Sweet Dreams: Managing Sleep Changes in Older Adults

Senior Tips  |  January 4, 2023

The inability to stay asleep and insomnia are common complaints of older adults. While it is not uncommon for them to sleep more lightly than they did when they were younger, they still need a good night’s sleep. Having insomnia or feeling sleepy throughout the day could be representative of underlying problems.

Just as with other physical symptoms, sleep quality can be associated with general health. Older adults with healthy sleep patterns may sleep less or less deeply but will feel energetic and rested during the day. Seniors who get less sleep and are tired and lack energy may need to address the underlying causes of their nocturnal wakefulness and insomnia.

What causes insomnia and nighttime wakefulness?

Many factors can contribute to wakefulness and insomnia. Improper diet, lack of exercise, and unstructured days may cause some seniors to have insomnia. Medications can interfere with normal circadian rhythms and cause alertness at night or drowsiness during the day. Physiological factors such as dementia, illness, nighttime pain, heart disease, or problems breathing while sleeping (sleep apnea) can interfere with sleep. Wakefulness and insomnia are also strongly associated with psychological factors such as anxiety or depression. Finally, poor sleep habits (see below) can strongly contribute to insomnia.

How can senior adults improve their sleep quality?

The first step is to assess and change any poor sleep habits. Poor sleep habits include drinking caffeine, alcohol, or too many fluids in the evenings; smoking (nicotine affects sleep); exercising before bed; and eating late meals. It is important to associate the bed with sleep and intimacy by not eating, working, reading, or watching television in bed. Also, seniors should not try to go to bed when they just are not tired. Some studies indicate that increasing the amount of time spent in bed can actually interrupt normal circadian rhythms. Limiting bedtime to 7 to 8 hours may improve sleep quality. Additionally, older adults should limit napping, which can cause nighttime wakefulness, and engage in relaxation techniques before bedtime.

Senior adults who experience insomnia may want to talk with their doctors to determine if medications or physical problems are affecting their sleep. They should be sure to discuss any physical or breathing discomfort, pain, or other factors they notice are keeping them up at night. They should also note the amount of alcohol and caffeine they ingest and whether they feel anxious, nervous, depressed, sad, or stressed. Identifying physical or psychological problems or sleep disorders and treating them can help individuals overcome sleep interruptions and insomnia, so they can get a better, more restful night’s sleep.

References

Carskadon, M.A., Brown, E. and Dement, W.C. (1982). Sleep fragmentation in the elderly: Relationship to daytime sleep tendency. Neurobiology of Aging, 3, 321-327.

Geriatric Mental Health Foundation. (n.d.). Sleeping well as we age: Insomnia is not a normal part of aging. Retrieved from http://www.gmhfonline.org/gmhf/consumer/factsheets/hlthage_sleep.html.

WebMD. (2013). Aging and sleep. Retrieved from http://www.webmd.com/sleep-disorders/guide/aging-affects-sleep.

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