Why Sleep Changes When You Get Older (And How to Get Better Rest)

Seniors and sleep often have a complicated relationship, leading older adults to question whether sleep is a friend or foe. Insomnia plagues nearly 50% of adults 65 and older, and millions more toss and turn every night because of other sleep-disrupting factors.

Some seniors give up on eight hours of sleep altogether, rationalizing that they need less sleep now that they’re older. But our time needed in slumberland doesn’t change as we age. What does change are our sleep patterns—or our sleep “architecture.” Even with the sleep changes we experience, we have ways to make sure we’re getting better, more restful sleep.

Normal sleep vs. aging sleep

Normally, people go through multiple sleep cycles at night. Each cycle lasts 90-110 minutes and consists of two states. The non-rapid eye movement (NREM) state has four stages lasting 5-15 minutes each, followed by one stage of REM. Stages 3 and 4 of NREM are the most restorative physically and mentally. REM sleep has an initial period of 10 minutes and increases after each subsequent REM cycle.

Seniors spend as little as one quarter as much time in crucial NREM stages 3 and 4 and in REM than people under 30 do. As Matthew Walker explains in his book Why We Sleep: Unlocking the Power of Sleep and Dreams, “The parts of our brain that ignite healthy deep sleep at night are the very same areas that degenerate, or atrophy, earliest and most severely as we age.”
The Sleep Foundation cites a slew of issues that affect sleep, including:

  • Increased time to fall asleep
  • Increased nighttime bathroom trips
  • Circadian rhythm changes
  • Insomnia
  • Snoring
  • Obstructive sleep apnea
  • Restless Leg Syndrome
  • Periodic limb movement disorder
  • GERD
  • Common medical conditions, such as diabetes, immune disorders, renal failure, and respiratory disease.

Research indicates that the biggest culprits in sleep disturbance in the elderly are physical and psychiatric illnesses and their medications.

Are You Getting Enough Sleep?

Seniors may not realize how severely their deep sleep has degraded in quality and quantity. Many also fail to associate poor sleep with their health deterioration. Two of the questions Walker poses in his book to help you determine whether you’re getting enough sleep are key:

  1. After waking up in the morning, could you fall back to sleep at 10am or 11 am? If yes, you’re probably not getting enough sleep, or the sleep is of poor quality.
  2. Can you function optimally without caffeine before noon? If no, then you are most likely using caffeine to mask your chronic sleep deprivation.

8 tips for more restful—and safer—sleep

Despite sleep changes, getting better sleep is essential for older adults’ health. So is making sure the bedroom space is safe at night, since every year an average of one in four Americans aged 65+ falls.

For better sleep:

  1. Spend time outside in the late afternoon to shift bedtimes to a later hour.
  2. Exercise for a deeper sleep.
  3. Consider cognitive-behavioral therapy (CBT) for depression and anxiety or CBT-i for insomnia. These non-drug treatments can be as effective as their drug counterparts.
  4. Ask your doctor if a melatonin prescription might help.
  5. Avoid sleep stealers like alcohol and caffeine.

For safer sleep:

  1. Keep a bedside lamp with an easy switch within arm’s reach.
  2. Add motion-activated night lights or install a dim light in the bathroom and hallways.
  3. Leave your phone on at your bedside with easily accessible emergency numbers.
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