Sleep and Older Adults | National Institute on Aging

Español

Older adults need about the same amount of sleep as all adults — seven to nine hours each night. But older people tend to go to sleep earlier and get up earlier than they did when they were younger. Getting enough sleep helps you stay healthy and alert. However, many older people don’t sleep well. If you’re always sleepy or you find it hard to get enough sleep at night, it may be time to talk with a doctor.

What is sleep?

You spend about one-third of your life sleeping or trying to sleep. But how does this basic human need work? Though it may seem simple, sleep is a complex process. Multiple parts of the brain work together to produce signals that prepare the body for sleep. Your circadian rhythm — “the body’s clock” — provides the timing for sleep. Sleep-wake homeostasis, a state of balance, is the body’s drive to sleep that increases the longer you are awake.

Certain signals in your body lead to sleep. These include melatonin, a hormone your body releases when it gets dark that makes you feel sleepy, and adenosine, a chemical that builds up in your brain while you’re awake and gets broken down while you’re asleep.

A good night’s sleep depends on sleeping when your body is prepared, sleeping seven to nine hours, and getting enough of each type of sleep.

There are two major types of sleep: rapid eye movement (REM) and non-REM. They are linked to patterns (waves) of electrical activity in your brain. REM and non-REM sleep occur in cycles, usually three to five each night. Both non-REM and REM sleep help you store memories.

• Non-REM sleep happens when your brain wave activity slows down, called deep sleep. You need deep sleep to feel refreshed in the morning. 
• REM sleep is when dreaming usually happens, when your brain wave activity is closest to what it is when you’re awake. Dreaming may help you process your emotions. 

Why is sleep important?

Sleep is important for your body — from the brain, heart, and lungs to energy, protection against disease, and mood. It also affects your ability to function during the day. A good night’s sleep can help you learn, create new memories, respond quickly, solve problems, pay attention, make decisions, and be creative.

Not getting enough sleep can cause harm to your body. Research shows that over time it can increase your risk of:

If you wake up tired, feel easily annoyed, have trouble falling asleep, or have trouble staying asleep, these may be signs you’re not getting a good night’s sleep.

Lack of quality of sleep can lead to:

How aging affects sleep

As you age, how you sleep changes. Older adults tend to go to bed earlier and wake up earlier than younger adults, and the amount of time spent in each type of sleep decreases. Sleep tends to be shorter and lighter, and you may wake up more often during the night. Older adults are also more likely to take medications and have medical conditions that affect sleep.

Many older adults don’t sleep well. Factors such as illness, medications, mental health, and pain can make it hard to get a good night’s sleep. Sleep disorders become more common with age, including insomnia (trouble falling or staying asleep), sleep apnea (pauses in breathing during sleep), and movement disorders such as restless legs syndrome.

Practicing better sleep habits and being diagnosed and treated if you have a sleep disorder may help improve your sleep.

Tips for getting a good night’s sleep

Getting a good night’s sleep is important to your well-being. The way you feel while you’re awake depends in part on what happens while you’re sleeping. During sleep, your body is working to help your brain and body be at their best.

Good sleep can help protect your mental and physical health, quality of life, and safety. Not getting quality sleep can increase your risk for health problems and affect how well you think, react, work, learn, and get along with others. Try these tips to sleep better:

• Follow a regular schedule by going to sleep and getting up at the same time each day, even on weekends or when traveling.
• Have a bedtime routine. Find ways to relax before bedtime each night. Read a book, listen to soothing music, or take a warm bath.
• Make your room comfortable for sleep and keep the temperature not too hot or cold.
• Try to get regular exercise, but not within three hours of your bedtime.
• Avoid napping in the late afternoon or evening.
• Avoid having caffeine late in the day, which can keep you awake at night. Items to avoid may include coffee, tea, chocolate, and soda.
• Avoid drinking alcohol, even small amounts.
• Try not to watch television or use a computer, cell phone, or tablet in the bedroom.
• Avoid eating large meals within two to three hours of your bedtime and avoid drinking large amounts of liquid late in the day.
• Talk with your doctor if you have problems with sleeping.

Insomnia and older adults

Insomnia is the most common sleep problem in adults age 60 and older. People with this condition have trouble falling asleep or staying asleep at least three nights a week. Short term insomnia can be caused by stress or changes to routine. Chronic, or long-term, insomnia lasts more than three months and can’t be fully explained by another medical cause.

Healthy habits at bedtime may help prevent or manage insomnia, and cognitive behavioral therapy (a type of counseling) can help. Sleep medicines may help in the short term, but they carry risks and should not be used long term.

If you have trouble sleeping, keep a sleep diary for a couple weeks. Keep track of when you go to bed, when you wake up during the night, and when you wake up for the day. Note whether you had caffeine or alcohol and whether you exercised that day. The sleep diary will help you identify patterns to discuss with your doctor and help with diagnosis.

Sleep apnea and older adults

Sleep apnea causes you to stop breathing for a few seconds repeatedly during sleep. Throat muscles relax during sleep, and in people with sleep apnea, this relaxation of the muscles blocks their airway. Snoring can be a sign, but not everyone who snores has sleep apnea. To treat sleep apnea, a continuous-positive-airway-pressure (CPAP) device may be used while sleeping. Sleeping in a position that keeps airways open or getting a dental device or surgery also may help.

If you suspect you have sleep apnea, it’s important to talk to your doctor. Undiagnosed or untreated sleep apnea can lead to serious health problems, including heart attack.

Movement disorders and sleep

Movement disorders make it harder to get good sleep. Read about these disorders below and talk with your doctor if you think you may have one of these problems.

Restless legs syndrome feels like there is tingling, crawling, or pins and needles in one or both legs. This feeling is worse at night and feels better with movement. Treatment with iron supplementation or medications is usually helpful.

Periodic limb movement disorder causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Medication, warm baths, exercise, and relaxation can help.

The body normally stays still during REM sleep, but people with REM sleep behavior disorder can move their muscles and act out their dreams. This disrupts sleep and can be dangerous. Treatment includes a safe environment to prevent injuries while sleeping, and medication or melatonin supplements.

Based on your symptoms, your doctor may suggest a polysomnogram — an overnight sleep test done at a sleep center that measures and records what happens while you sleep, including your brain activity, eye movements, and muscle activity — to make a diagnosis. 

Alzheimer’s disease and related dementias and sleep

Alzheimer’s disease and related dementias can cause changes such as sleeping too much or not enough, waking up often, and wandering or yelling at night. This affects the sleep of both the person with dementia and their caregiver. Poor sleep quality can make dementia symptoms worse, so it is important to take steps that help improve sleep and nighttime safety. Find tips for managing sleep problems for people with Alzheimer’s.

You may also be interested in