Do Older Adults Need Less Sleep?

image of an elderly man with insomniaMany older adults feel that a good night’s sleep is more elusive than it once was. You may feel tired earlier in the evening, but then sleep for less total hours than you used to.

Perhaps you wake frequently during the night, or wake early in the morning and struggle to fall asleep again.

People sometimes say they just don’t need as much sleep as they did when they were younger. They may feel that they simply need less sleep or accept insomnia as a normal part of the aging process.

You still need your sleep as you get older

Researchers disagree with the idea that older people need less sleep. However, they do recognize that people can experience a variety of changes to their sleep as they age.

A 2009 review of sleep disorders found that 50% of older people report some form of insomnia. Naturally, this also means that many people over 65 don’t feel that their sleep has changed much.

But for those who do experience sleep problems, the intensity of the symptoms can vary significantly, ranging from mild disturbance through to chronic insomnia.

Interestingly, the evidence suggests that an increase in sleeplessness doesn’t seem to be caused by age per se. In fact, scientists think that it’s very often the result of other factors related to ageing.

Medical conditions causing sleep problems

As you get older, you’re more likely to suffer from different medical or psychological conditions, and take different types of medication. Some of those conditions and medications can in turn affect your sleep, for example:

  • Arthritis can cause pain and discomfort, keeping you awake.
  • Asthma and other respiratory conditions can cause you to wake up coughing. There are some respiratory conditions that are more common as you age, like sleep apnea, which I’ll discuss in more detail later.
  • There’s some evidence that medications commonly taken by older people, such as statins, beta blockers and thyroid drugs can increase the risk of insomnia.
  • Changes to your day to day activity, such as stopping work or socialising less, can contribute to sleep difficulties. And for some people, these changes can be linked to mental health conditions (such as depression or anxiety) which negatively impact your sleep.

Examples likes these show that sleep problems aren’t necessarily an inevitable part of getting older that you just need to learn to live with. Your body still needs to sleep; it’s still an important part of staying physically and mentally healthy.

So if you do have any health conditions, take medication, and suffer from poor sleep, it’s worth speaking to your primary care doctor about.

Let’s take a look at some other causes of sleep problems in older people, and ways you can manage them.

Keep an eye on your fluid intake

image of a cup of tea being poured at nightNeeding to wake up during the night to use the bathroom becomes more common as you age. Waking up occasionally is perfectly normal, but you might have a condition called nocturia if it regularly happens multiple times per night.

Nocturia is a significant cause of sleep problems in older people. Researchers have found that nearly 80% of older people say that their sleep is often disturbed by needing to go to the bathroom at night.

A practical way to deal with this is of course to reduce your fluid intake in the evening – especially drinks containing alcohol or caffeine. It’s important to avoid dehydration though, as that in itself can disrupt your sleep, so make sure you get enough fluid earlier in the day.

And some medications can affect the bladder, so ask your doctor what can be done to help you if your medication is a factor.

Advanced sleep phase disorder

If you regularly go to bed and wake up several hours earlier than societal norms, it could be that you have a sleep disorder known as advanced sleep phase disorder.

This is a sleep disorder where your body clock shifts, and is more common in older adults. It can result in people feeling sleepy as early as 8 or 9 o’clock, but only sleeping for a few hours before waking in the early hours of the morning.

Advanced sleep phase syndrome doesn’t need treatment if you don’t particularly mind that sleep pattern, and it’s not interfering with your daily life and well-being.

However, it’s common for sufferers to wake up at the same (early) time every morning, regardless of the time they went to bed the night before. This can result in tiredness and problems as a result of sleep deprivation.

Two ways to get the body clock back into line are through light exposure or melatonin supplements. Exposure to bright light in the evening will stop your body producing melatonin, preventing you from feeling tired.

In the summer months, this can be as simple as getting outdoors in the late afternoon and evening. Alternatively, you can look into bright light therapy devices.

Whether you take these two options or not, you might like to try to change your sleep schedule gradually. One way to do this is to push back your bedtime by 20 minutes a day until you reach your desired bedtime.

Snoring & Sleep apnea

image of a man snoring and keeping his partner awake in bedIt’s thought that snoring can worsen as you age. We naturally gain weight with age, and an increase in weight around the neck can cause the throat to narrow. Additionally, muscle tone decreases, which makes the airways more susceptible to vibration.

There are many ways to stop snoring, and it’s often just a case of trying different techniques and devices until you find one that works.

However, snoring could be caused by a more serious sleep disorder known as sleep apnea. Because of the potentially serious consequences of untreated apnea, anyone who shows one of the key signs – snoring – is advised to consult their doctor and be tested for apnea.

Sleep apnea can be successfully managed with a CPAP machine, as well as with surgery and oral implants. Clinicians also recommend that patients try to reduce their weight to improve their breathing naturally.

You should also avoid alcoholic drinks before going to sleep; alcohol relaxes the muscles of the airways, which makes you more likely to snore.

Stay active to manage insomnia

Exercise is widely viewed by experts as a safe and effective way of managing insomnia, no matter how old you are.

But research shows that only 10 – 15% of older adults get the minimum recommended level of physical activity a day. This means that the majority of older people spend long periods of time doing little or no exercise at all.

If you’re over 65, researchers in the US recommend that you aim for 150 minutes of moderate activity per week, or 75 minutes of intensive activity a week. Activities suggested include walking, dancing and jogging.

If this isn’t possible, the researchers advise that older adults should do whatever their health conditions allow. Even a little exercise could help you sleep better.

Get your daily dose of sunshine

two ladies doing exercise in a sunny parkWhile all exercise is good, exercising outdoors is preferable as it exposes you to sunlight. And in fact, even just being outside is preferable to spending all day indoors.

The presence of sunlight is one of the factors that tells the body to stop producing the melatonin that makes you sleepy. Melatonin is an important hormone involved in regulating your sleep patterns.

So by being outside during the daylight, you’ll help your body adapt to a regular, natural sleep pattern. You’ll also feel less tired during the daytime hours.

Darkness is also important for a natural sleep cycle. But sometimes, particularly in the summer months when the days are longer, it may still be light outside when you’re getting ready for bed.

You might find that making your bedroom darker helps you fall asleep when it’s light outside. If it’s too bright, try installing a blackout blind or wearing a sleep mask. And avoid using devices such as computers, laptops, tablets or mobile phones in the hour before bed unless they have a blue light filter.

Change your daily routine

Sticking to a very regular sleep routine can be an effective cure for insomnia. But it’s not always easy when you feel tired during the day, or don’t have commitments such as work that help enforce a tighter schedule.

As you get older, you might be more inclined to nap during the day. A nap can be a great way to combat tiredness, but it can also interfere with your sleep at night.

To stop this happening, you might want to schedule a set nap time. A nap in the early afternoon of no more than 20-30 minutes should leave you feeling refreshed without ruining your sleep that night.

Regular bedtimes and waking times can also help assert control over your sleep. It’s especially effective to stick to a regular waking time. It’s easier to control than the time you fall asleep, and can help keep your sleep schedule in check.

Even if you haven’t slept well the night before, don’t be tempted to sleep in. Stick to your routine and get out of bed. You might be a little more tired during the day, but the constant waking time will help bring consistency to the falling asleep time too.

Some older people suffer from chronic insomnia

Although there are many circumstances and habits that can lead to sleep problems, some older people do suffer from chronic insomnia.

As I mentioned earlier in the article, insomnia in older people is often caused by a variety of factors (such as underlying health conditions, lifestyle and metabolic changes and medications). This can make it quite difficult to identify a single cause for your sleep difficulties.

If you don’t find that the advice in this article applies to you, you may want to consider talking to you doctor about Cognitive Behavioural Therapy for Insomnia (CBT-I).

CBT-I is an effective alternative to sleeping pills, and offers many patients a more permanent solution to their chronic insomnia. During a session, you’ll work with a therapist to recognize the thoughts, attitudes and behaviors that impact on your sleep.

CBT-I can also help you identify any underlying causes of your sleep problems. This is particularly helpful for people who find it hard to pinpoint exactly what’s stopping them from sleeping well.

Closing thoughts

Some people find that their sleep gets worse with age, but it doesn’t have to be an inevitable part of growing older that just has to be accepted. There are many healthy, active older people who sleep very well.

Having said that, getting a good night’s sleep can require a little more preparation as you age. And it’s definitely worth making the effort – sleep is important for your mental and physical health, no matter how old you are.

For some older people, health conditions are a major barrier to being more active or spending time outdoors. However, if you’re able to get more exercise, you might find your sleep improves. When you next talk to your doctor about your sleep problems, you might also want to discuss ways of safely and comfortably being more active.

I also highly recommend reading about good sleep hygiene, which is essentially advice about self-help techniques and lifestyle choices encompassing everything from food choice to relaxation techniques.

And if any of the ideas in this article seem to apply to you – such as snoring, frequent trips to the bathroom or a big change in your sleep pattern, it’s a good idea to mention them to your doctor.

If there are ideas in this article that you can put into practice yourself, that’s great. But it’s always useful to seek a professional medical opinion and the support that they can offer.

Your views

Has your sleep changed over time? Do you know what causes your sleep problems, or have any useful advice for others about managing them?

Feel free to leave a comment below with your story, questions and ideas.

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