Sleep changes in Older Adults
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How much sleep do older adults need?
Most adults need 7 or 8 hours of sleep each night to feel fully alert during the day. This is usually also true for people age 65 or older. But as we get older, we might have more trouble sleeping. Many things can get in the way of sleeping well or sleeping long enough to be fully rested.
What sleep changes are common in older adults?
Older adults might get sleepy earlier in the evening. Older adults may have insomnia, which makes it hard to fall asleep when they go to bed or stay asleep all night. They might wake up very early in the morning and not be able to go back to sleep.
What causes sleep problems?
A number of things can cause sleep problems. By the time an adult is over 65 years old, their sleep-wake cycle may not seem to work as well as it did when they were younger. As we age, our body makes less of the chemicals and hormones that help us sleep well (growth hormone and melatonin).
Some lifestyle habits (such as smoking and drinking alcohol or caffeinated drinks) can cause sleep problems.
Sleep problems may be caused by illness, by pain that keeps a person from sleeping or by medicines that keep a person awake.
However, people of all ages can have a sleep disorder such as sleep apnea. Restless legs syndrome or periodic limb movement disorder are also conditions that can cause problems with sleep.
What is sleep apnea?
Sleep apnea is a disorder in which a person stops breathing repeatedly while asleep. People who have sleep apnea usually snore very loudly. They stop breathing for 10 to 30 seconds during sleep and then start breathing again with a gasp. This can happen hundreds of times in a single night. Every time this happens it causes the person to wake up a little bit, which disrupts sleeping patterns and makes it hard for the person to get a good night’s rest. It can also cause high blood pressure and increase the risk of heart attack.
If you have sleep apnea and are overweight, it might help to lose weight. If you smoke, you should quit. It will also help to sleep on your side, stop drinking alcohol or using sleep medicines.
Many people who have sleep apnea need to wear a nasal mask during the night to keep their airways open. The mask treatment is called “continuous positive airway pressure,” or CPAP. It helps you breathe normally during sleep.
Surgery is also an option for people who have severe cases of sleep apnea.
What is restless legs syndrome (RLS)?
RLS is a condition in which your legs feel very uncomfortable when you are sitting or lying down. RLS can make it hard for you to sleep.
What is periodic limb movement disorder (PLMD)?
PLMD is a condition in which a person kicks one or both legs many times during sleep. Often the person doesn’t even know about the kicking unless a bed partner talks about it. It prevents good sleep and causes daytime sleepiness. Some people who have restless legs syndrome also have periodic limb movements during sleep. Medicine may help both of these problems.
What can I do to sleep better?
- Go to bed and get up at the same time every day, even on the weekends.
- Do not take naps longer than about 20 minutes.
- Don’t read, snack or watch TV in bed. Use your bedroom for sleep and other rooms for other activities.
- Avoid caffeine about 8 hours before bedtime.
- Avoid nicotine and alcohol in the evening. Alcohol might help you fall asleep initially, but it will probably make you wake up in the middle of the night.
- Don’t lie in bed for a long time trying to go to sleep. After 30 minutes of trying to sleep, get up and do something quiet for a while in a different room, such as reading or listening to quiet music. Then try again to fall asleep in bed.
- Ask your healthcare provider if any of your medicines could be keeping you awake at night. Medicines that can disrupt sleep include antidepressants, beta-blockers and cardiovascular drugs.
- Ask your healthcare provider for help if pain or other health problems keep you awake.
- Try to exercise a little every day. Exercise helps many older adults sleep better.
Sleep Problems in the Elderly by DN Neubauer, M.D. (05/01/99, http://www.aafp.org/afp/990501ap/2551.html)