As we age we often experience normal changes in our sleeping patterns, such as becoming sleepy earlier, waking up earlier, or enjoying less deep sleep. Some even have a harder time falling asleep and more trouble staying asleep than when they were younger. However, it is a common misconception that sleep needs decline with age and that disturbed sleep, waking up tired every day, and other symptoms of insomnia are a normal part of aging. Sleep is just as important to our physical and emotional health as we age as it was when we were younger.
We can’t help but wonder what is keeping our older adults awake at night. Changes in the patterns of our sleep occur as we age and this may contribute to sleep problems. Sleep occurs in multiple stages including light and deep sleep, and periods of active dreaming (REM sleep). The sleep cycle is repeated several times throughout the night and while the total sleep time may remain constant, older adults spend more time in the lighter stages of sleep than in deep sleep. This causes them to feel more tired during the day and the need to go back to bed earlier. Research suggests this can be attributed to physical and psychiatric illnesses and medications used to treat them.
As with other diseases that advance with age, insomnia is also higher among older adults. Insomnia may be chronic or acute and is often related to an underlying cause or medical condition. You should always speak with your physician about insomnia symptoms and about any effects these symptoms may have. Sometimes making a few daily life changes such as cutting back on caffeine and mid afternoon napping may help solve the problem while other times there may need to be medication changes or other treatment methods. When effects are serious and left untreated, insomnia can take a toll on a person’s health causing difficulty concentrating, increased risk for accidents and illnesses, and significantly reduce quality of life.
Other causes of poor sleep may include:
· Snoring- This is most commonly associated with people who are overweight and the condition often becomes worse with age. Loud snoring is particularly serious as it can be a symptom of obstructive sleep apnea and is associated with high blood pressure and other health problems.
· Obstructive Sleep Apnea- With sleep apnea, breathing stops - sometimes for as long as 10-60 seconds - and the amount of oxygen in the blood drops. This alerts the brain, causing a brief awakening and then breathing resumes. These stoppages of breathing can occur repeatedly, causing multiple sleep disruptions throughout the night and result in excessive daytime sleepiness and impaired daytime function. Untreated sleep apnea puts a person at risk for cardiovascular disease, headaches, memory loss and depression. If you have ever been told you stop breathing or make loud gasping noises during sleep, make sure you speak to your physician about these signs as treatments can greatly improve your sleep disturbances.
· Restless legs syndrome (RLS) - This is a common neurological movement syndrome characterized by an irresistible urge to move the limbs. With this syndrome there is an unpleasant, tingling, creeping or pulling feeling that occurs mostly in the legs and usually becomes worse in the evening and makes it difficult to sleep through the night.
· Chronic Medical Conditions- As we age, there is an increased incidence of medical problems, which are often chronic. In general, people with poor health or chronic medical conditions have more sleep problems. A few examples may include heart failure, menopause and hot flashes, respiratory diseases such as asthma, gastro esophageal reflux disease (GERD), diabetes mellitus, renal failure, immune disorders, Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, osteoporosis, and hormone changes can all lead to many restless nights.
· Poor sleep habits and sleep environment- These include irregular sleep hours, consumption of alcohol before bedtime, and falling asleep with the TV on. Make sure your room is comfortable, dark and quiet, and your bedtime rituals conducive to sleep.
· Medications- Older adults tend to take more medications than younger people and the combination of drugs, as well as their side-effects, can impair sleep. Speak with your physician about changes and effects of your medications.
· Lack of exercise- If you are too sedentary, you may never feel sleepy or feel sleepy all the time. Regular aerobic exercise during the day can promote good sleep.
· Stress- Significant life changes like retirement, the death of a loved one, or moving from a family home can cause stress. Nothing improves your mood better than finding someone you can talk to face-to-face.
· Lack of social engagement- Social activities, family, and work can keep your activity level up and prepare your body for a good night’s sleep. If you’re retired, try volunteering, joining a seniors’ group, or taking an adult education class.
· Lack of sunlight- Bright sunlight helps regulate melatonin and your sleep-wake cycles. Try to get at least two hours of sunlight a day. Keep shades open during the day or use a light therapy box.