At the moment I’m getting many enquiries from people who are struggling to sleep. When having a look at the data, I have noticed that many people aged 70years and older have contacted me. Often, they are finding that their sleep isn’t as good as it was prior to COVID -19. For some people it’s the anxiety surrounding the virus, for others it’s related to social isolation and that they are now living with their families to avoid being alone at this present time.
Living with family members, when you are used to living alone, can bring its own challenges, so I strongly suggest that good communication is key. For example, it you have been allocated the spare room, but find it so cluttered you can’t sleep well, then talk to your family. As social distancing was brought in really quickly, your relative probably didn’t have chance to make the room as pleasant and comfortable as they would have liked to. Together perhaps you can reduce the clutter for a more restful night’s sleep.
So this latest blog, focuses on sleep and the elderly, I talk you through why sleep changes with age, what can cause sleep problems with age, and of course I offer suggestions of how you can improve your sleep. Some of what is mentioned here, is what I discussed in the Helping the World to Sleep Facebook group, here is the link
Why does sleep change with age?
Most people sleep between 7 and 9 hours each day. However, they may not get all their sleep at night. Around 4 in 10 older people have at least one 30-minute nap every day. Most people over the age of 80 nap for more than one hour each day. At night, some older people take more than half an hour to get to sleep. This is the case for about 1 in 3 women and 1 in 6 men. Important to remember that changes to our sleeping pattern are a normal part of aging. As people get older, they find it harder to fall asleep (this is known as sleep latency) and have more trouble staying asleep, than when they were younger (this is known as increased sleep fragmentation).
Changes in our sleep patterns (also known as sleep architecture) occur. Usually sleep happens in multiple cycles including dreamless periods of light and deep sleep and REM sleep where dreaming occurs. This cycle is repeated several times during the night and research shows that although the total amount of time older people sleep is the same, they spend more time in the lighter stages of sleep rather than deeper sleep.
In addition to changes in sleep patterns that occur as we age, other factors affecting sleep are the body clock (or circadian rhythms) that coordinate the timing of our bodily functions, including sleep. For example, older people tend to become sleepier in the early evening and wake earlier in the morning compared to younger adults. This pattern is called advanced sleep phase syndrome. The sleep rhythm is shifted forward so that 7 or 8 hours of sleep are still obtained but the individuals will wake up extremely early because they have gone to sleep quite early. The reason for these changes in sleep and circadian rhythms as we age is not clearly understood. Many researchers believe it may have to do with light exposure and treatment options for advanced sleep phase syndrome typically include bright light therapy.
Melatonin is a hormone, that is produced naturally in the body at night which promotes sleep. Older people make less melatonin so they may find it difficult to get off to sleep. Other factors may interfere with sleep and cause awakenings during the night. These include hot flushes in postmenopausal women and the need to go to the toilet during the night. Pain may make it difficult to stay in one position for the whole night. Also, after retirement, many people find it convenient to take a short nap during the day, which can reduce the need for sleep at night.
What causes sleep problems with age?
Some common reasons include:
Poor sleep habits: If you don’t keep a steady schedule for going to bed and waking up, it can affect your body’s internal clock and make it even harder to get good sleep. Also, at any age, it’s a minus if you drink alcohol before bedtime, nap too much, or stay in bed when you’re not sleeping.
Medications: Some drugs make it harder to fall or stay asleep, or even stimulate you to stay awake. If you think that might be true for you, ask your doctor to check.
Worry, stress, or grief. Aging brings many life changes. Some are positive. Others are really hard. When you lose someone you love, move from your family home, or have a condition that changes your life, that can cause stress, which can hamper your sleep.
If changes like these affect you or an aging loved one, talk with your doctor or a counsellor/psychologist. It could help ease your mind so you can sleep better.
Too much downtime. Many people stay active well into their golden years. But if your days are too idle, you may find it harder to get good sleep.
A racing mind. When your mind is full of thoughts and can’t switch off, perhaps it would be helpful to address those thoughts or calm them down. See Sleep Well with Dr Sue, for more suggestions to address these issues https://sleepwellwithdrsue.com
What medical conditions can interfere with sleep?
Many conditions can make it harder to sleep. Some that are common in older people are arthritis, osteoporosis, Parkinson’s, incontinence, indigestion, heart disease and lung diseases such as asthma or COPD. The drugs used to treat these conditions may also interfere with sleep. Anxiety and depression can both interfere with getting off to sleep as well as cause wakefulness during the night. Dementia or Alzheimer’s disease can make sleep worse.
Research suggests that two-thirds of nursing home residents have problems with their sleep.
Sleep problems tend to increase when there is not enough exercise or interesting activities during the day or people go to bed too early.
What can I do to improve my sleep?
There are many simple things that can be done to improve sleep.
- The most important is to keep regular sleep hours. Try to go to bed at about the same time every night, when you are actually tired, and get out of bed about the same time every morning. An alarm clock can help with this, although have it facing away from you.
- Avoid sleeping in, even if you have had a poor night’s sleep and still feel tired.
- Don’t go to bed too early and aim to only spend the time in bed that you actually need for sleep (e.g. 8 hours). If you happen to wake early, think about getting out of bed and starting your day. Regular sleep habits strengthen your Body Clock’s sleep-wake rhythm.
- Check your basic sleep hygiene, is your room too light or dark enough? too warm/cold? is your room noisy? does it feel stuffy or cluttered? If you are staying with family, talk to them to see how you can address these issues to help you sleep better.
- Try to get out into the sunshine during the morning and late afternoon as this will also help your body clock.
- Exercise during the day will help you to feel sleepier at night.
- Take care with naps. An afternoon nap may help your energy levels but may also interfere with sleeping at night. Naps can be a problem if they are late in the afternoon or last longer than 15-20 minutes. The best approach is to experiment to find what works best. It is important to remember that sleep needs and sleep patterns change with age and different circumstances.
- Don’t go to bed with full or empty stomach,
- Stop drinking caffeine, smoking/vaping approximately 2 hours before bed.
- Switch off your technology at least an hour before bed, relax and wind down, creating a bedtime routine.
Remember a good sleep is vital for good health, and any concerns you have are best raised with your doctor.