Sleep and Aging: Sleep Guide for Seniors

Understand common sleep problems seniors face and how to treat them.

By Ashley Little

There’s a common misconception that your sleep matters less as you age, but in fact, the inverse is true. No matter where you lie on the age spectrum you should be conscious of improving your sleeping habits for your holistic health.

For older adults, this is especially true. Your sleeping habits will naturally change as you age, so it’s important that you remain aware of those shifts and understand the best ways to protect your sleep quality.

Seniors may experience changes in becoming more sleepy during the day, being ready for bed earlier in the evenings, waking up earlier, or having trouble achieving deep sleep. Although these changes can be normal, suffering from disturbed sleeping patterns or other symptoms of insomnia are issues that should not be dismissed as a side effect of aging.

Your sleep is critical to your well-being, and any issues you experience should be acknowledged and treated. Take action to learn how to recognize common sleep problems you may experience as you age and the best methods for treatment.

Common Sleep Problems for Seniors

Some sleeping habit changes are natural to experience with age, but others are worthy of concern. These conditions are common sleeping issues that seniors face and should work to resolve.

Insomnia

Insomnia is one of the most common problems affecting sleep among seniors. For older adults, insomnia can quickly become chronic and harmful to mental and physical health. The long-term effects of insomnia and sleep deprivation for seniors include risk of weakened immune system, high blood pressure, and depression.

Diagnosing insomnia in seniors is often troublesome due to personal resistance to seek treatment for seemingly minor issues and the complicated unraveling of medication effects and lifestyle factors. Identifying common signs of insomnia can help you understand when your sleeping problems become severe.

Once you recognize signs of senior insomnia, it’s important to act fast at understanding the cause and working towards a solution. Insomnia may be on-set by stress or anxiety, consumption of stimulants or alcohol, nighttime pain, irregular sleeping habits, neurodegenerative disorders, or sleeping disorders.

Circadian Rhythm Shifts

The body’s internal clock is responsible for controlling sleep/wake cycles. In older age, seniors begin to experience changes in circadian rhythm. The timing of these shifts usually occur earlier in the evening, leaving adults and seniors feeling sleepy earlier than usual. Some experience minor implications from these shifts, but the physical effects of changes in circadian rhythm can be dramatic for others.

Along with feeling tired earlier in the evening, shifts in your circadian rhythm can also lead to a decrease in the amount of deep sleep one experiences during the night, particularly stages 3 and 4. These stages are important for seniors because they are related to memory consolidation and the restorative features of sleep. Deep sleep also allows one to sleep throughout the night without disturbances. Without deep sleep, seniors are likely to wake up several times throughout the night and can wake up feeling like they hardly slept.

Underlying Medical Problems

Many sleep problems that seniors suffer from are secondary problems that are caused by underlying medical conditions. Common health problems associated with sleep problems include:

• Gastroesophageal reflux disease
• Osteoarthritis
• Urinary incontinence
• Neurodegenerative disorders
• Respiratory conditions
• Sleep apnea
• Depression or anxiety

If you have a medical condition that causes discomfort or trouble breathing, it’s likely that condition is the cause of your sleep disturbances. Experiencing pain is also a common condition elderly people experience which can disrupt sleep.

Certain medications may also be the cause of your sleep problems. Check with your doctor to be sure your medications are right for you.

Restless Leg Syndrome (RLS)

Restless Leg Syndrome (RLS) is a sleeping disorder in which one experiences the need to move the legs or feels as if they are moving on their own. This disorder is also characterized by the sensation of tingling, twitching or crawling, and painful aches and itching. Needless to say, RLS causes major sleep disruptions during the night. RLS and other movement disorders can be triggered by excess caffeine consumption (particularly later in the afternoon), nicotine, alcohol, sleep deprivation, and certain medications.

Menopause and Hormonal Changes

During perimenopause through menopause, women experience many hormone shifts that can have an impact on sleep quality. The production of estrogen and progesterone slows during these phases, which can contribute to difficulties falling asleep at night. Shifts in hormones can also lead to changes in mood and sensitivity to stressors. Some women experience depression during perimenopause and menopause due to estrogen loss which can have secondary effects leading to sleeping problems.

Hot flashes also often accompany menopause. During hot flashes, adrenaline surges through a woman’s body and can wake her from sleep, along with the discomfort in bodily temperature changes.

Mental Health Decline

Senior isolation and loneliness is one of the most common conditions for older adults. Many life changes that occur in the elder years including losing a spouse, children moving away, the growing fear of becoming a burden, and living alone can lead to seniors experiencing social isolation. This chronic loneliness causes an overall mental health decline which can affect a senior’s mood and disturb sleeping patterns.

Treating Insomnia for Seniors

Sleeping pills are a common treatment in sleep medicine for those suffering from insomnia, particularly the class of drugs called benzodiazepines. These drugs induce sedation, muscle relaxation, and lower anxiety. It is highly discouraged to use benzodiazepines as a long-term treatment, especially for aging adults. The side effects of benzodiazepines include confusion and dizziness and can be dangerous for the elderly.

Doctors will frequently prescribe non-benzodiazepines for short-treat insomnia treatment for seniors, including Ambien, Lunesta, and Sonata. For long-term insomnia treatment, the following alternative methods are recommended.

Improve Sleep Hygiene

Maintaining proper sleep hygiene requires more than cleaning your sheets regularly. The real meaning of keeping up with your sleep hygiene is about evaluating your bedtime routines, sleeping habits, and addressing how well you rest each night.

For best sleep hygiene practices, we recommended implementing a wind down routine into your evenings. In the last one to two hours before your bedtime, turn away from screens and technology. The devices around you emit stimulating blue light which will make it more difficult to fall asleep at night.

Fill your time with activities that calm your mind and body. Try reading, filling in a crossword puzzle, or some light yoga stretches to relax before bedtime. Once you decide on the components of your wind down routine, stick to it. Staying consistent with your sleep schedule is key to a feeling well rested. Your body will learn to adapt and relaxing in the evening before bedtime will become easier with time.

Create Better Lifestyle Habits

The way you fill your days will have a large impact on your sleep quality at night. For your best sleep health, keep up with healthy lifestyle habits. For many seniors their activity levels decline with age, which can have an adverse effect on sleep. Maintain regular levels of activity by walking for 20 to 30 minutes each day. This will help you burn off the extra energy that keeps you up at night.

Stimulating your mind is equally as important as stimulating your body. Keeping an active mind contributes to positive mental health and an overall better quality of life. Avoid senior isolation and loneliness by building a community nearby or join local clubs to have activities to look forward to each week and company to enjoy.

Remember the importance of the substances you consume as well. A “nightcap” won’t help you sleep as well as you may think. Though alcohol has the effect of making you feel drowsy, it leads to poor sleep quality during the night. Also be sure to avoid caffeine and other stimulants late in the afternoon or evening.

Consider Natural Remedies for Sleep

As an alternative to using sleeping pills as an aid for better sleep, there are several natural remedies seniors should consider. These can include:

• Warm bath
• Melatonin supplements
• Mindful meditation
• Warm cup of tea
• Essentials oils such as lavender, chamomile, and cedarwood

Find what works best to help you relax and implement it into your nightly routine.

Bedroom Considerations for Seniors

As you age, you will learn to adapt to the changes with your sleeping patterns. Along with the shift that occur in your circadian rhythm, you should also make adjustments in your bedroom to adapt to your body’s changing needs.

Comfort

Making your bedroom ideal for better sleeps starts with the surface you sleep on. The best mattresses for seniors offer exceptional support to maintain neutral spinal alignment while balancing with enough contouring to relieve pressure points in the shoulders and hips. A firm side offering edge support is another important factor, making it easier for seniors to get out of bed.

For seniors with arthritis, joint pain, or back pain, high-density memory and latex foam mattresses in the medium to medium-firm spectrum are best for comfort. Older people may also want to consider an adjustable bed if they suffer from poor circulation, leg cramps, acid reflux, sleep apnea and snoring, or back pain.

Accessibility

When you’re aging in place, making modifications to be sure your home is accessible is important in each room of your house. For the bedroom, you should start by clearing pathways from the doorway to the bed, especially if you use a wheelchair, walker, or cane. Stow away cords from any bedroom or medical electronic devices to avoid accidents.

When it comes to making your bed accessible, you will want to check that the bed sits no more than 20 to 24 inches from the floor to the top of the bed. For extra safety precautions, you may want to install bed rails. Some bed rails are designed for the sleeper to operate, while others require assistance from a caregiver, so be sure to choose the option that is right for you.

There are certain considerations to be made about bedding products for safety reasons. Avoid bed skirting or a bedspread that reaches the floor to prevent accidental falls when climbing out of bed. A mattress protector can also be a smart investment for seniors. This will protect your mattress from any odors or stains associated with wetness issues and can easily be laundered.

As you age there are normal changes to expect in your sleeping habits, but if your sleep quality begins to suffer you should begin working to understand the cause of your sleep disruptions and possible solutions for improvement.

If your sleep problems continue to persist, it is best to seek advice from a medical professional for personalized treatment.

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