Sleep Changes as You Age: Better Sleep for Older Adults

As we get older, our sleeping patterns change just as surely as our skin and hair. Understanding the difference between new sleep changes and deeper sleep problems is important. Poor sleep is often assumed to be a normal part of aging, but that’s not the case!

We’ll discuss how sleep changes with aging as well as age-related health conditions that can affect sleep. We’ll give examples of what you can do to establish a steadier sleep schedule, and touch on when to see a doctor if you suspect a genuine sleep disorder.

For those getting older, sleeping schedules transform from nighty marathons to shorter sprints. You’ll still need 7-9 total hours of sleep just as younger adults do, but they may be spread over 24 hours. This is a natural result of decreasing hormone production.

As you get older, your body produces lower levels of growth hormones and less melatonin. Melatonin is the natural hormone that your brain produces to tell you that is time to sleep in response to darkness. When darkness doesn’t make you sleepy, night sleep becomes more fragmented. You no longer go to sleep at the beginning of the night counting on a long, reliable, deep sleep before waking to daylight.

Diabetes and prostate issues can mean frequent bathroom use, resulting in less sleep.

Heart and kidney issues can make it very difficult and uncomfortable to lay flat, even if you’ve been a back sleeper all your life.

Sleep apnea can develop later in life, particularly if it's due to excess weight and lack of muscle tone in the neck and airways. This can cause you to stop breathing periodically, leading to snoring, frequent waking, and gasping for air.

Certain medications like antidepressants, beta blockers, etc.

Arthritis, osteoporosis, and chronic pain can wake you at any hour and wreck a good night’s sleep.

Menopause and post-menopause hormonal imbalances can cause another layer of complication around sleep disturbance on top of the reduction of growth horomonoes and melatonin.

Depression and anxiety often develop in older adults as a result of decreased mobility, the loss of loved ones, and/or lack of social engagement. These can all negatively impact sleep quality.

One of the best things you can do to cultivate better sleep at any age is called sleep hygiene. Think of it as a research-backed bedtime routine to encourage your body’s ability to work through the stages of sleep.

Keep your bedroom, dark, quiet, and cool.

No screens in the bedroom. TV, cell phones, tablets and other devices need to be put away or charged somewhere else at night.

Whether or not you sleep the entire time, keep the same bedtime and wakeup time every day, even on weekends.

Exercise at least 30 minutes a day to increase weariness, but never within 3 hours of bedtime. (Always consult your doctor before starting an exercise regimen!)

Do your best to stay awake later in the day or keep naps brief. Try to carry the sleepiness to your bedtime routine.

No large meals, tobacco, alcohol, and stimulants (such as coffee and chocolate) late in the afternoon. It is especially important to steer clear of them in the 3 hours before bedtime.

If you can’t sleep for 30 minutes or longer, get out of bed and try reading a book - a real book, not a tablet. You can also walk quietly around the house or write in a journal. Keep movements slow and calm, the point is to avoid worry, upset, and adrenaline. Go back to bed when you feel sleepy again.

Similar to writing in a journal, keep a sleep diary to share with your doctor. It helps them understand where the hurdles are in your sleep and wake cycles - and how they can help.

Only use sleep medicines as recommended by your doctor. Older people respond differently to over-the-counter sleeping pills and other sleep aids than younger people.

Sleep deprivation is more acutely problematic than the sleep changes that come as you get older. If you or a loved one experience the following health issues leading to sleep deprivation, sleep cycle disruption, or excessive daytime sleepiness, you should contact a healthcare provider:

Movement disorders such as restless leg syndrome (RLS) and periodic limb movement disorder become more common as you age. Sleep cycle disruption from shaking or kicking yourself awake merits a discussion with your doctor, especially if it’s keeping you from getting to sleep in the first place.

Rapid Eye Movement behavior disorder is a condition where the neural pathways that keep you still while you sleep stop working. You begin moving and vocalizing your dreams. It is gradual, but does get worse with time and needs to be addressed with your health care team.

Sleep Apnea is another condition that requires a doctor’s care. If someone tells you that you snore loudly and/or you feel excessive daytime sleepiness, it’s important to be evaluated by a sleep specialist. Sleep apneas can lead to much more serious health problems like high blood pressure and heart disease that can in turn cause heart failure. The good news is that it's fairly common in older adults and can be very well controlled through CPAP treatment.

Your quality of life matters! No age changes that. If you feel that you are truly having trouble sleeping, are not getting anywhere near enough sleep, or are experiencing a lower quality of life from a lack of REM sleep, seek help. Whether you are suffering from social isolation or an underlying health condition, your journey to better sleep starts to a call to your healthcare provider.

References

• U.S. Department of Health and Human Services. (n.d.). A good night's sleep. National Institute on Aging. Retrieved September 28, 2022, from https://www.nia.nih.gov/health/good-nights-sleep

• U.S. National Library of Medicine. (n.d.). Aging changes in sleep: Medlineplus medical encyclopedia. MedlinePlus. Retrieved September 28, 2022, from https://medlineplus.gov/ency/article/004018.htm