Sleep and Age

As we age, the amount of sleep that we need and the amount that we get changes a great deal. Newborns require far more sleep each day than young children do, and then adolescents need less sleep than they did as children or they will as adults. Though the amount of sleep that we get as adults is relatively regular, once we start to show the signs of old age our sleep abilities usually change again. This change happens to both men and women but is more pronounced in men, and can be a source of extreme frustration. This may be why so many seniors rely on sleep aids in order to get a good night’s sleep. Though the changes that take place in our ability to sleep as we age can vary from person to person, the general consensus is that as we enter our golden years, sleep just becomes more difficult and less satisfying. People still feel the same need for sleep – in fact sleep studies have shown that the difference between the amount of sleep needed by the average senior citizen and a person in their thirties only differs by about half an hour - but getting to a good night’s sleep becomes an increasing challenge. One of the main complaints heard about sleep in seniors is the fact that they wake up far too early each morning. Seniors are much less likely to be able to sleep as late as they would like, and they often awaken long before their alarm clock goes off in the morning. There are a number of theories as to why this is the case, but the most probably reason is the fact that there are significant changes that take place in the brain as we age, including in the volume and number of neurons that are present. As the brain’s volume decreases by approximately 20 percent when we age, the ability to sleep diminishes in the same way. The sleep that is most missed by seniors is deep sleep. As we age the amount of deep sleep that the body gets gradually decreases. This process starts when we are young – in our middle age we get half as much deep sleep as we did when we were in our teens or twenties, and once we are in our seventies we barely get any at all. When deep sleep diminishes, so does REM sleep, which means that we do not dream as actively as we once did. Unfortunately, both deep sleep and REM sleep are integral parts of our feeling of being mentally and physically refreshed, and their absence in our old age is noticeable in the way that we feel. The end result of the loss of deep sleep and REM sleep is that we awaken much more frequently during the course of each night. Our sleep is much more fragmented and much less restful. The awakenings that we have always experienced multiple times during the course of the night increase dramatically, so that instead of shifting from periods of alertness to sleep dozens of times we may instead wake up as often as 150 times during the course of the night, and then have a much harder time transitioning back to drowsiness and falling back to sleep. All of these awakenings leave us feeling exhausted the next day. This is the reason that so many older people end up taking naps during the daytime, particularly during the late afternoon when we are experiencing a down period in our circadian rhythm. Though naps are disruptive to our sleep cycles when we are younger, they may fill the gaps in our sleep requirements when we have aged in much the same way that they do for infants who need so much more sleep than children and adults do. It is important that seniors not take so many naps that they impact their ability to sleep during the night any more than they already are experiencing. One of the problems that elderly people find in trying to get a good night’s sleep is that they are much more sensitive to the things that cause disrupted sleep. Even though their hearing may be impaired they are much more sensitive to noise than younger people are, and a sound that a younger person will sleep through will instantly awaken an elderly person. Similarly, stress and anxiety are far more likely to keep an older person from getting a good night’s sleep than would be the case for a younger person.  The same is true for an uncomfortable sleep environment and shifts in the temperature of a room. Finally, older people are far more likely to be suffering from a variety of physical or psychological ailments that in and of themselves may keep them from falling asleep, or which may require that they take medication that will have a negative impact on their ability to fall asleep.  They may be physically uncomfortable due to arthritis or other bodily pains, or may be suffering from depression or anxiety about the loss of loved ones, about their own medical conditions, or because of their uncertainty about their own future. Older people are much more likely to turn to sleeping pills and other sleep aids than any other age group – in fact approximately fifteen percent of those over 65 report taking sleeping pills regularly, and the age group accounts for forty percent of the sleep aids sold in the United States, although their age group represents less than fifteen percent of the population.  Though these medications may offer relief, they are also a cause for concern, particularly as people may become more confused as they get older, or may be prone to falling if they get up in the middle of the night and are dizzy or unbalanced as a result of the sleep medicine that they have taken.  Older patients should exercise caution and consult with their physician about the best solution to their sleep problems.