Healthy Sleeping Habits and the Elderly

Healthy Sleeping Habits and the ElderlyEvery person needs sleep; not only does a good night’s sleep help you look and feel great, your basic survival depends on it. People who enjoy 7-9 hours of restful, uninterrupted sleep nightly have notably better physical and mental health than those who don’t.

Researchers have linked sleep disorders, deprivation or constant disruptions with a host of serious illnesses and chronic diseases including:

  • Obesity
  • Type-2 Diabetes
  • Depression
  • Heart Failure

As people age, they naturally sleep less. According to the Division of Sleep Medicine at the Harvard Medical School, “over a typical lifespan, the amount of time we spend each day sleeping declines.” Newborns sleep around 18 hours daily, while older adults often sleep less than 6 hours per 24-hour period.

The Stages of Sleep

Scientists have discovered there are five distinct brainwave stages that make up the complete sleep cycle, progressing from stage 1 through to REM sleep. During stages 1 and 2, your breathing begins to slow down and you feel slightly chilled; however, you can be easily awoken.

Once the body and mind relax, you move into stages 3 and 4, also known as “deep sleep;” being disturbed during these stages can leave you feeling extremely groggy and disorientated. Stage 5, also known as the REM Stage (Rapid Eye Movement) is when you dream; during this stage, your brain is very active yet your body is virtually paralyzed.

In healthy individuals, this sleep cycle is repeated several times throughout the night, while those with sleep disorders often never move past the 2nd or 3rd stage of sleep.

Health Benefits of Sleep

During sleep all your muscles relax, your internal temperature and blood pressure drops while your heart rate slows down, allowing the cardiovascular system to rest and inflammation to subside. While researchers remain unclear about exactly how and why sleep makes us healthier, a connection between poor sleep and compromised health is undisputed.

Getting a healthy night’s sleep has been positively linked with improved cognitive functioning, lower rates of inflammation and heart disease, and improved resistance against viruses like influenza and the common cold.

Healthy Sleeping Habits and the ElderlyMental Wellness and Sleep

Sleep is an important component of mental health and wellness; people who do not sleep well are more prone to suffering from a host of mental and emotional problems such as decreased focus and attention, memory loss, confusion, anxiety and agitation.

Sleep deprivation makes everyday living difficult and can be exceptionally stressful; simple tasks like remembering names and phone numbers become challenging, while decreased alertness among the elderly has been linked to serious medical issues such as medication errors and fatigue-related falls.

Disordered sleep is also a common symptom of many psychiatric conditions including both moderate and severe depression, paranoia, manic depression (bi-polar) and post-traumatic stress disorder. Poor sleep habits can both lead to the onset of mental and emotional problems as well as make existing mental health problems worse.

Common Sleep Disorders Among Seniors

Most sleep disorders experienced by older adults are associated with preexisting medical conditions, medications or their environment. According to UBM Medica’s online publication Psychiatric Times, “Insomnia is the most commonly reported sleep disturbance in older adults and is defined as the inability to initiate or maintain sleep.”

Insomnia can be caused by physical problems such as sleep apnea, restless leg syndrome (RLS), heartburn, diabetic neuropathy, joint pain, constipation and frequent nighttime urination. Often environmental factors negatively impact sleep for seniors such as sharing a bed with a snoring or restless mate, outside noise or light entering the bedroom. This is particularly true for seniors who live in a nursing home or other institution where their sleep may be frequently disrupted by other residents, cleaning staff or nurses conducting patient checks throughout the night.

Elderly people with dementia are particularly prone to sleep disorders due to the degeneration of their brains, which in turn interrupts their ability to achieve REM sleep. Psychiatric Times reports that “during any 24-hour period, institutionalized patients with severe dementia may not spend a single hour completely awake or completely asleep,” spending their days and nights in a constant state of severe confusion, sleep deprivation and disorientation.

Age-Related Sleep Problems

According to a literature review by researchers at the University of California, approximately half of all adults over the age of 65 experience “some form of sleep difficulty, including longer sleep onset times, lower fates of sleep efficiency, more time in bed, more awakenings during the night, earlier wake up times, and more daytime naps.”

Researchers have linked age-related sleep problems to a variety of factors, including chronic conditions such as arthritis, sleep apnea, incontinence and restless leg syndrome, all which make it difficult for seniors to both fall, and stay, asleep. Both women and men experience hormonal changes as part of the normal aging process which can disrupt sleep patterns including a natural decline in the production of melatonin, a hormone which helps to induce drowsiness and triggers the body that it needs sleep. Alzheimer’s disease has also been linked to sleep disturbances in the elderly since the disease impacts how the brain functions.

Many prescription and over-the-counter medications that are often used by the elderly can also negatively impact both quality and quantity of sleep; for example, many beta-blockers (drugs used to treat hypertension and glaucoma) can cause nocturnal coughing, while some anti-inflammatory drugs that are used to treat arthritis can lead to insomnia.

Ways to Improve Sleep Habits

Healthy sleeping habits involve developing and maintaining a regular sleep schedule, minimizing the use of sleep-disrupting substances and creating a sleep-friendly environment. As people age, their natural sleep schedules (known as the circadian rhythms) tend to shift towards going to bed early and then waking up early in the morning. Most seniors find that it’s easier to adjust their daily schedules to match their natural sleep patterns; however, it’s important to still maintain a regular sleep pattern by going to bed and rising at roughly the same time every single day. This helps to combat insomnia and the development of unhealthy sleep patterns (such as watching TV all night and sleeping throughout the day).

Some medications as well as certain foods and beverages are known to make sleeping difficult. Avoid consuming any caffeinated products such as tea, coffee, sodas and chocolate within 8-10 hours of bedtime as caffeine is both a stimulate (keeps you awake) and a diuretic (increases urination). Don’t eat fatty or spicy foods later in the day that may give you sleep-disrupting heartburn or indigestion, and refrain from eating before bed - when your body is digesting food, it is unable to relax and cool down, an important part of achieving a restful sleep.

You should also remove all electronic devices from your bedroom, including digital clocks and televisions - TVs and computer screens emit light waves that stimulate the brain, making it difficult to sleep immediately after watching a show or using a computer. Try to make your bedroom as dark as possible (without creating tripping hazards) and keep the temperature low - this helps your body cool off and achieve a restful state. Replace the light bulbs in your night lights with red bulbs, since red light does not trigger nighttime alertness like white or yellow lights do.

Sleep experts recommend that people who are suffering from disturbed sleep keep a diary to help pinpoint the root cause of their restless nights. This diary can help your medical provider identify factors that may be impacting your ability to achieve a restful night’s sleep and lead to the development of a plan to help improve both how long and well you sleep. If you believe you are having trouble sleeping because you are taking certain medications, speak with your doctor about what treatment options are available to you.

Online Sleep Resources for Seniors

Why We Sleep - An detailed article on the science of sleep, first published in the November 2003 issue of Scientific American.

Your Guide To Healthy Sleep - This 60-page publication from the National Heart, Lung and Blood Institute of the U.S. Department of Health and Human Services provides easy-to-understand information about sleep, why it’s important and the common causes of sleep disturbances along with links to further information about sleep.

Sleep Problems in the Elderly - A detailed online resource which discusses sleep problems among seniors.

Sleep Disorders in the Elderly - An academic research paper which discusses the prevalence of sleep disorders among seniors along with an explanation of the causes and possible treatment options.