brain, spinal cord, and nerve disorders
Overview of Sleep
Essentials for Older People: Sleep
Up to half of older people say that they do not sleep as well as they would like. As people age, total sleep time and deep sleep tend to decrease, and sleep is more likely to be interrupted. Although causes of poor sleep may be the same as for younger people, age-related changes may also contribute to poor sleep. As people age, they may participate in fewer activities and become less physically active, making falling asleep and staying asleep harder. If older people have to move into a relative’s home or a nursing home, they may have no control over such things as temperature and noise levels. The resulting discomfort can make sleeping more difficult. Older people may go out less and spend less time outdoors, reducing their exposure to sunlight. If the eyes are not exposed to enough sunlight, the body's internal (biologic) clock may become out of sync with the earth’s cycle of light and dark. Then, people may have difficulty sleeping when they are supposed to (at night). Also, as people age, the body produces less Over-the-counter sleep aids and growth hormone. This change affects sleep because both of these hormones promote deep sleep. Older people are more likely to fall asleep and wake up early than are younger adults and children. Compared with younger people, older people also spend less time in deep sleep (which may help the body recover from daytime activities). Once asleep, they wake up more often and more easily. As a result, they feel less refreshed when they wake up, even though they may have spent a long time in bed. Usually, these changes alone do not indicate a sleep disorder in older people, but they may indicate a disorder if the changes make it difficult for people to function during the day. Older people tend to be less tolerant of changes in sleep habits. For example, they may be more prone to jet lag and problems related to shift work. Older people are more likely to have medical and emotional disorders that can interfere with sleep. Disorders interfere with sleep in several ways: By causing pain (as occurs in Osteoarthritis (OA) ) By making breathing difficult (as occurs in heart or lung disorders) By making people have to urinate more often, waking them up frequently during the night (as occurs in Benign Prostatic Hyperplasia (BPH) , Depression , which is common among older people, also interferes with sleep. Older people are more likely to take drugs that affect sleep. Some (such as diuretics for heart failure) increase the need to urinate and thus interrupt sleep. Other drugs make people sleepy during the day or stimulate them. Either way, sleeping at night may be harder. Drugs to aid sleep (hypnotics), whether prescribed by a doctor or available over-the-counter (OTC), even in small doses, can have side effects These side effects are more likely to occur in and cause more problems in older people. They can include daytime drowsiness, clumsiness, nervousness, agitation, difficulty urinating, and confusion. These drugs also increase the risk of falls during the night. Older people tend to take naps because they do not sleep well during the night. Napping during the day may help compensate for not sleeping during the night, but it may also make sleeping at night more difficult. Napping may be more likely because the aging body is less able to regulate blood pressure as needed. For example, after a big meal, blood pressure decreases, and the body needs to pump relatively more blood to the head. The aging body is less able to make this adjustment. As a result, older people lie down more, sometimes resulting in a nap. Generally, older people need as much sleep as they did when they were young and should not accept poor sleep as part of aging. They can take measures to improve sleep, such as the following: Stay active. Spend time outside. Avoid foods and beverages (such as those that containcaffeineor alcohol) that can interfere with sleep or only drink caffeinated beverages early during the day. Make sure that their bedroom is conducive to sleep. Go to bed and—more importantly—wake up at regular times. 