than when you were younger, but still feel rested and energetic during the day, it might just be that you now need less sleep. Every person’s sleep needs are different. However, if you are noticing that your lack of sleep is affecting your daytime activities, you should investigate the cause of your sleeplessness and take steps to get better rest. Consult a doctor if you have concerns about your sleeping patterns.
References
- Townsend-Roccichelli J, Sanford JT, Vandewaa E. Managing sleep disorders in the elderly. Nurse Pract. 2010;35(5):30-7.
National Institutes of Health. NIHSeniorHealth. Sleep and Aging. Accessed 5/8/2013. - National Sleep Foundation. Aging and Sleep. Accessed 5/8/2013.
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