Fact Checked And Reviewed By Brenda Peralta, Registered Dietitian and Health Coach
Last Updated on, November 27th, 2024
Have you started to notice changes in your sleep? Maybe you used to drift off easily and stay asleep all night. But now, things are different. Falling asleep is tougher. You might even ask yourself, “What’s behind these changes in how I sleep?”
This shift could be due to changes in your sleep patterns. Many people find that their sleep gets trickier as they age. Some have trouble falling asleep. Others can’t stay asleep, or health issues¹ disrupt their rest.
This article looks at the 14 reasons why you might not be sleeping as well as you used to. We’ll explore how getting older changes sleep. Also, we’ll talk about health, medications, and even your sleeping environment. The goal is simple: to help you understand why sleep changes with age, and to help you find ways for better rest.
According to the Centers for Disease Control and Prevention (CDC) adults 18 years and older typically need between 7 to 9 hours of sleep.2 This need decreases with age. The sleep quality also drops. For instance, older adults often sleep lighter and wake up more frequently at night. But, how much sleep do older adults need?
Do Older People Need More Sleep?
The CDC recommends that people aged 60 and older get at least 7 hours of sleep every night. This challenges the thought that older adults need more sleep. In fact, research suggests that getting extra sleep doesn’t have any real advantages.
For example, a study3 compared health outcomes to sleep duration. It found that sleeping beyond 8 hours offered no discernable benefits. This remained regardless of participant age.
What Causes Increased Sleep in Older Adults?
A normal sleep pattern consists of several sleep cycles. Further, each sleep cycle includes 4 distinct stages (abbreviated as N). These four stages include light sleep (N1 & N2), deep sleep (N3), and vivid dreams (rapid eye movement or REM sleep).
Many factors influence how much time you spend in each stage. These include:
Reason 1: Changes in Sleep Patterns (Architecture)
You spend the majority of the time in REM sleep during a sleep cycle. But, as you get older, you may notice a shift to light sleep (stages 1 and 2).1 This leads to waking up more often at night and less REM sleep.
During REM sleep,4 we have vivid dreams, and our memories become stronger.This may be why you also feel you increasingly forget past events as you age.
Reason 2: Circadian Rhythm Adjustments
The aging process also influences your natural circadian rhythm. Your circadian rhythm matches up your sleep and wake cycles with day and night. Thus, your sleep pattern changes with age.
Older adults tend to go to bed and wake up earlier than when they were younger.1 This happens for two reasons:
Genetic changes. One study5 found a connection between genes and aging that affects your circadian rhythm.
Hormone release changes. As you get older, the timing of hormone release changes.6 These affect the sleep cycle in older adults, leading to changes in their sleep patterns.
Reason 3: Physical Health Conditions
Physical health conditions can also affect sleep quality and duration. This includes conditions like arthritis and fibromyalgia which cause chronic pain.
In one study,7 over 85% of study participants ages 18 to 85 noted poor sleep quality because of their chronic pain. Participants also experienced trouble falling asleep.Unfortunately, the decrease in their sleep quality also led to the worsening of their pain.8
Reason 4: Medication Side Effects
Many older adults are on medications because they have multiple health conditions. In some cases, these medications cause unwanted side effects,9 which may impact your sleep.
The problem worsens if you are taking several medications, including those purchased over-the-counter. When you take 5 or more medications (polypharmacy),10 you might see changes in your sleep quality. That’s why following up with your healthcare provider regularly is important.
There isn’t a specific number of medications that will cause drowsiness. But, certain types of medications10 may lead to issues with sleep. These include:
Using one or a combination of these medications may affect your sleep.
Reason 5: Psychological Factors and Mental Health
Several studies prove mental health impacts sleep. For instance, people with anxiety may experience difficulties falling asleep. Those with depression have trouble waking up often. Likewise, stress can cause you to wake up easily. So it may be hard to fall and stay asleep if you struggle with mental health.
Mental health and sleep quality are part of a two-way street. Researchers followed over 8000 people11 to see if better sleep helped their mental health. Patients with depression, anxiety, and stress all showed an improvement in their symptoms with better sleep.
On the other hand, poor sleep12 is a risk factor for developing and worsening mental health conditions. Effective mental health interventions can contribute to improved sleep and vice versa.
Reason 6: Reduced Physical Activity
Not getting enough physical activity affects your sleep. Researchers believe it may be due to stage 3 or deep sleep improvements.
Many studies13 show that adults who exercise regularly for at least 2 months have better sleep. For example, middle-aged women assigned to different exercise programs for 12 weeks14 saw similar results.
So when is the best time to exercise to improve your sleep? The answer varies from person to person. Exercise increases your heart rate and body temperature. It also provides an adrenaline rush making it hard to sleep. But this isn’t the case for everyone. So determining the best time to exercise may take trial and error.
Reason 7: Neurological Changes and Dementia
In 2020, an estimated 7 million people15 aged 65 and up had some form of dementia. Dementia is a gradual and irreversible decline in memory, reasoning, and behavior.
Older adults with dementia see changes in their sleep patterns. They experience more daytime sleepiness with problems falling and staying asleep. Treating dementia may improve these symptoms or at least slow their progression.
Conversely, if you have trouble sleeping your risk of having dementia increases. A recently published study looked at 10 years of data for adults aged 65. It looked at people who had difficulty falling asleep, staying asleep, or taking sleep medication. The data revealed that having trouble falling asleep and taking sleep medicine increases the risk of dementia.16
Reason 8: Dietary and Nutritional Impacts
Your dietary choices impact your sleep quality. An unhealthy diet lacks the recommended nutrients. Thus, eating over-processed foods17 decreases the quality and amount of sleep you get.
Conversely, certain foods and food groups help improve your sleep. For instance, some foods boost melatonin levels while others affect serotonin levels. Changes in these levels help you get to sleep faster and stay asleep longer. Foods found to impact sleep positively include18:
Bananas
Pineapples
Oranges
Kiwi
Cherries and tart cherry juice
Salmon
Tuna
Oysters
Krill
Milk
The Mediterranean diet18can also improve sleep. It focuses on increased intake of fruits, vegetables, whole grains, and healthy fats. With this diet, it’s recommended to avoid red meats and heavily processed foods. A balanced and nutrient-rich diet improves sleep quality and overall well-being.
Reason 9: Increased Need for Cellular Repair
During sleep, your body releases growth hormones to promote cellular repair and regeneration. Unfortunately, older adults see decreased hormone secretion,19 which could impact their sleep. Hormone release follows circadian rhythms. Natural changes in your rhythm with age decreases the amount of hormones released over time.
Changes in hormone release also affects how your body repairs itself. This leads to changes in its function and immune response. For older adults, changes in immune function20 make it harder to fight off infections.
Reason 10: Social and Environmental Changes
You may have been looking forward to getting more sleep when you retire. But, for some older adults, no longer working has the opposite effect. When you were working, you likely kept a consistent work schedule. In retirement, your days may no longer be as structured. This leads to problems with sleep.
Research shows individuals notice changes in sleep patterns after retiring. Retirees in a study went to bed later, slept longer, and woke up later without a schedule.21,22
Sleep apnea causes you to start and stop breathing while asleep. Almost 6 million people in the US have sleep apnea, and it predominantly affects older adults.23 Understandably, sleep apnea and other breathing disorders (like asthma and COPD) can affect your sleep quality.
Unfortunately, to help improve sleep, older adults may turn to over-the-counter and prescription sleep aids.24 But, these medications don’t come without risk (as discussed).
The American Geriatrics Society recommends avoiding them if possible. Instead, it recommends working on sleep hygiene to treat long-term sleep problems.
Reason 12: Boredom and Lack of Stimulation
Have you ever felt sleepy when you had nothing to do? A lack of stimulation affects cognition in the elderly, changing their sleep patterns. In addition, constant fidgeting or searching for ways to occupy your time impacts sleep.
Further, a connection between boredom and refusing to go to bed even when tired has been established. A study25 with 270 people found that not paying attention made sleeping difficult. It also caused people to postpone going to bed.
Reason 13: The Role of Grief and Loss
The loss of a loved one affects everyone in different ways. The grieving process26 leads to difficulty falling asleep and staying asleep. Older adults are more prone to experience grief and loss for several reasons, including:
Losing a spouse or close friends that have been around for many years
Increased awareness of their own mortality
Being isolated from from family and friends
Losing many loved ones at one time
Many studies show that grieving can lead to more sleep disruptions. Having other mental health issues, like depression or PTSD, increased them.
You can’t predict how long grief will affect your sleep, but finding ways to cope with your grief helps. Counseling26 can also improve sleep.
Reason 14: Sensory Decline and Sleep
A loss of hearing or vision changes how long and well you can sleep. With vision loss, people can’t tell the difference between day and night. This affects the natural light-dark cues help to regulate your circadian rhythm.27
Partial and complete hearing loss could also lead to problems with insomnia. Some older adults feel stress, anxiety, and depression about not being able to communicate28due to not being able to hear. This leaves them unable to get enough sleep.
What is the Impact of Getting Too Much or Too Little Sleep?
Getting too much and too little sleep can significantly impact your physical health, mental well-being, and overall quality of life.
What Are the Risks of Sleeping Too Much in Older Adults?
Many people complain about not getting enough sleep. But have you ever considered the effects of getting too much sleep?
Many health problems are associated with sleeping more than 9 hours per day. For example, too much sleep increases your risk of developing chronic conditions.29 Older people who sleep a lot may have trouble thinking, which can lead to dementia.
The reasons behind these risks are complex. Excessive sleep may disrupt circadian rhythms, impacting hormonal regulation and cardiovascular function. Too much sleep is also a sign of other underlying health conditions. Regular follow-up with your health care provider is necessary to keep an eye on these changes.
What Are the Consequences of Not Getting Enough Sleep in Older Adults?
Lack of sleep30 also raises the chances of getting or worsening chronic diseases and dementia.
A study31 examined how sleep duration affects aging in adults aged 50-75. The results showed that individuals who slept 7-8.5 hours lived longer without chronic illnesses. For people who slept less than 7 hours or more than 9 hours had a 1-3 year shorter disease-free life expectancy.
What are Solutions and Advice for Improving Sleep?
By now, you may be wondering if there are so many things that impact your sleep, what can you do to improve it? This is where sleep hygiene becomes important.
Older adults can sleep better by developing good sleep habits and dealing with underlying issues. Luckily, researchers have also looked at proven evidence-based ways to improve your sleep.
Here are a few to consider:
Make a sleep schedule: Go to bed and wake up at the same time every day. You’ll even want to keep this schedule on weekends to avoid disruptions in your sleep.
Create a restful environment: Make your bedroom comfortable, quiet, and dark. Using blackout curtains and removing electronic devices can also help.
Avoid too much stimulation: Avoid or decrease your use of caffeine and nicotine, especially before bedtime.
Get regular exercise: Exercising is great for managing health conditions and stress. However, you’ll want to avoid vigorous exercise close to bedtime.
Improve eating habits: A light, balanced meal is recommended over a heavy meal close to bedtime. Likewise, avoid foods that may worsen conditions like heartburn.
Keep naps short: Avoid napping for longer than 20-30 minutes at a time. You’ll also want to skip a nap if it gets too late in the afternoon.
Reduce stress: Try relaxing with deep breathing or meditation to reduce stress.
If you still can’t sleep, talk to your doctor or a sleep expert. You might need more tests, like sleep studies, to find out why you can’t sleep enough. With this information, your healthcare provider can create a tailored treatment plan.
Conclusion
It’s clear that sleep changes with age, and getting the right amount of sleep is challenging. Many factors impact your sleep quality, from deciding when to retire to eating the right foods.
Research shows older adults 60 and up need at least 7 hours of sleep. If you’re getting too much or too little sleep over time, your risk of developing chronic diseases or dementia increases.
So regularly talk to your doctor about your sleep to find out why you’re having trouble. Use evidence-based recommendations to improve your sleep hygiene. If this doesn’t help, you may benefit from counseling or, in some cases, medications.
In summary, as you get older, your sleep habits will likely change naturally. But, you can counteract this by being proactive.
Written By Board Certified Pharmacotherapy Specialist | PharmD, MPH, BCPSZuri Hawkins Jarret
Follow on :
Zuri Hawkins-Jarrett graduated with her doctorate in pharmacy from The University of Georgia College of Pharmacy. She completed her residency training with Piedmont Columbus Regional in ambulatory care.
Zuri also has a Master of Public Health degree from Emory University with a focus on Prevention Science. She has a passion for pharmacy and public health to help those in her community diagnosed with chronic conditions.
We use cookies to collect and analyse information on site performance and usage and to enhance and customise content and advertisements. By clicking Accept or by clicking on any content on this site, you agree to allow cookies to be placed. Click on our Privacy Policy page to understand what kind of data we collect and what we use it for.Accept
There are no comments yet