Sleep & Ageing:
A Senior Sleep Guide
- Last Updated:
Sleep issues plague people at any age, but there’s a high prevalence of certain ones in older people. Sleep and ageing is a tricky topic, and awful to experience.
Thankfully there are solutions to some of the problems—but first, we need to examine the main problems with sleep and ageing.
How Much Sleep Do We Need As We Age?
You’ve probably heard that adults need eight hours of sleep per night. You may have also heard the broader range of 7–9 hours. This is true for adults—but you may also know that you require less sleep as you age.
It’s simple to assume this means kids need more sleep than adults, which is true again, but older adults need less sleep than younger adults, too. The range comes down to 7–8 required hours of sleep for older adults.
However, many people don’t get the recommended amount of sleep. One survey of adults in the UK reveals that 67 percent of those over 18 have sleep issues—older people included.
Twenty-three percent of adults sleep less than five hours a night, which is below the requirement for younger and older adults alike.
These issues can be caused by all kinds of things, from disorders to bad practices to underlying conditions. We’ll take a look at the first and last element now, and address the bad practices later in the article.
Sleep Problems and Ageing
The following sleep problems are a small portion of a wider selection of struggles. These are the issues that sleep health groups around the world have found are most prevalent in adults aged over 60.
The surveys that discovered the prevalence are US-based, but we’ll do our best to cite what we know about the same problems in the UK.
1. Insomnia
In the survey above, 31 percent of the UK’s sleep problems have insomnia as the cause. The NHS states that insomnia is a problem for older or elderly people in particular, but they don’t state why. We’ll tailor our theories to why it may impact older people more.
Just so you know the definition of insomnia, insomnia is when you struggle to sleep at night for several days or months at a time. It can come and go throughout your life but if it lasts for six months or more at once it’s considered chronic.
Insomnia Causes
The causes below are by no means all the causes, but here are some likely to impact older people:
- Anxiety, stress and depression: Older people may be stressed or depressed about living on a fixed income, losing friends and family members, dealing with medical conditions and more. Half of adults over 55 have mental health struggles, some feeling he symptoms worsen with age.
- Bad environment for sleep: Older people may have had their current bed for longer than its prime, live with noisy younger family members or have loud neighbours, all of which contribute to insomnia.
- Medication: Some medication causes insomnia, such as epilepsy medicine, steroids and antidepressants.
- Underlying conditions: If you suffer with your heart or from chronic pain it can cause or worsen insomnia. Insomnia can also be a hidden side effect of undiagnosed disorders, like cancer, Parkinson’s disease, respiratory problems and more.
- Lifestyle: As a retired person, you may wish to live life as you couldn’t as a working person. If this leads you to stay up late, or drink alcohol before bed, you may be damaging your chances of getting healthy sleep.
Insomnia Symptoms
- Difficulty falling asleep at night, or napping, despite being exhausted;
- Cognitive difficulties in the day, like being unable to concentrate or remember things;
- Feeling irritable and angry for no reason;
- Frequently waking up at night;
- Waking up too early with an inability to resume sleep;
- Being tired or unrefreshed when waking in the morning.
Insomnia Treatments
Insomnia can be treated with therapy, medication or lifestyle changes depending on the cause. Speaking to your GP and determining the root of the problem will ensure you get to the bottom of it and get the right treatment.
If your insomnia is caused by stress or mental health-related factors and you’d rather not go to therapy, you can ask for medications or try an over-the-counter solution. We’ll be discussing these later in the article.
2. Sleep Apnea (or Apnoea)
Stepping away from insomnia, we come to a condition that’s also common in older people but is far more serious than the one explored above.
People with this condition stop breathing for up to a minute at a time while sleeping. Because of this, you may wake up coughing or gasping for breath.
Obstructive Sleep Apnea
This version of sleep apnea is more common, and thankfully the easiest to fix. In this case, the obstruction is in the airways and can be caused by several things including weight gain and muscle collapse. In some cases your tongue falls back, and blocks off the airway, making it difficult for you to breathe.
Sleep apnea gets more common with age, due to the natural ageing process. As we get older our muscles weaken, including in the throat and nasal area
There are several machines working as sleep aids that can help keep your airways open. They ensure you stay breathing while sleeping, so your brain and body get adequate oxygen all night. However, in extreme cases, you may need surgery on your upper airway though thankfully this is rare.
Doctors may also advise you to lose weight if you’re overweight, as the excess can put pressure on your airways, forcing them to close.
Central Sleep Apnea
Central sleep apnea can be treated via machines, too, but it gets more difficult as you realize the cause. With central sleep apnea, your brain is the problem and stops communicating effectively with your breathing muscles.
Your body literally forgets to breathe as the brain doesn’t send those signals, and so you end up oxygen-deprived, coughing and gasping.
Sleep Apnea Risks
When you have sleep apnea you’re more at risk for cardiovascular disease as well as stroke. As you’re not breathing your vital organs are missing out on the oxygen they need to function, damaging them in the process.
Sleep apnea is one of the most dangerous conditions there is thanks to these risks, and thanks to the symptoms. If you stop breathing for too long in sleep you’re at risk for brain damage, or even death.
If you fear you have sleep apnea, we urge you to consider it an emergency and seek help as soon as you can. Sleep apnea can easily play a role in a multi-faceted death and often goes untreated.
3. Snoring
Snoring is considered a parasomnia. Parasomnia is “odd behaviour at night” where you may sleepwalk, talk, text or experience other issues. Snoring is one of the tamer parts of the condition.
Like sleep apnea, older adults are more prone to affliction based on the weaker muscles in the airway. Snoring comes from partially obstructed breathing, hence how it comes with age. It can also occur if you have a cold, are overweight or are dealing with allergies.
Your throat and tongue are too relaxed, and if it gets any worse you may develop obstructive sleep apnea. Snoring often accompanies both types of sleep apnea.
While snoring itself isn’t an issue, it’s worth getting checked out of you or a loved one notices you snore. You may be able to catch worse issues early and gain access to a machine that keeps your airways open, preventing the snoring from developing into the much worse sleep apnea.
Snoring may also cause insomnia if it’s loud enough to wake you up, so there’s another reason you might want to get the issue under control as early as possible.
4. Restless Leg Syndrome
Rather than waking you up, there are some ailments that stop you from falling asleep easily at all. Restless leg syndrome typically occurs when you lie down—you start feeling an itching, burning or tingling that you can’t get rid of. It usually feels like it’s under the skin.
The sensation goes away if you move the limb, hence the term restless leg syndrome. Having to move your leg constantly keeps sleep at bay, whether it’s before you get to sleep at all or after waking up in the middle of the night.
Unfortunately, the disorder occurs my many older sleepers, and has no known cause. Here are some theories people believe cause restless leg syndrome:
The underlying conditions that occasionally accompany restless leg syndrome are:
- Issues with the spinal cord;
- Low iron;
- Nerve damage with diabetes or other diseases;
- Kidney failure.
Be sure to consult a GP if you have restless leg syndrome, as you may have one of these underlying conditions requiring treatment. The syndrome itself has no exact cure but treatments may include muscle relaxers, weighted blankets and therapy.
5. Periodic Limb Movement Disorder
Similar to restless leg syndrome, you may also experience periodic limb movement disorder, or experience this affliction instead. The limbs move during sleep instead and won’t always wake you up but it can cause fatigue and muscle pain the next day.
In more extreme cases it can disrupt your sleep. If restless leg syndrome doesn’t accompany the disorder you’ll probably be able to return to sleep easily. Despite this, you’re still experiencing the fragmented sleep pattern that can leave you tired and dissatisfied the next day.
6. REM Sleep Behaviour Disorder
Statistics show in various countries that REM sleep behaviour disorder is most common in older adults. It sometimes appears alongside Parkinson’s and Alzheimer’s disease, which are both more common in older people, hence its prevalence in the age group.
The disorder’s main symptom is thrashing in sleep, and sometimes suffers will walk, eat or bathe during sleep. This may wake sufferers up, or wake others around those with the condition.
There’s limited treatment for the disorder, with melatonin being the primary substance for it. It can help put you into a deeper sleep and effectively reduce or eradicate the flailing and other parasomnia-like activities it brings.
Senior Sleep Aids: Medication
Now that we’ve explored the main disorders found in older people, we can jump into medications you may be prescribed to alleviate symptoms.
Benzodiazepine Hypnotics
This type of drug is a tranquilizer of sorts, that effectively knocks you out fast by making you drowsy and unable to break out of it. Some of the medications work by relaxing your body, others by making your mind calmer.
Many of them are addictive or have a high dependency rate. They work in different ways to get the desired effect, and are usually prescribed in the most severe cases of insomnia or other ailments.
You should also note that common side effects include daytime drowsiness, irritation and memory issues.
Insomnia Medications
- Temazepam, which relaxes both body and mind to help you maintain comfortable sleep.
- Loprazolam, usually a treatment for more extreme cases of insomnia.
- Flurazepam/Dalmane, another medication used for the most severe cases of insomnia.
- Diazepam, mainly used for temporary insomnia.
- Lorazepam is also used for temporary insomnia, but rarely longer-term issues as the medication is addictive.
- Nitrazepam is prescribed for temporary insomnia.
Restless Leg Syndrome
The main medication used to treat restless leg syndrome is clonazepam. It doesn’t sedate you, but relaxes you enough to fall asleep faster.
Non-Benzodiazepine Hypnotics
Physicians prefer this type of drug and they’re often referred to as z-drugs. They’re less addictive than the medications above, and you’re less likely to develop a dependency.
- Zolpidem induces sleepiness, helping you get through restless leg syndrome and temporary insomnia.
- Medications containing zopiclone may work for insomnia, though they don’t work for everyone.
- Ramelteon, which isn’t always classed as a non-benzodiazepine or a z-drug, behaves like one by helping the melatonin in your system so you can combat insomnia.
Alternative Medication Solutions
If you’d rather go over the counter, there are ways you can help yourself. There are some mild sleeping pills available over the counter but they may not work well for insomnia. For that, you’re better off going to your GP and who’ll likely prescribe something from the lists above.
You can also request something listed below from your GP, making it clear you don’t want something too strong or unnatural.
Pain Relief
Chronic pain can keep you up at night, and if you recognize that it’s doing so, you can take a pain reliever. Over-the-counter medications can work in some cases, but you could also ask your GP for something stronger.
By comparing the underlying cause you’re eliminating your inability to fall asleep and should get to the night without issues.
Supplements
If you dislike the idea of sleeping pills and the medications above, and your issues aren’t caused by chronic pain, you can go natural. Melatonin is the hormone that helps you sleep, and is released around bedtime. It usually requires a prescription.
You can look into 5-HTP supplements or Valerian root, which don’t usually need a prescription. Both of these can cause drowsiness or sedation and may help someone who struggles to fall asleep.
We wouldn’t recommend non-prescription medication for long-term insomnia or at all for restless leg syndrome, but they can help short-term insomnia. They’re also worth trying if you don’t have actual insomnia, but some nights you struggle to turn your mind off before going to sleep.
Senior Sleep Aids: Sleep Health Improvements
If you don’t have a serious condition and your main problem is insomnia, then medication isn’t always the answer. Unless it’s long-term insomnia, you can combat the issue with some simple lifestyle changes. That said, this is usually for lifestyle-induced insomnia.
Avoid Mental Stimulation
Technology is fascinating, and it’s easy to become dependent or even addicted to screens as an older person. The internet is a world of old friends, old music and old stories you thought were lost forever.
However, the blue light from screens keeps you awake so it’s best to avoid them before bed. Plus, turn off the TV as it can keep your mind too engaged.
If you need entertainment before going to sleep, read a relaxing book. A page-turner can be too much of a thrill, so read one you’re sure you can put down at any time without feeling too invested in the story.
Stay Active
While relaxing before bed is a good thing, it’s best to be active during the day. A sedentary lifestyle won’t tire you out enough to go to bed at a reasonable hour.
Get out there, go for a walk, and stimulate your mind with some crosswords, puzzles or an exciting book. If you can, do some light exercise. Many older people still jog occasionally, or yoga is a non-strenuous activity you may enjoy.
Try to stop all exercise about three hours before you go to bed so the adrenaline doesn’t keep you awake. If you’re doing to exercise, make it in the morning, or perhaps in the late afternoon to give yourself an extra boost to get through the evening slump.
Set A Bedtime
Having a set bedtime will help your circadian rhythm stay in gear, letting you sleep through the night with relative ease.
Ensure you go to bed at the same time every day and try getting up at the same time each morning so your body adapts to this naturally and lets you get the rest you deserve.
Avoid Alcohol
Alcohol can negatively impact sleep, so avoid it before bedtime. While it feels harmless to have a glass of sherry to put you to sleep, or have a nice evening with some old, mature scotch, save your enjoyment of retirement for earlier in the day.
If you drink coffee or tea, also avoid them before bed as the caffeine can keep you awake.
Have a Bath
Bathing, or even taking a shower, before bed can help your body feel drowsy. In the water, your temperature shoots up only to plummet once you get out again.
Alongside that, warm water relaxes your muscles which is great for when you’re going to bed.
Optimise Your Bedroom
When sleeping, you want:
- Comfortable bedding;
- Temperature optimisation;
- Complete darkness;
- Minimal noise.
Try spending a night in a different bed and if you sleep better, you may need a new mattress.
If the temperature is the issue, invest in some wool bedding if you’re too hot as it aids coolness and is breathable. If you’re too cold, grab an extra blanket instead.
Finally, for a too-bright and noisy space, blackout curtains and earplugs work wonders.
Avoid Your Bedroom During the Day
Try to spend most of your day in other parts of your dwelling so your brain associates your bedroom with sleep time. As time goes on you may notice you feel drowsier and ready for bed every time you enter your bedroom.
If you can’t avoid the bedroom all day, at least avoid sitting on your bed. A nice little chair in the corner will do wonders for keeping your association with the mattress to nighttime only.
Age-Based Considerations
Medications and lifestyle changes might not always work. You or an older loved one may also be hesitant to seek help for a sleep ailment. There are some things to consider when seeking help for a sleep disorder at an older age.
Weight Issues
As we get older the metabolism slows and we’re more likely to gain weight. As weight can cause obstructive sleep apnea, and obesity is linked to other sleep issues, it’s a struggle.
If you or a loved one have gained weight recently and sleep struggles are cropping up, it may be a factor. It’s a difficult issue to admit to but be aware that anything you tell a doctor remains in strict confidence.
Your GP has your best interests at heart, and will likely run tests as well as recommending a weight-loss diet to help ease your issue.
Your sleep issue may be cured by something as simple as a bit of weight loss—try to get over any hesitation and realise your gains are natural and happen to most people at some point.
Gender Differences
The survey mentioned at the start of the article, linked again here for ease, reveals that more women than men report sleep issues. While this may reveal that women are more prone to the issues, that’s not always the case.
If you have an older male loved one, be sure to ask him about his sleep regularly and let him know that issues are natural, and he shouldn’t be ashamed to report them.
If you’re an older male reading this and seeing yourself in these issues, please talk to a loved one or your GP. Sleep issues are nothing to ignore and can indicate far more serious conditions which are also age-based considerations.
Dementia
With dementia, parts of the brain die. Parts of the brain controlling sleep and the circadian rhythm may fall victim to this, too.
Disturbed sleep has long since been measured in elderly care facilities, and insomnia is sometimes an early symptom of a more serious condition. Alzheimer’s disease, a form of dementia, is also a possibility.
One study reveals that adults with sleep problems are at a greater risk of developing Alzheimer’s disease.
Final Thoughts
Older people are more likely to develop:
- Insomnia
- Sleep apnea
- Snoring
- Restless leg syndrome
- REM sleep behaviour disorder
If you find yourself dealing with sleep issues, it may be one of those. Consult your GP as soon as possible so you can find relief, and treat any underlying conditions.
Disclaimer – The advice above should not be considered medical advice and is meant to provide an overview of the kind of sleep issues seniors and older people may face. If you are at all concerned about your health, no matter what age, always consult your GP.
