From the Guidelines
As we age, our sleep patterns tend to become more nocturnal due to the deterioration of our circadian rhythm system and the decrease in melatonin production, leading to earlier sleep onset and wake times, as well as more fragmented sleep patterns. This change is also influenced by the increased prevalence of medical conditions such as arthritis, prostate issues, sleep apnea, and restless leg syndrome, which can disrupt nighttime sleep 1. Additionally, certain medications for age-related conditions may interfere with normal sleep patterns. The symptoms of insomnia differ between older adults and the younger population, with older adults more likely to report problems with waking after sleep onset (difficulty maintaining sleep) than they are to report problems with sleep onset latency (time to fall asleep) 1.
To manage this shift, several strategies can be employed, including:
- Maintaining consistent sleep schedules
- Limiting daytime naps to 30 minutes
- Getting regular exercise (but not close to bedtime)
- Reducing evening screen time
- Creating a comfortable sleep environment These strategies can help regulate sleep patterns as we age. Furthermore, cognitive behavioral therapy for insomnia (CBT-I) and other psychological interventions, such as stimulus control, relaxation strategies, and sleep restriction, can also be effective in managing insomnia in older adults 1.
It is essential to note that insomnia can have significant consequences on daily functioning, cognitive function, and overall quality of life, making it crucial to address sleep disturbances in older adults 1. By prioritizing sleep health and implementing effective management strategies, older adults can improve their sleep quality, reduce the risk of sleep-related disorders, and enhance their overall well-being. Therefore, it is recommended that older adults prioritize sleep health and seek professional help if they experience persistent sleep disturbances.
From the Research
Sleep Patterns and Aging
- Sleep patterns change with aging, independent of other factors, and include advanced sleep timing, shortened nocturnal sleep duration, increased frequency of daytime naps, increased number of nocturnal awakenings and time spent awake during the night, and decreased slow-wave sleep 2, 3.
- Most of these changes seem to occur between young and middle adulthood; sleep parameters remain largely unchanged among healthy older adults 2, 3.
- The circadian system and sleep homeostatic mechanisms become less robust with normal aging 2, 3.
Nocturnal Changes with Age
- The amount and pattern of sleep-related hormone secretion change as well with aging 2, 3.
- Melatonin levels might decline with age, with a decrease in maximal nocturnal peak concentration 4.
- Total melatonin production in 24 hours seems not to change in healthy ageing, but the maximal nocturnal peak concentration of melatonin might decline 4.
Sleep Disturbances in Older Adults
- Sleep disorders in older adults increase with aging, likely due to increased sleep latency, decreased sleep efficiency, and total sleep time 5.
- Common sleep issues include chronic insomnia, circadian rhythm sleep-wake disorders, sleep-related movement disorders, and sleep-disordered breathing 5.
- The causes of sleep disturbances in older adults are multifactorial 2, 5, 3.