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How Sleep Patterns Change With Age

How Sleep Patterns Change With Age

Jan. 5th, 2022

As you age, your sleep patterns are likely to change. According to Medline Plus, older adults are more likely to wake up 3-4 times during the night.1

It is estimated that nearly half of men and women over the age of 65 have at least one sleep problem. There are many different causes of sleep pattern changes, from a difference in overall lifestyle with retirement to natural biological clock changes.2

Here is how sleep changes with age, as well as some ways seniors can improve their sleep quality at night.

Insomnia

Insomnia, which is a persistent inability to fall or remain asleep, is a common reason for lack of sleep. It is estimated that 10-30% of adults suffer from insomnia, with people over the age of 60 more at risk.3

A few causes of insomnia include:4

  • Stress
  • Poor sleep habits (such as long naps or an irregular bedtime schedule)
  • Traveling
  • Eating late at night
  • Medications
  • Mental health disorders such as anxiety
  • Sleep-related disorders such as sleep apnea

There is still ongoing research as to why insomnia occurs more frequently in older adults. Currently there is no evidence that seniors need less sleep than other age demographics.

Circadian Rhythm Changes

Another common reason why older adults suffer more frequently from a lack of sleep include changes to the circadian rhythm. The circadian rhythm is the sleep-wake cycle that controls your body’s temperature, hormones, and digestion. It’s been found that the circadian rhythm is affected by sleep time and aging, resulting in a decreased sleep cycle.5

A few reasons why the circadian rhythm changes includes:3

  • Lack of Melatonin. Melatonin is a hormone that plays a role in the body’s sleep-wake cycle. As you age, the body produces less melatonin, which can impact sleep quality and cause insomnia.
  • Shift in Timing of the Sleep/Wake Cycle. Older adults tend to feel sleepier earlier in the evening, which can cause a shift in the body’s natural sleep cycle. This can be a cause of advanced sleep phase syndrome, which causes a person to fall asleep between 7-9pm and wake up 3-5am.
  • Reduction of time in light. It is estimated that seniors need at least 1 hour of bright light exposure to maintain a normal sleep-wake cycle. However, many seniors spend too little time outside, which causes their cycle to shift. This is another way how sleep changes with age.

A disruption to the circadian rhythm can make someone feel less alert and cause them to feel tired during the day.

Daytime Napping

Naps are common for seniors, with an estimated 20-60% of older adults reporting that they nap throughout different studies. Many studies show that about 60% of senior participants take naps that last anywhere from 30-90 minutes.6

There are some benefits to napping, such as better memory retention and improved cognitive functioning. However, excessive naps longer than 20-40 minutes can be caused by poor sleep quality, and people who take long naps will usually feel groggy after waking up. This is because the napper is more likely to wake up from a deeper stage of sleep, which can negate some of the cognitive benefits that come with taking a quick nap.7

Long naps can also worsen sleep problems during the night because they can change a person’s natural sleep cycle. This can cause someone to feel unable to fall asleep at night, or further induce insomnia.8

It’s important that older adults take naps that don’t interfere with their natural sleep cycle. Naps should only be taken if they are short. It is also recommend to take a nap in the early afternoon so that way it doesn’t impact sleep quality at night.

Sleep Disorders

Another way sleep changes with age is many adults experience sleep disorders, many of which are linked to a decrease in sleep quality.

Some of these sleep disorders include:

  • Narcolepsy. This is a sleep disorder where the person will feel drowsy and suddenly fall asleep. One symptom of narcolepsy is a loss in muscle tone, which can cause someone to be unable to perform facial expressions or stand. People who are at risk for narcolepsy have a family history of it, have an auto immune disorder, or experience a brain injury or tumor.9
  • Sleep Apnea. Sleep apnea is when your body’s breathing patterns change to suddenly start and stop. Signs of sleep apnea include snoring, a dry throat when awaking, and gasping for air during sleep. Sleep Apnea is more likely to occur in older adults, especially if there is a family history of it.10
  • Restless legs syndrome. This is a condition where the person has an uncontrollable desire to move their legs, usually at nighttime or when sitting down. Those with restless leg syndrome feel uncomfortable unless they move their legs to relieve the symptoms. Restless leg syndrome can develop at any age.11

Medications and Health Conditions

As you age, you’re more likely to encounter different illnesses and mental health conditions that require different medications. It is estimated that 40% of adults over age 65 take 5 or more medications.12

However, many medications have been linked to disrupting or changing sleep patterns, which can impact your overall sleep quality.

Here are a few health conditions that many older adults currently face that require medications that could change sleep patterns.

Hypertension

High blood pressure, also known as hypertension, is a common health problem found in many adults. The CDC estimates that nearly half of adults in the United States – 47% – have hypertension.13

Some medications that are alpha-blockers will be prescribed by doctors to treat hypertension; however, these medications can contribute to insomnia and a disruption in sleep patterns. Alpha-blockers are able to help the blood vessels open up, which can decrease hypertension in the body. But one trade-off is that alpha-blockers have been linked to a decrease REM (Rapid-eye movement) sleep, which is the period of sleep when you are dreaming. REM sleep has been found to positively affect memory and helps you feel rested.14

Depression

Another problem many older adults struggle with is depression, with an estimated 6 million Americans over the age of 65 experiencing it.15

Depression in older adults can be caused by a number of factors, such as feeling like there is a loss of independence with age or the grieving of a loved one who might have recently came down with a serious illness.

SSRI medications, which are used to help treat depression, have been linked to insomnia. It is estimated 10-20% of those who take an SSRI medication experience agitation, insomnia, mild tremors, and impulsivity. While it is unclear what the exact cause of these side effects are, there is a strong likelihood that antidepressant medications could be interfering with sleep patterns.14

Nasal Decongestants

Decongestants are used by millions of Americans, mainly for allergies, sinuses, and flus. Decongestants are available at many over-the-counter pharmacies and don’t typically require a prescription.

One reason people take decongestants is because it can be uncomfortable and difficult to sleep with a stuffy nose. However, decongestants shrink the blood vessels and tissues, which in turn can increase blood pressure and make you feel jittery. This can cause insomnia, and the effects can be long lasting if someone were to become dependent on taking nasal decongestants each night.16

Some Ways to Get Better Sleep at Night

It’s important to take charge of you or your loved one’s health and try to get a good night’s sleep each night. Some tips you and your loved ones can use to improve sleep quality include:17

  • Go to bed and wake up at the same time
  • Sleep in a comfortable environment
  • Reduce noise distractions
  • Avoid eating/drinking caffeine or sugar before bed time
  • Exercise daily
  • Turn off electronics before bed
  • Relax before bed with an activity such as reading or meditation

Get a Good Night’s Sleep

Saber Healthcare encourages you and your senior loved ones to work on getting the right amount of sleep each night. If you or a loved one is struggling to get enough sleep at night, discuss options with your doctor to improve the amount of rest you get each night.

To learn more about Saber Healthcare and the services we offer, click here.

Saber Healthcare is an organization dedicated to providing consultant services to long term care providers. This article is for informational purposes and is not meant to be seen as professional advice. Please consult with a medical expert before relying on the information provided.

Sources

  1. “Aging changes in sleep.” A.D.A.M., INC., Medline Plus. Last updated 30 November 2021. Accessed 30 December 2021. Link: https://medlineplus.gov/ency/article/004018.htm
  2. Ambardekar, Nayana, ed. “Sleep and Aging.” WebMD, Compass. 14 August 2021. Accessed 30 December 2021. Link: https://www.webmd.com/healthy-aging/guide/sleep-aging
  3. Fry, Alexa. Rehman, Anis. “Insomnia & Seniors.” OneCare Media, SleepFoundation. 18 September 2020. Accessed 30 December 2021. Link: https://www.sleepfoundation.org/insomnia/older-adults
  4. “Insomnia.” Mayo Foundation for Medical Education and Research. 15 October 2016. Accessed 30 December 2021. Link: https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167
  5. “What are circadian rhythms?” National Institute of General Medical Sciences. Accessed 30 December 2021. Link: https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx
  6. Zhang, Zeyu et al. “Napping in Older Adults: A Review of Current Literature.” Current sleep medicine reports vol. 6,3 (2020): 129-135. doi:10.1007/s40675-020-00183-x. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992388/
  7. “Can a Nap Boost Brain Health?” John Hopkins Medicine. Accessed 30 December 2021. Link: https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-a-nap-boost-brain-health
  8. Pride, Laura. “Seniors: To nap or not to nap….” Poncono Record. 5 August 2020 Accessed 30 December 2021. Link: https://www.poconorecord.com/story/lifestyle/boomers/2020/08/05/seniors-to-nap-or-not-to-naphellip/113412448/
  9. “Narcolepsy.” Cleveland Clinic. Last Updated 16 March 2020. Accessed 30 December 2021. Link: https://my.clevelandclinic.org/health/diseases/12147-narcolepsy
  10. “Sleep Apnea.” Mayo Foundation for Medical Education and Research. 28 July 2020. Accessed 30 December 2021. Link: https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
  11. “Restless legs syndrome.” Mayo Foundation for Medical Education and Research. 21 January 2021. Accessed 30 December 2021. Link: https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168
  12. Newsom, Rob. DeBanto, John, ed. “Aging and Sleep.” OneCare Media, Sleep Foundation. Last Updated 23 October 2021. Accessed 30 December 2021. Link: https://www.sleepfoundation.org/aging-and-sleep
  13. “Facts About Hypertension.” Center for Disease Control and Prevention. Last reviewed 27 September 2021. Accessed 30 December 2021. Link: https://www.cdc.gov/bloodpressure/facts.htm
  14. Neel, Armon B. “10 Types of Meds That Can Cause Insomnia.” AARP. Accessed 30 December 2021. Link: https://www.aarp.org/health/drugs-supplements/info-04-2013/medications-that-can-cause-insomnia.html
  15. Bruce, Debra Fulghum. “Depression in Older People.” WebMD. 4 June 2020. Accessed 30 December 2021. Link: https://www.webmd.com/depression/guide/depression-elderly
  16. Clancy, Rosemary. “Nasal Sprays and Insomnia.” LetSleepHappen. 29 August 2017. Accessed 30 December 2021. Link: https://www.letsleephappen.com.au/blog/nasal-sprays-and-insomnia
  17. “Tired? 6 Ways to Get More Rest at Night.” Saber Healthcare Group. 22 November 2020. Accessed 30 December 2021. Link: https://www.saberhealth.com/news/blog/get-better-sleep
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