Sweet Dreams? : Resting Easier As We Age

By Judith S. Parnes, L.C.S.W., C.M.C.

Many older adults complain about sleeping poorly. In addition to insomnia they experience a number of other sleep disorders, such as sleep-disordered breathing, periodic limb movement disorder, restless leg syndrome, and circadian rhythm disturbances.  Symptoms of these disorders are very commonly mistaken as normal processes of aging; however, they should actually be diagnosed as medical health issues and therefore be treated.  Effective remedies are available that can help lead to an improved quality of life for many. Both daytime and nighttime routines must be considered to manage sleep disorders. 

            It is true that sleeping patterns and sleep quality become different as we age. There is a decrease in the amount of deep sleep (stages 3 and 4) and a decrease in the percentage of REM sleep.  In addition, nighttime hours are generally more fragmented (sleep interrupted by wakefulness).  A widespread misunderstanding is that older adults do not need as many hours of nighttime sleep as younger adults do; but in fact, the change in sleep need is very small.  Many factors impact the amount of restful sleep you can get at night:

• Daytime sleep: Napping more than one hour during the day can lead to a decrease in the number of hours you can sleep at night.
• Circadian rhythm: The timing of sleepiness typically shifts to an earlier time.
• Medications: Many commonly prescribed or over-the-counter drugs can disrupt sleep.
• Lifestyle/behavioral factors can cause or worsen sleep problems.
• Physical/ Mental health Problems: Pain and suffering may worsen sleep problems.
• Sleep disorders:
  • Insomnia: (is the complaint of) Not sleeping long enough or having enough hours of restful sleep.  *The majority of these complaints in older adults are linked to some other condition that affects sleep quality. 
  •   Sleep Disordered Breathing (SDB): Not being able to breathe at times throughout the night.  SDB affects people of all ages, but the number of people who experience this problem increases with age
  • Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS): Repetitive, rhythmic movements during sleep that become more severe with age; an irresistible urge to move the legs. 
  • Advanced Sleep Phase Syndrome (ASPS):  Falling asleep earlier than normal or preferred.

Effective strategies to improve the quality and amount of sleep in older adults include, being active, limiting naps, staying out of bed, increasing exposure to bright light, creating a nighttime routine, and keeping the sleeping environment quiet and dark.