It’s common for older people to have trouble sleeping, and it is widely accepted that poor sleep is an inevitable symptom of old age. However, according to top researchers, seniors need as much sleep as adolescents- about 7 to 9 hours. If you are struggling to fall asleep at night or feel your sleep quality is not as good as it used to be, don’t give up hope- common sleep problems might have an easy cure, depending on what the root of the problem is. Read on to learn more about what goes on in the brain during sleep, how those mechanisms change as we age, and some ways to alleviate common sleeping problems.
Stages of the Sleep Cycle
Sleep is a complicated process, with several fluctuating stages. We typically go through four stages of sleep, and sleep studies with brain activity monitoring have provided useful EEG data to help us gain a better understanding of the processes that occur while we are sleeping.
When we first begin to fall asleep is the time we refer to as alert wakefulness, and EEG monitoring shows the brain typically emits beta waves during this stage. These change to alpha waves as we drift off, and then the first official stage of sleep, stage one, is marked by theta waves. During this time, we might experience visual and auditory hallucinations, such as seeing shapes, hearing whispers, or feel like we are falling. Some people physically twitch and kick as they drift off, perhaps due to the feeling of falling backward.
Stage two is marked by a dramatic change in brain waves, called sleep spindles on an EEG, that might happen because our brain is shutting down some processes like responses to things going on around us, and preparing our brains for REM sleep. As people age, the ability for sleep spindles to occur seems to diminish- we see this in the decreasing amount of sleep spindles in EEGs of those more advanced in age.
Stages 3 and 4
The third and fourth stages are typically referred to in tandem because they are marked by similar if not identical patterns. Both stages are marked with slower delta waves, and this stage is referred to as slow-wave sleep. During this period, we might be disoriented if we are woken up, but are able to wake up quickly if a pertinent environmental event occurs, such as a parent hearing their baby cry, but perhaps not by excessive traffic outside our window.
After about ninety minutes of cycling through the different stages, the cycle begins to reverse and return to a state akin to alert wakefulness- EEG data shows a flurry of beta waves during this stage, usually characteristic of an awake brain. We wake up easily in this stage of sleep too, and it is referred to as paradoxical sleep because though the body is fully engaged in the sleeping process, the mind appears to be fully active- even displaying some neuron activity in the brainstem that isn’t present during waking hours. During REM sleep, people often wake up several times and fall back asleep without remembering in the morning. As we age, our ability to fall back asleep tends to diminish, sometimes disappearing completely.
How Sleep Changes as We Age
Sleep study research, as well as countless reports from people around the world, indicates that older people have a harder time sleeping. Staying asleep through the nite is often cited as one of the most common sleep problems that arise in older age. As we get older, diseases such as Alzheimer’s that affect cognition tend to greatly disturb sleeping patterns as well- sundowning is the term for a person with dementia who wakes up shortly after falling asleep and stays awake, leading to miserable waking life. Regardless of dementia, as we age, our circadian rhythm– the bodies natural sleep cycle- tends to change, and as a result we simply start to sleep less during the night.
There are other issues that can lead to sleep loss, such as
- Medical issues like restless leg syndrome, heart palpitations, and side-effects from medications could all be to blame for a sleepless night
- Nighttime incontinence can lead to men and women waking up well before they intend to, and unable to get back to sleep
- Consuming unhealthy amounts of tobacco, caffeine, or alcohol, particularly later in the day, and perhaps any amount can cause a person to develop insomnia or early waking
Medical Issues That Can Affect Sleep
It can be easy to overlook a lost night’s rest as simple restlessness, but oftentimes an underlying medical condition might be the culprit.
Restless Leg Syndrome
Restless leg syndrome can cause a person to have a hard time falling asleep because the leg muscles spasm uncontrollably in the evening- up to 35% of older adults experience this disorder, according to recent research. Medications may be available to treat this relatively common experience.
Recent research shows that nearly half of adults over age 65 have sleep apnea, which is a potentially dangerous condition where a person can stop breathing for several seconds while asleep, causing the person to wake up throughout the night. However, only about eight percent of adults are tested for sleep apnea. Talk to your doctor if you think that you may be living with sleep apnea. For an official diagnosis, you’ll undergo a test where you sleep in a research room for doctors to monitor you to look for the reasons behind your restless nights. If sleep apnea is diagnosed, a c-pap breathing device is typically prescribed, to be worn overnight.
Nighttime heartburn is a common ailment and may feel just like upper chest, shoulder, or back pain. Lowering the number of fats and sugars you eat could help improve heartburn, as well as simply elevating your pillow a bit- sitting up helps keep the stomach acid from flowing up into your esophagus, preventing heartburn from occurring.
People with advanced diabetes symptoms will become lethargic throughout the day, often leading to nighttime restlessness. Regulating your blood sugar is the way to combat daytime drowsiness. A healthy diet and moderate exercise is the best way to naturally do this, and nighttime walks can be a great way to help regulate insulin throughout the night as well as the next day- also, the exercise could help tire you out!
The pain of osteoarthritis, particularly in the evenings, can cause someone to lose a lot of sleep. It is estimated that up to 70% of people with osteoarthritis will have some kind of sleep disturbance. A doctor will be able to help determine any medications that may help, but sleeping with a safe heating blanket has been known to help soothe swollen joints and may help sufferers of nighttime arthritis pain get some rest.
Nocturnia, or frequent nighttime urination
Nocturnia is the clinical term for waking up to urinate throughout the night, due to a combination of creating too much urine during the night, and the bladder’s lower ability to hold urine until the morning. There are many reasons why we might need to get up many times a night to use the restroom, but more than twice every night is not normal. The best place to start for answers is our doctor’s office.
Anxiety and depression
It might be easy to overlook anxiety as a legitimate health issue, but after many sleepless nights spent staring at the ceiling and worrying, the lasting effects are undeniably bad for our health. In a sleep study conducted on adults with chronic insomnia, 81% of people responded positively to cognitive behavioral therapy (CBT), which focuses on improving anxiety-producing thoughts to encourage sleep. Over a third of these participants reported their insomnia to be greatly improved.
Medication interactions and side-effects
Many medications, such as those prescribed for anxiety, pain, and common health issues, can disturb our sleep, especially as we get older and our rhythm changes. Sedative-type medications can cause sleep cycles to be disturbed, and some medications may cause side effects in the body preventing us from getting to sleep altogether. It is advisable to check with your doctor regarding all medications you are taking, to make sure none of them are contributing to your problem getting to and staying asleep.
Getting Better Sleep
Seek treatment for medical problems as soon as they are identified. Sleep issues are often the result of an irregular heartbeat, sleep apnea, restless leg syndrome, and many more easily treatable ailments. A trip to your primary care physician can help uncover many areas that may be contributing to your lack of good sleep.
Take sleep-encouraging supplements, or increase natural exposure. Research shows that certain deficiencies lead to a decreased ability to pass from the initial stages of sleep, where it is quite easy to be woken up, to the deeper REM stages that are so critical to a full night’s rest. Key nutrients that help us sleep have been shown to be depleted by blue lights from televisions and computer monitors, however, exposure to sunlight can increase natural levels for some of these nutrients, such as melatonin and vitamin D. Supplements for other key factors to healthy sleep can also be taken, such as 5-hydroxytryptophan (5-HTP), the hormones progestin and melatonin, calcium, and magnesium. A full metabolic analysis from a doctor or holistic practitioner might be helpful in finding areas in your health regime that could be improved to help you sleep better.
Make healthier lifestyle choices to encourage better sleep, such as limiting tobacco and alcohol consumption, as well as eliminating sugar and caffeine later in the day. Increasing physical activity, particularly aerobic exercise, during the day has been shown to help improve sleep as well. In addition to these obvious ways to practice a healthier lifestyle, another way to encourage health is to simply enjoy the outdoors- taking a walk in the evening has been advised to ease a restless mind, as well as a wealth of other health benefits, like helping to naturally regulate blood sugar.
Create a consistent nighttime routine to help ease your mind into sleep. Keep sleeping areas tidy and distraction-free- don’t let the glare of a device keep your brain from effectively hibernating, and try to keep distracting sounds to a minimum. Some people find that soft music and white noise machines help them fall asleep, others need absolute silence. Save activities, even reading, and crossword puzzles, for other areas in your house, so you won’t be tempted to do anything except for sleep in your bed. It might also help to adjust the temperature and humidity of the bedroom to encourage more restful sleep, as well as introduce aromatherapy with soothing scents like lavender and chamomile, both shown to encourage sleepiness and easily available in oil format to sprinkle on bedsheets, and into humidifiers and other similar devices.
Learn to meditate
There are many ways to try to ease the mind into sleep thru meditation. Guided meditation can be very useful for people who want help learning how to begin, or those who are experienced in meditation and love the soothing music and gentle voice lulling them to a peaceful sleep. There are many free playlists on YouTube, as well as many free phone apps, such as the free HeadSpace app (what this writer personally uses). Mindfulness meditation is the practice of focusing on one thing, either a part of your body or your breathing, or perhaps a soothing color in your mind’s eye, or a beautiful mandala tapestry hung across from your bed. The idea is to maintain focus on this thing until your mind is able to relax- this practice often takes 20 minutes to an hour.
Health Breakthrough’s 2011, p. 120
Psychological Science, page 197