Addressing Sleep Concerns in Seniors

Sleep concerns in seniors – whether in the quality or the quantity of sleep – are quite common. One reason is the change in the body’s internal clock as we age. Called circadian rhythms, these 24-hour daily cycles inform us when we’re hungry, when we produce hormones, and when we are sleepy. 

The internal clocks of older adults also may not function as well as younger adults because the brain receives cues from the amount of light the eyes take in, and seniors tend to have less exposure to sunlight, thereby distorting the signals the body receives. Also, aging produces changes in the level of hormones that help promote sleep.

But seniors do not have to accept sleep deprivation as a normal part of aging. What are the causes of sleep concerns in seniors, and what can be done about them?

What Robs Seniors of Sleep?

Not only do seniors’ circadian rhythms change, leaving them more tired in the afternoon and waking up earlier in the morning, but seniors also spend less sleep time in the deeper stages of sleep and may wake up more frequently at night. 

Health conditions can also disrupt sleep—depression, anxiety, heart disease, and diabetes to name a few. Pain and the side effects of medications may also contribute to sleeplessness. 

Interestingly, retirement affects sleep. No longer waking at a certain hour to go to a job, and sleeping later as a result and taking long afternoon naps alter our sleep patterns. 

Also, changes in the urinary system increase with age, requiring more nighttime visits to the bathroom. 

Sleep Disorders

How much sleep do seniors need? According to the National Sleep Foundation, seven to eight hours is the recommendation. 

Here are some of the challenges to reaching that number:

Sleep apnea. With sleep apnea, people experience pauses in breathing while asleep due to a partial collapse of the upper airway. The result is fragmented sleep that can affect oxygen levels in the body. Untreated sleep apnea can contribute to memory loss, liver problems, mental confusion, a weakened immune system, high blood pressure, abnormal cholesterol, fatigue, heart disease and diabetes. 

People may have sleep apnea and not know it. Symptoms are often apparent to a bedmate — loud snoring, stopping breathing, or gasping for air during sleep. Other signs include awakening with a dry mouth, morning headache, excessive daytime sleepiness and difficulty focusing while awake. 

Treatments such as continuous positive airway pressure (CPAP) and oral appliances help keep oxygen flowing into the lungs while asleep. Losing weight can also improve sleep apnea symptoms while reducing heart disease risk.

Restless leg syndrome. This is a sleep movement disorder that involves an uncomfortable urge to move the legs while trying to sleep. The sensations have been described as tingly, crawling, and creeping. The condition can lead to anxiety and depression, and may worsen. 

Consuming caffeine or alcohol, or using tobacco can aggravate symptoms. Certain medications can also cause or worsen restless leg syndrome. Kidney disease, nerve damage due to diabetes, and anemia (iron deficiency) has been linked to it as well. 

There are medications that can be effective in relieving symptoms. 

Insomnia. Insomnia refers to the inability to fall asleep or stay asleep. It is one of the particularly common sleep concerns in seniors.

Insomnia can be caused by stress, anxiety, hormones, or digestive problems. It can result in depression, difficulty concentrating, irritability, weight gain, and impaired cognitive abilities. 

Treatments may include cognitive behavioral therapy to help control or eliminate negative thoughts and worries. There are also prescription medications that can help get a person to sleep and stay asleep. However, physicians do not recommend these medications as a long-term solution. 

Consult a Physician 

If a sleep disorder is suspected, talk to a physician. He or she may order a physical exam or a medication review, ask about your sleep habits, or recommend a sleep study. This last option includes spending a night at a sleep center monitored to record your activities while asleep, including brain waves, breathing, heartbeat, and eye and body movements. 

Good Sleep Habits

Exercise. People who exercise regularly not only improve their overall health, they also usually fall asleep faster and sleep longer. 

Eliminate substances and practices that prevent sleep. Limit or eliminate tobacco use, caffeine consumption, and alcohol. A drink may get you to sleep, but studies show it will not make you sleep better.  

Also, eat dinner at least four hours before bedtime, and develop a bedroom routine. The routine could include taking a bath, reading, listening to music, or pursuing other relaxing practices that signal your body that the time to sleep is approaching. 

Turn off distractions such as TVs, cellphones, and bright lights. According to Harvard Health Publishing, TV screens, and energy-efficient lighting is increasing our exposure to blue light wavelengths, which suppresses the secretion of melatonin, a hormone that influences circadian rhythms.

Practice sleep hygiene. Pull the shades to darken the bedroom and lower the thermostat—staying cool helps people sleep better. Set a regular bedtime and a time to wake up in the morning. Don’t try to stay in bed later in the morning to make up for lost sleep.  

Reduce risks. Seniors should remove all trip hazards from the bedroom that can result in a fall during the middle of the night. Make sure a light is within reach, as well as a telephone (but not a cellphone that sends notifications during the night)

Nap sparingly. According to the Sleep Foundation, a brief nap (10 to 30 minutes) in the early to mid-afternoon, can be “refreshing and restorative.” However, longer naps later in the day can negatively impact sleep quality and duration at night. 

The Benefits of a Good Night’s Sleep

With adequate sleep, people are more likely to experience: 

• An increased appetite for healthy food 
• Fewer food cravings
• More energy
• Better regulated insulin
• An improved immune system
• A reduction in stress
• Improved focus
• Better memory 

Take a look at our blog for more resources on senior health concerns.