Over the course of the lifespan, the adult's need for deep nonREM sleep gradually decreases, as this stage of sleep is most beneficial for physical development in early youth and adulthood. However, elderly people still need the same amount of sleep, despite the fact that they seem to not sleep as much.
Elderly people have different sleep patterns and habits than their younger peers. Some of these are a lifetime's inventory of learned behaviors, while other habits are responses to preexisting illness, inappropriate environment or chronic pain. The elderly tend to go to bed earlier, rise earlier and nap more often. They also rise more often in the middle of the night, typically to use the restroom, to take medications, or to deal with pain and stiffness in joints. Sleep disorders are more likely to occur with the elderly, much in the same way that all other health complications become more common during this time in their lifespan: aging can have a negative impact on all body processes.
Most sleep disturbances in this age group can be attributed to chronic physical and/or mental health issues, as well as to medications they are taking to treat these problems. Drug interactions and side effects are likely a bigger influence over sleep quality for the elderly than for any other age group.
Good quality and quantity of sleep for the elderly is, therefore, very important for their well being. Getting good sleep helps with improved recovery from surgery or illness, better pain management, mood stability, cognitive function and fatigue.
Sleep problems specific to the elderly population
Insomnia
This is perhaps the biggest sleep problem among the elderly, and its causes are many: poor sleep hygiene, dietary influences, smoking or drinking habits, lack of daily exercise, pain, neurological health problems, and drug interactions or side effects.
Sleep Breathing Disorders
Snoring and Obstructive Sleep Apnea (OSA) are major problems for the elderly due to the inevitable collapse of muscular tension in the upper airway tissues, which causes resistance and can lead to obstructed breathing while asleep, especially among those with preexisting respiratory problems like COPD or asthma. Central Sleep Apnea (CSA) can be problematic, as the neurological drive to sleep that originates in the brain may begin to malfunction in the later years.
Circadian Rhythm Disorders
Advanced Sleep Phase Disorder is a circadian rhythm disorder in which the elderly tend to grow sleepier earlier in the evening. It is not unusual for elderly people to go to bed as early as 7pm at night. Research has not nailed down an explanation for this phase delay, which is the virtual opposite of the Delayed Sleep Phase Disorder experienced by adolescents.
Movement Disorders of Sleep
Restless Leg Syndrome and its cousin, Periodic Leg Movement Disorder, can rob an elderly person of their deepest sleep and is generally due to nutritional deficiencies that are easily corrected once the disturbance is diagnosed.
Other Disorders of Sleep
Because of the reduced tension of the tissues in the esophagus and a general malfunctioning of the digestive system in the elderly, Gastroesophageal Reflux Disease (GERD) can also be an enemy of good sleep for many elderly people.
What can I do?
If you are elderly and struggle with getting quality sleep, or with getting enough sleep, please consult your doctor. It can be a very complicated process, discovering the root cause of your sleep issues. It's worth the trouble, though. If you can find out and fix these problems, you'll weather any current health problems you have with less effort and stress. You will also find yourself in a better mood and with more energy to tackle daily tasks.
If you are the loved one of an elderly person and you know they are struggling with sleep disturbances, it's a good idea to encourage them to visit their doctor and even attend that appointment if you can. Sometimes having a second person at a doctor's visit can help an elderly person to interpret their conversation with the doctor and clarify instructions for treatment (such as how to take a medicine or how to avoid certain problem foods or habits that might be contributing to their sleep problems). If your loved one is in a skilled nursing facility, establish a regular dialog with the caregivers there and note anything unusual you notice about your loved one's sleeping habits. Sometimes these facilities have residential spaces which are not dark enough or quiet enough for good sleep. Anxiety issues related to living in a facility can also be part of the problem behind some kinds of sleep problems, such as insomnia. Also, while naps are not necessarily a bad thing, too many lengthy naps during the day can mess with circadian rhythms unnecessarily. You might want to have your loved one keep a nap diary to rule out too many naps as a cause for nighttime insomnia.
