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According to the National Sleep Foundation, about two-thirds of elderly adults experience one or more symptoms of sleep disturbance at least a few nights a week. But, rest assured, there are ways to achieve the restful sleep that is so essential for your health.

Common sleeping problems

As people age, they tend to have a harder time falling asleep and more trouble staying asleep than when they were younger. It is a common misconception that sleep requirements decline with age. In fact, research demonstrates that our sleep needs remain constant throughout adulthood. Changes in the patterns of our sleep — what specialists call “sleep architecture” — occur as we age, and this may contribute to sleep problems.

While the prevalence of sleep disorders tends to increase with age, much of the sleep disturbance among the elderly can be attributed to physical and psychiatric illnesses and the medications used to treat them.

How chronic medical problems affect sleep

As we age, there is an increased incidence of medical problems, which are often chronic. In general, people with poor health or chronic medical conditions have more sleep problems. For example:

  • Hypertension is associated with both snoring and sleep apnoea; both increase as we age.
  • Heart failure and disease affects a significant number of Australians, who also have sleep apnoea.
  • Menopause, with its accompanying symptoms, can lead to many restless nights.
  • Gastroesophageal reflux disease (GERD) causes difficulty both falling and staying asleep. This is more likely to occur while in the supine (on your back) position.
  • Sleep patterns among people with dementia are typically fragmented, and this fragmentation increases as the condition worsens. Sleep-disordered breathing also occurs more frequently in those with Alzheimer’s disease, while those with Parkinson’s disease are more likely to have RLS symptoms.
  • The pain and discomfort of arthritis and other musculoskeletal conditions make it difficult to sleep through the night.
  • Medications for chronic medical conditions can adversely affect sleep.

How to establish healthy sleep patterns

If you are getting healthy sleep on a regular basis, you should feel alert during waking hours. There are a number of behavioural modifications you can make to establish healthy sleep.

  • Set up an ideal sleeping environment; your bedroom should only be for sleep.
  • Relaxation and meditation may reduce sleeping tension.
  • Activities such as reading or drinking tea can induce sleepiness.
  • Restrict time in bed if you spend too much time lying awake.

If you are experiencing difficulty sleeping, consider whether an event or particular stress could be the cause. If so, the problem may resolve in time. If not, talk to your doctor about your symptoms. It is helpful to keep a week or two-week long record of your sleep hours, fatigue levels throughout the day and any other symptoms you may be experiencing.

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Insomnia and aging

The prevalence of insomnia is higher among elderly adults. About 44% of older persons experience one or more of the night-time symptoms of insomnia at least a few nights per week or more. Insomnia may be chronic (lasting over one month) or acute (lasting a few days or weeks) and is often related to an underlying cause such as a medical or psychiatric condition.

What causes insomnia?

Insomnia can be a disorder in its own right, but often it is a symptom of some other disease or condition. Half of all those who have experienced insomnia blame the problem on stress and worry. In the case of stress-induced insomnia, the degree to which sleep is disturbed depends on the severity and duration of the stressful situation.

Sometimes this may be a disturbing occurrence like loss of a loved one, loss of a job, marital or relationship discord or a tragic occurrence. Anticipation of such things as weddings, vacations or holidays can also disturb sleep and make it difficult to fall asleep or remain asleep. Insomnia can also occur with jet lag, shift work and other major schedule changes. Rates of insomnia increase as a function of age, but most often the sleep disturbance is attributable to some other medical condition.

Some medication can lead to insomnia, including those taken for:

  • Colds and allergies
  • High blood pressure
  • Heart disease
  • Thyroid disease
  • Asthma
  • Pain medications
  • Depression (especially some antidepressants)

Symptoms of insomnia include:

  • Difficulty falling asleep
  • Waking up frequently during the night
  • Waking up too early in the morning
  • Dissatisfying sleep and irritability
  • Daytime sleepiness and difficulty concentrating

What are the best ways to treat insomnia?

When effects are serious and untreated, insomnia can take a toll on your health. People with insomnia can experience excessive daytime sleepiness, difficulty concentrating and increased risk for accidents and illness as well as significantly reduced quality of life. Both behavioural therapies and prescription medications singly or in combination are considered effective means to treat insomnia; the proper choice should be matched to a variety of factors in discussion with a physician.