Sweet Dreams as You Age
Poor sleep is not a normal part of aging. But if you can’t sleep, remember that you’re not the only one. Many adults 60 and older say they suffer from insomnia, according to the National Institute of Aging (NIA).
When you get enough sleep, you feel restored and refreshed, both physically and mentally. Too little sleep or poor-quality nighttime sleep can make you irritable or depressed; disrupt your concentration; cause memory problems, depressed mood, excessive daytime sleepiness, and increased use of over-the-counter or prescription medications. Too little sleep may even lead to falls.
How much is enough?
Older adults need about the same amount of sleep as younger adults: 7 to 9 hours per night, on average, says the NIA. Still, it’s not unusual for older people to take more than 30 minutes to fall asleep, to sleep less at night, to sleep less deeply and wake up more often throughout the night, and to nap more frequently during the day. Naps can be a good way to meet your sleep needs, as long as you don’t overdo it. As a general rule, it’s a good idea to limit naps to 20 to 30 minutes so that they won’t take away from your nighttime sleep. You may have a serious problem with sleep if — for more than 2 to 3 weeks — you are so tired during the day that you cannot function normally. You should talk to your health care provider or a sleep disorders specialist for help.
Sabotaging your sleep
Your sleep may be disrupted for many reasons. The NIA, says one of the possible reasons for these changes is that older adults may produce and secrete less melatonin, the hormone that promotes sleep. They may also be more sensitive to changes in their environment, such as noise. Years of less-than-ideal sleep habits may be ingrained, such as going to bed with the TV or radio on.
Other causes of poor sleep, according to the NIA, include insomnia, snoring, sleep apnea, and movement disorders like restless legs syndrome.
Symptoms of insomnia include:
Taking more than 30 to 45 minutes to fall asleep
Waking up frequently at night
Waking early and being unable to get back to sleep
Waking up feeling tired
Insomnia can have a variety of causes, the NIA says. They include the need to use the bathroom during the night because of an enlarged prostate (men), or continence problems (women); disorders, such as heartburn, arthritis, menopause, and cancer, that cause discomfort at night; neurologic or psychiatric conditions, such as Parkinson disease, depression, or dementia; lifestyle habits such as napping too much, getting too little exercise, or drinking alcohol or caffeine; and side effects of certain medications.
Sleep apnea and snoring are 2 breathing conditions that affect sleep. When severe, they cause people to wake up often at night and be drowsy during the day. Restless legs syndrome and periodic limb movement disorder, which causes people to move their limbs while asleep, also can lead to poor sleep and daytime drowsiness.
Whatever the cause, we spend less time in deeper sleep by ages 60 to 70 than we used to.
If you’re not getting enough sleep, see your health care provider to find out if the cause is illness or medication.
Suggestions from the National Sleep Foundation may help ease you into dreamland:
Maintain a regular schedule for going to bed and waking up; limit the amount of time you nap.
Exercise earlier in the day. Exercising within 6 hours of bedtime can make it hard to fall asleep.
Spend time each afternoon in natural light.
Caffeine, nicotine, and alcohol can trigger sleep problems, so get help from your health care provider if you need to cut back or quit. Don't drink beverages with caffeine later in the day.
Create a soothing bedtime ritual that helps you relax, such as taking a warm bath, putting on comfortable pajamas, meditating, praying, or writing in a journal to set aside your thoughts until the next day.
Create a safe and a comfortable place to sleep, such as locks on all doors and smoke alarms on each floor, a lamp you can turn on easily, and a phone by your bed.
If you wake up and are unable to go back to sleep within 15 to 20 minutes, get out of bed. Leave the bedroom and do something relaxing, like reading a book. When you feel sleepy again, head back to bed rather than fall asleep on a couch or chair.
It may help to talk with your health care provider about your sleep habits. Tell him or her if you think physical symptoms, such as pain or restless legs, or feelings, such as depression or anxiety, may be troubling your sleep. Ask whether any of your medications may interfere with sleep. For instance, drugs for high blood pressure or depression may disrupt sleep for some people.
In general, avoid prescription medications to help you sleep. They have many side effects and can make you drowsy during the day. They can also increase the risk for falls and even hip fractures after falling. They may be OK to use for a short time in some cases. The over-the-counter medicine diphenhydramine is often used for sleep and is found in several combination products. But diphenhydramine has not been shown to improve the quality of sleep, and it can cause confusion, daytime drowsiness, constipation, and difficulty urinating. The natural products valerian and melatonin also have not been proven effective for sleep. Talk with your doctor before taking any of these to help you sleep.
- Gomez, Wanda, RN, Ph.D.
- MMI board-certified, academically affiliated clinician