Older People and Sleeping

 Ageing and Sleep

How do older people sleep differently?

Most people sleep between 7 and 9 hours each day.  However older people may not have all their sleep at night, around 4 in 10 older people have at least one nap every day. This is usually for at least half an hour. Most people over the age of 80 nap for more than one hour each day.

At night, some older people take more than half an hour to get to sleep. This is the case for about 1 in 3 women and 1 in 6 men.  Older people also tend to wake up more at night and spend less time in deep, refreshing sleep.

Why is older peoples sleep different?

At night, our body makes a hormone that promotes sleep, called melatonin. Older people make less of it so they find it more difficult to get off to sleep.  Other factors may interfere with sleep and cause wakenings during the night. These include hot flushes in post-menopausal women (see Menopause and Sleep), the need to go to the toilet during the night and other medical problems such as arthritis that make it difficult to stay in one position for the whole night.  In addition, after retirement many people find it convenient to take a short nap during the day.

What diseases can interfere with sleep?

Many diseases can make it harder to sleep. Some that are common in older people are arthritis, osteoporosis, Parkinson's disease, incontinence, indigestion, heart disease and lung diseases such as asthma or COPD. The drugs used to treat these conditions may also interfere with sleep. Some sleep disorders are more common in older people, including sleep apnea and periodic limb movement disorder.

What about mental problems and sleep?

Anxiety and depression can both interfere with getting off to sleep as well as cause wakefulness during the night.

Dementia or Alzheimer's disease can make sleep worse (see Dementia and Sleep). People with these conditions are more confused at night and may wander around the house.  This is disturbing for both the person with the disease and the carer. Because of these problems, the older person may need to be placed in a nursing home.  Two thirds of nursing home residents have problems with their sleep. This may be worse if there is not enough exercise or interesting activities during the day.

What sleep problems do older people have more often?

At least 1 in 4 older people have sleep apnea or periodic limb movement disorder.  The sleep disturbances associated with these problems often disturb the sleep of the bed partner as well as the patient. Insomnia is seen in 4 in 10 older people. One in 10 older people have insomnia that is a problem for more than 3 months.

How is it treated?

Treatment for a sleep problem depends on the cause, so the problem has to be accurately diagnosed before treatment commences. It is important to talk to a doctor about sleeping problems. There are a variety of effective treatments for snoring, sleep apnea, restless legs,insomnia and other common sleep problems.  If you have insomnia, your doctor might recommend melatonin.  Sleeping pills are effective for a short time, but should not be used for longer than a few weeks. They become less effective with time. You may find it difficult to stop taking them and they may also make you drowsy the following day.

What might your doctor do?

Your doctor will talk to you about your sleep problems and try to work out the cause of your difficulties. This is important as what is done depends on the diagnosis. You might require referral to a sleep specialist.

What could you do?

There are many simple things that can be done to improve sleep. The most important is to keep regular sleep hours.  Try to go to bed at about the same time every night and get out of bed about the same time every morning. An alarm clock can help with this.  Avoid sleeping in, even if you have had a poor night's sleep and still feel tired.  If you happen to wake early, think about getting out of bed and starting your day.  Regular sleep habits strengthen the internal body clock’s sleep-wake rhythm.  See Good Sleep Habits.

Take care with naps.  An afternoon nap may improve night-time sleep, but it may also interfere with sleeping at night. This is often a problem if the nap is late in the afternoon or lasts longer than 15-20 minutes. The best approach is to experiment to find what works best. It is important to take into account that sleep needs and sleep patterns change with age and different circumstances.

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Where and when should you seek help?

Talk to your local doctor if you have persisting problems with your sleep. This could be trouble getting to sleep (see Insomnia) or feeling sleepy during the day (see Excessive Daytime Sleepiness). Neither of these are normal results of ageing. Something can be done about both of them. You might also want to seek help if your partner notices something wrong with your breathing during sleep. There are effective treatments for both snoring and sleep apnea.

What else might cause the symptoms?

Insomnia may not be related to getting older. It could be because of stress, depression, anxiety, medications or something else. Remember that it is always best to be candid with your doctor about these matters.

For more information

https://www.nia.nih.gov/health/publication/good-nights-sleep

Sleep Health Foundation
ABN: 91 138 737 854
Suite 114, 30 Campbell Street, Blacktown, NSW, 2148
T: (02) 8814 8655 F: (02) 9672 3884
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