The Truth About Why Sleep Gets Worse As You Age
One of the most interesting things about sleep is how dynamic it is. Day in and day out, it ebbs and flows in response to what’s happening in our life.
As we age over a lifetime, our requirements for sleep change as well. While everyone knows that babies need the most sleep, one of the most common misconceptions about aging and sleep is that older adults need far less. The truth is that while older adults get less sleep because sleep worsens as they age, the requirements remain the same.
Why Does Aging Affect Sleep?
“Aging affects sleep primarily due to changes in the body’s circadian rhythms, physiological needs, and other age-related health conditions that can contribute to poor sleep quality,” Isabella Gordan, a Sleep Science coach and co-founder of Sleep Society, tells Sleepopolis. “Moreover, our levels of hormones such as melatonin and growth hormone, which are essential for regulating the body’s internal clock, begin to decrease with age as well. Ultimately, lower levels of these hormones contribute both to more fragmented sleep cycles and an overall decrease in deep or restorative sleep.”
How Sleep Changes As We Age
Sleep doesn’t change as a result of age per se. It does, however, change due to shifts in the circadian rhythms, frequent nighttime wakings, and the increased frequency of daytime naps that occur as we get older.
Shifts In Circadian Rhythms
It’s well-documented that aging can have a deleterious impact on circadian rhythms, a common feature of which is advanced sleep timing. Day to day (or night to night), that translates to earlier bedtimes and waking earlier in the mornings. So while it may look like older adults are sleeping less, that’s not necessarily the case; it’s likely a shift in their sleep schedule.
Frequent Nighttime Waking
Beyond circadian rhythm shifts, research shows that sleep architecture also changes with age. “As we get older, the quality of our sleep declines by reducing the amount of time spent in those deeper stages,” says Gordon. One study showed that not only does the percentage of N3 sleep decrease at a linear rate of 2 percent per decade, but REM sleep, while not as profound, also decreases. Another study found that total sleep time decreased with age at a rate of about 10 minutes per decade — 8 minutes per decade for men and 10 minutes per decade for women.
Gordon adds, “older adults often suffer from fragmented sleep because they tend to wake up more frequently throughout the night due to other age-related conditions such as joint pain or discomfort from arthritis.”
More Napping
Research shows that approximately 15 percent of people 55 years and over are reported to nap anywhere from four to seven times per week, so older adults and their loved ones may notice an increase in daytime napping as the years tick by. While some may say that an increase in the frequency of daytime naps is just a logical consequence of fragmented sleep, some researchers have proposed that the higher frequency of daytime naps is due to changes in how sleep is consolidated. Sleep lost during the overnight hours is moved to the afternoon, but the total sleep time in a 24-hour period essentially remains the same.
Longer Time Recovering From Sleep Schedule Shifts
While this may only apply to a small segment of the population, some older adults may have a harder time adjusting to sleep schedule changes like Daylight Savings Time or jet lag.
Do Older People Need Less Sleep?
It’s a common misconception that older adults need less sleep. The truth is that while the quality and duration of their sleep may deteriorate as a result of hormonal and physiological changes, their sleep requirements remain relatively unchanged. Moreover, fragmented sleep as a result of things like pain and frequent overnight bathroom trips can deal a pretty big blow to the sleep quantity of older adults, but again, their prescription for 7 to 9 hours of sleep doesn’t change much.
“As we age, our energy levels naturally decline due to changes in metabolism and hormone production, which can cause us to need fewer hours of sleep than when we were younger,” says Gordon. “So, older people may require slightly less sleep compared to when they were younger, but not significantly less. Generally, adults need between seven and nine hours of sleep per night, depending on the individual’s physical and mental health.”
Gordon also reminds us that a consistent lack of restorative, quality sleep can lead to very real health consequences like fatigue, decreased cognitive function, and a weakened immune system. “And, everyone, regardless of age, must ensure that they get the necessary amount of restful sleep each night for optimal health.”
The Centers for Disease Control and Prevention (CDC) shares the following guidelines for sleep requirements by age.
Common Sleep Challenges For Aging Adults
Increased nighttime activity (like nocturia), chronic pain, and health issues like restless leg syndrome and sleep apnea are just some of the most common sleep challenges for aging adults.
Nocturia
Nocturia is the medical term for waking up multiple times per night to go to the bathroom. It’s estimated that 50 million people in the U.S. have nocturia, and as much as 24 percent of adults over age 65 will have two or more episodes of nocturia each night. Nocturia certainly sounds like a nuisance, But beyond that, it often leads to fragmented sleep and a decrease in sleep duration for older adults.
Pain
Pain can impair anyone’s sleep quality — older adults included. The problem is further exacerbated by the fact that pain and poor sleep are bi-directional. Pain leads to poor sleep, and poor sleep can exacerbate pain.
Insomnia
Like pain, insomnia is not an issue that’s limited to older adults, but the inability to fall asleep and stay asleep is certainly a challenge worth mentioning.
Drowsiness During The Day
As a result of the disruption to their sleep quality and quantity, older adults may find themselves on the hamster wheel of excessive daytime drowsiness.
Sleep apnea
Obstructive sleep apnea is marked by pauses in breathing during sleep. For some people, those disruptions can occur hundreds of times per night, ultimately leading to fragmented sleep and poor sleep quality.
Restless Leg Syndrome
Restless legs syndrome (RLS), also known as Willis-Ekbom disease, can begin at any age, while late-onset RLS typically begins somewhere around age 45. In either case, the throbbing, aching, crawling, and creeping feeling in the legs that typically make an appearance while you’re sleeping or resting can and will impair sleep. And unfortunately, the symptoms usually worsen with age.
REM sleep disorder
Typically making its first appearance around age 50 or older, REM sleep disorder primarily affects older adults. The disorder causes people to act out their dreams, in many cases, violently, so it usually has a deleterious effect on sleep.
Menopause
Sleep issues among perimenopausal and menopausal women are extremely common, as decreasing estrogen levels are associated with difficulty falling asleep and more frequent awakenings.
Sleep Tips For Aging Adults
Sleep is essential for optimal health and maintaining a good quality of life. So, to help you prevent the downstream effects of poor sleep quality and short sleep, Gordon offers the following tips.
Set A Consistent Bedtime Routine And Stick With It
A regular bedtime routine helps your body prepare for rest. If need be, incorporate practices like yoga or meditation to help yourself wind down.
Limit Caffeine Consumption
Too much caffeine can interfere with your natural sleep rhythms and can prevent your body from entering deep levels of relaxation necessary for restful sleep. So, avoid caffeinated beverages late in the day and opt for herbal teas to help promote relaxation at nighttime.
Create A Calming Sleeping Environment
Make sure that your bedroom is dark, quiet, comfortable, and cool so that you can easily fall asleep each night. Consider using blackout curtains or eye masks if outside lights are an issue, and use sound machines or fans to drown out any noise disturbances while you’re trying to drift off to dreamland.
Exercise Regularly But Not Right Before Bed
Regular exercise is great for overall health, but be sure to watch the clock. Physical activity too close to bedtime can be counterproductive as it increases alertness which could make falling asleep difficult.
Keep A Journal
If you find yourself constantly lying in bed with your mind racing, consider writing down any thoughts or worries that come to mind in a journal and then put the notebook away until morning. This will help clear your head and allow you to relax before sleep.
Sleep Safety For Aging Adults
For most people, sleep is a relatively safe activity — you’re tucked in under the covers; what could possibly go wrong? Well, if you factor in impaired mobility, cognitive decline, and a dark room, the odds of nighttime accidents increase exponentially. To mitigate these risks, you may want to keep the following tips in mind.
- Make sure to keep a working phone near the bed
- Secure loose rugs
- Consider adding night lights
- Eliminate clutter
- Don’t lean or brace on furniture; invest in a walker or bed rails if need be
When To Consult A Doctor
Gordon suggests consulting your doctor if:
- You’re having prolonged difficulty falling asleep or staying asleep
- Your sleep is significantly affecting your daily life
- You experience other symptoms such as extreme fatigue, vivid dreams, irregular breathing, snoring, or insomnia
Gordon cautions that beyond the issues directly linked with your sleep, other physical and cognitive issues, including “noticeable weight gain, poor concentration, daytime mood swings, increased irritability, and frequent headaches may all warrant a visit to your doctor. A doctor can help diagnose underlying conditions related to sleeping difficulties, such as thyroid disorder, diabetes, or depression, and can provide medical advice on improving your sleep quality. Similarly, a sleep specialist can help identify any underlying causes behind disturbed sleep patterns and suggest treatments accordingly.”
The Last Word From Sleepopolis
As a general rule, adults aged 18 – 60 require anywhere from seven to nine hours of sleep. And while the requirements don’t change much through our adult lives, sleep typically worsens as we age due to a host of physiological, hormonal, and environmental changes. And while sleep quality and duration may take a hit, lifestyle changes and modifications to your sleep hygiene could prove helpful.
