Do Older People Need Less Sleep?

Allison Kim, RN, BSN, University of Virginia; Caroline Doyle, PhD, University of Pittsburgh; Jessee Dietch, PhD, Oregon State University; and Meghan Mattos, PhD, University of Virginia

 

What is “healthy sleep” for older adults, and why is it important?

In hectic everyday life, healthy sleep is becoming increasingly harder to achieve. This is especially true for older adults, who are more likely to experience fragmented sleep and sleep disturbances than their younger counterparts. 

Did you know older adults need just as much sleep as young adults? For most people, this is at least seven hours per night! Many of us who already struggle to maintain good sleep hygiene might hear this and dismiss its importance. After all – we’ve all managed to get through our days with less-than-ideal amounts of sleep and suffered little to no repercussions, right? 

No. Studies have shown that sleep is vital for our everyday mental performance, mood, and  health. Hormones released during sleep help with our physical recovery, growth, and energy use. Regular lack of sleep is connected to increased risk of high blood pressure and heart disease down the line. 

It’s not just the amount of sleep that matters. Sleep quality is also key and can be impacted by nighttime sleep disturbances. Older adults especially struggle with getting not just high quantity, but high quality, sleep for various reasons. As we age, our sleep becomes more fragmented, and we become lighter sleepers. Not only that, but medications, illness, and distress can all affect the quality of sleep – things that older adults often contend with.

What are common sleep problems for older adults?

Some common causes of sleep disturbances and sleep disorders for older adults include:

• Insomnia: problems falling and staying asleep which can affect daytime functioning
• Circadian rhythm changes: changes in the body’s biological 24-hour clock that may interfere with the times you might feel sleepy or wake up 
• Sleep apnea: recurrent pauses in breathing during sleep
• Restless legs syndrome and periodic limb movements: uncomfortable sensations in the legs during the evening or nighttime hours, sometimes accompanied by leg jerks or kicks that can occur during sleep
• Rapid eye movement (REM) sleep-behavior disorder: physically acting out vivid dreams, sometimes with violent leg or arm movements
• Nightmare disorder: recurrent disturbing dreams that interfere with sleep or daytime functioning
• Nocturia: the complaint of awakening from sleep at night to use the restroom becomes especially problematic when returning to sleep afterward is difficult

If you’re experiencing disturbed sleep, it’s important to figure out the cause with your health care provider to develop a specific treatment plan. For example, behavioral changes such as establishing a nightly routine can greatly help insomnia but are unlikely to help sleep apnea. Keeping a record of your sleeping problems can be helpful when you talk to your provider, and they can run tests or refer you to a specialist to find what the underlying cause may be. 

Tips for healthy sleep hygiene

Treatment for your sleeping problems mostly depends on what exactly causes your sleep disturbances throughout the night. However, some steps can improve your overall sleep quality, such as:

• Keep a consistent sleep schedule. Don’t get in to bed until you are feeling sleepy and ready to fall asleep, and try to get up around the same time each morning. 
• Try to avoid long naps or sleeping for several hours during the day. If you do take naps, try to keep them under an hour by setting an alarm. 
• Get regular exercise and spend time outdoors. Daylight can greatly help your body maintain its biological clock and can help you feel sleepy at the right times. 
• Make sure the room you sleep in is comfortable. This includes temperature, bedding, sound, and light. 
• If you can’t fall asleep, don’t stay in bed. Instead, consider getting up and doing an enjoyable, low-light activity until you feel sleepy enough to get back in bed.
• Try not to consume any caffeine at least 8 hours before you sleep. 
• Engage in a calming wind down routine in the 1-2 hours before bed. This means shutting down electronics that have stimulating content (for example, watching the news), dimming the lights (or wearing sunglasses), and doing a few relaxing activities that help your body and mind prepare for bed. 
• Try not to eat large meals close to bedtime, but eating a light snack is okay. 
• Keep the room that you sleep in safe by: 
  • Ensuring that all your smoke alarms are working on every floor
  • Placing light-blocking curtains on bedroom windows 
  • Locking all exits and entrances to your home – including windows
  • Keeping emergency numbers next to a bedside phone
  • Having nightlights in hallways and rooms
  • Making sure your rooms are trip-free by moving cords and area rugs out of the way

If you have nocturia, talk to your doctor about its causes. Then ask about the most appropriate behavioral strategies to improve your sleeping experience.

Additional resources

American Sleep Apnea Association
888-293-3650

Circadian Sleep Disorders Network

National Sleep Foundation
703-243-1697

Restless Legs Syndrome Foundation
512-366-9109

Society of Behavioral Sleep Medicine

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