Why Is It So Difficult to Get Good Sleep as We Age?

Not sleeping well? Age-related insomnia is not something you should ignore.

Do you find yourself waking up earlier than you did in your 20s and 30s? Some older adults don’t mind rising at the crack of dawn. Others, however, complain of constant fatigue — especially if pain or chronic conditions are preventing them from falling asleep or forcing them to get up in the middle of the night.

It’s a myth that older adults need less sleep than young adults: Seniors still need between seven and nine hours of sleep, according to the National Institute on Aging. And it’s no secret that we need adequate rest to stay healthy. After years of studying what happens to our bodies and brains while we’re asleep, neurologists and other scientists have established a link between consistent, refreshing sleep and physical and emotional well-being. This connection intensifies with age and can result in memory problems, being more prone to falls, and feeling depressed.

Sleep problems are more than an annoyance; they’re a threat to health and longevity. Several studies, including a small 2012 study published in the Annals of Internal Medicine, have found a link between sleep deprivation and insulin resistance. Another study, published in 2013 in Nature Neuroscience, found that poor deep sleep in older adults is directly linked to brain deterioration and memory problems.

As people grow older, they tend to have more trouble falling asleep, according to the National Sleep Foundation. In fact, the National Institutes of Health report that almost half of adults age 60 and over are affected by insomnia.

Causes of Age-Related Sleeplessness

Sleep deprivation in older adults may result from one or more factors, including:

Biological

Circadian rhythms — our natural sleep-wake cycles that last roughly 24 hours — determine the times we fall asleep and wake up. As we age, our sleeping patterns can change. Older adults tend to get sleepier earlier in the evening, which means they usually wake earlier in the morning: a circadian rhythm sleep disorder known as advanced sleep phase disorder (ASP), according to the American Academy of Sleep Medicine. For some, this change is inconsequential: They still get seven or eight hours of sleep, just at an earlier time than they used to. But for others, their internal clocks go haywire and they struggle to fall or stay asleep. For older people especially, this can become a vicious circle: The longer the sleep problems persist, the harder it is to readjust to normal patterns.

Medical

Many older adults develop chronic health conditions that impair the quality of their sleep. Prominent among these are diabetes, gastroesophageal reflux disease (GERD), heart disease, and depression, according to the Centers for Disease Control and Prevention. Arthritis and other chronic pain can also wreak havoc on sleep, and hot flashes and hormonal fluctuations during menopause can interfere, as well. Sleep apnea, a condition marked by repeatedly interrupted breathing at night, often prevents individuals from getting sufficient rest. Medications can disturb sleep, too — for example, diuretics for treating high blood pressure and heart disease may require numerous trips to the bathroom.

Emotional

Anxiety and depression arising from situations such as an empty nest, retirement, the loss of a close friend, and financial or health challenges can seriously curtail sleep. Even worrying about not getting enough sleep can result in poor or less sleep. Clearly going to bed with a lot on your mind isn’t conducive to a good night’s rest.

Environmental

People who have recently moved to a nursing home or an assisted-living facility often miss the comforts they enjoyed when they were on their own. As a result, their quality of sleep may decline.

How to Get a Good Night’s Sleep

Although some aspects of aging are out of your control, there are steps you can take to improve your quality of sleep, which in turn can improve your mental and physical health. The National Institute on Aging suggests taking these steps to get better rest:

Stick to a schedule

Monitoring and controlling your circadian rhythm is key to proper sleep. Go to sleep and wake at the same time every day — even weekends. If you take a nap, do it at least three hours before your bedtime in order to avoid being kept up late.

Make a routine

Make it a habit to do whatever relaxes you, such as reading, writing, or soaking in the tub, before bed. Try to avoid screens in the hour prior to sleep, as the blue light has shown to affect your brain’s levels of melatonin, the hormone closely tied to sleep.

Enhance your bedroom

The bedroom should ideally be for two things only: sleeping and sex. So keep your television out of the bedroom. The room should also be dark, cool, and quiet.

Embrace exercise

Being active can greatly improve your sleep quality. Just be sure not to exercise within three hours of bedtime as it can keep you awake.

Be smart about what you eat and drink

Eating large meals close to bedtime or drinking caffeine and alcohol will make it much harder for you to fall or stay asleep. A small snack before bed can be helpful. Also try not to drink as many beverages as it gets later into the evening, as it increases the likelihood that you will have to get up and go to the restroom in the middle of the night.

Sleep has a profound effect on our physical and emotional well-being, which is why it’s imperative to take sleep problems seriously. A talk with your doctor can help you determine why you’re having trouble sleeping and take steps to solve the problem.

Dana Rasso

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