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Sleep Problems in the Elderly: How to Overcome Elderly Sleep Disorders

Elderly not sleeping at night

Medical professionals recommend between seven and eight hours of sleep every night, but many older adults struggle to meet this amount. As we age, our sleeping patterns change and become choppier. As such, more than half of people aged 60 and over have at least one sleep complaint. Frequently reported issues among the elderly include having trouble falling asleep, sleeping fewer hours, frequent night-time awakenings and daytime fatigue.

Why is sleep important?

Superior health, especially for those aged 60+, starts with a restful sleep. Good sleeping habits have been linked to increased alertness, enhanced memory, improved mood, regulated appetite and reduced stress and anxiety. Also, older adults who don’t sleep well are more likely to suffer from depression, cardiovascular problems, excessive daytime sleepiness, diabetes and weight problems.

A medical professional explains how sleep patterns change with ageing and how much sleep we need,as well as outlining tips for better sleep.

Understanding sleep quality

There are two types of sleep: Non-Rapid Eye Movement (NREM) and Rapid Eye Movement (REM).

NREM covers stages 1-4 of the sleep cycle. During NREM, breathing and heart rate are slow and regular, blood pressure is low and the sleeper is relatively still.

REM sleep is much deeper than the NREM stages. During REM, your eyes move behind your eyelids while the rest of your muscles are immobile and the body experiences dreaming. REM sleep is important for the brain’s learning and memory functions and is what leaves people feeling refreshed and energised the following day.

Common sleep problems in the elderly

People aged 60 and over frequently report waking up at earlier times, taking longer to fall asleep, increased night-time awakenings and lesser amounts of sleep. Some common sleeping disorders among the elderly include:

Insomnia: This occurs when a person regularly has difficulty falling or staying asleep.

Obstructive Sleep Apnoea: This is when the walls of the throat relax and narrow during sleep, which interrupts normal breathing.

Restless Legs Syndrome: This common condition causes an overwhelming irresistible urge to move the legs, which can disrupt sleep.

Elderly sleep disorders

What causes sleep problems in the elderly?

As we get older, there are many possible factors that could affect the quality and duration of our sleep. In older age, our body chemistry changes as we produce less melatonin, meaning that we spend less time in the deep sleep (or REM) cycles. There are also more frequent shifts between sleep stages, which makes it more likely for people to wake suddenly. The combination of less REM sleep and more fragmented sleeping patterns means that we feel less refreshed and energised.

Other studies have identified a link between poor sleep quality and several medical conditions common among pensioners. These include:

• Parkinson’s disease

Alzheimer’s disease

• Chronic pain (e.g. arthritis)

• Cardiovascular disease

• Neurological conditions

• Gastrointestinal conditions

• Lung or respiratory conditions

•Poor bladder control

Other factors which have been proven to disrupt sleep include certain medications, caffeine, alcohol, stress, anxiety, depression and smoking.

How to reduce sleep problems in the elderly

Improving sleep hygiene is very effective and low-risk in older adults. Common interventions include:

• Establishing a consistent bedtime that is late enough to reduce early morning awakenings

• Finishing meals several hours before going to bed

• Having a relaxing bedtime routine

• Minimising intake of caffeine, alcohol and nicotine, especially in evenings and at night

• Managing stress

• Increasing morning exercise

Older adults should avoid sleep-depriving activities such as daytime napping, using the bed for non-sleeping activities and looking at TV or computer screens before bed. Also, instead of lying in bed awake and watching the clock, it helps to get up and engage in a soothing, non-stimulating activity. These tips will help elderly adults to improve their sleep quality:

• Ensure that your bedroom is comfortable, cool, dark and quiet.

• Engage in a relaxing activity such as meditation, progressing muscle relaxation, biofeedback or listening to soothing music.

• Avoid napping in late afternoon and evenings, as this naptime will take from your night-time sleep.

• Get into a routine of going to bed and waking up at the same time every day.

• Obtain 20-30 minutes of gentle daily exercise. The earlier in the day the better, as exercising later in the day will leave the body stimulated and make it harder to get to sleep that night.

• Avoid caffeine, nicotine and alcohol later in the day. Better still, try to eliminate your intake of these altogether.

• Indulge in a relaxing routine (e.g. reading, taking a warm bath) before going to bed.

• Remove any impediments to a good night’s sleep from your bedroom. These include bright lights, loud sounds, sources of excess heat/cold, televisions and computers.

• If you can’t get to sleep overnight, leave your bedroom and engage in a relaxing activity until you feel tired. Trying to force yourself to go to sleep is very ineffective.

When should elderly people talk to a doctor about sleep disorders?

Sometimes it may be necessary to see a doctor about your sleeping problems. Fortunately, most sleep disorders can be treated effectively. It’s advised that you arrange to see a medical professional if:

• You have had difficulty with sleeping for months.

• Changing your sleeping habits hasn’t worked.

• Your sleeping issues are negatively impacting your daily life.