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Sleep and Aging

This article is adapted from Basic Ministry for the Second Half of Life (2012) and “Sleeping and Aging,” Certification in Gerontology at McHenry County College in Illinois.

Sleep is essential to a healthy, productive life. While sleep disorders and changes affect all of us as we age, older adults undergo many sleep-related changes that can affect their physical and psychological well-being.

Sleep is not just a "resting brain." It is a basic necessity of life and is as essential to our health as air, food, and water. When we sleep well, we feel refreshed, alert, and ready to face the challenges of life. If we don't get enough sleep, our jobs, relationships, health, and safety can suffer (National Sleep Foundation, 2012).

Occupying approximately 30 percent of each day, sleep is a complex, highly organized, physiological state and it is crucial to the proper functioning, restoration, and repair of our bodies.

Our sleep needs remain constant throughout our lives, although we may meet those needs in a variety of ways. It is a common misconception that sleep needs decline with age. Whether a person is 2 years old or 82 years of age, most people still require seven to nine hours of sleep each night in order to remain healthy. When we sleep well, we awake refreshed and alert (National Sleep Foundation, 2012; Neikrug & Ancoli-Israel, 2010).

Sleep Changes with Aging

While our need to sleep does not change, our ability to get a restful night's sleep may be more elusive as we age. Sleep problems in the elderly are not a normal part of aging. Many problems face aging adults and affect the quality and quantity of their sleep. These include Stress, Chronic and acute pain, Environmental factors...Diet and Psychological factors.

Stress is perhaps the most common cause of short-term sleeping difficulties. Triggers include family problems, job-related pressures, shift work, jet lag, environmental interferences (such as too much noise or light, interruptions from children or other family members, and the size and comfort of the bed), marriage problems, or illness or death in the family (National Sleep Foundation, 2012).

Chronic pain sufferers may have difficulty falling asleep and staying asleep. Although pain thresholds increase with age, pain causes distress and discomfort. Environmental factors can dramatically affect the quality and quantity of sleep (Meiner & Luekenotte, 2006). Some of these are common: Poor ventilation, Uncomfortable or poor-quality mattress, Ambient room temperature (which should be no lower than 65 degrees F.), Noise (which can result in sleep deprivation and alterations in comfort, pain, and stress), Humidity and Lighting.

Diet is also a major factor in the cause of sleep disorders:

Caffeine consumption has been linked to insomnia, Restless Leg Syndrome (RLS), and Periodic limb movements disorder PLMD.

Over-the-counter medications that contain caffeine or caffeine-related substances (such as cold and cough preparations) can increase sleep disorders.

Even a few cups of coffee in the morning can affect the quantity and quality of sleep at night.

Nicotine leads to difficulty falling asleep and staying asleep, and smokers are four times as likely to suffer from sleep apnea as nonsmokers (National Sleep Foundation, 2012).

Alcohol reduces overall sleep time; including Rapid eye movement (REM) and Nonrapid eye movement (NREM) sleep (Meiner & Luekenotte, 2006).

Many older adults take a number of medications that may adversely affect sleep, including antidepressants, antihypertensives, steroids, and medications for asthma (Meiner & Luekenotte, 2006; National Sleep Foundation, 2012).

Psychological factors can play an important role in the sleep experiences of older individuals. These factors include bereavement, retirement, Holocaust trauma, anxiety, depression, fear of death in sleep, psychiatric disorders, fear, and loss of autonomy.

Sleep Hygiene

Following simple "sleep hygiene" suggestions may be helpful (Meiner & Luekenotte, 2006; National Sleep Foundation, n.d. d):

Try to get at least 7 to 8 hours of sleep each day.

Sleep and arise at approximately the same time each day, even on the weekends.

Establish a relaxing bedtime routine (such as reading, meditating, or taking a hot bath) to allow your body to unwind and prepare for sleep.

Avoid caffeine (coffee, tea, soft drinks, chocolate), nicotine, and alcohol late in the afternoon or evening.

Don't nap during the day, even if you are tired. If you must nap, limit yourself to one half hour nap a day.

Exercise regularly but not within three hours of bedtime since it will raise the heart rate and keep adrenaline levels high.

Make your sleeping environment as comfortable, relaxing, quiet, and dark as possible.

Check the effect of your medications on sleep.

Wait until you're sleepy to go to bed.

If you do not fall asleep after 30 minutes, do not toss and turn. Instead, get up and involve yourself in relaxing activity, such as reading or listening to soothing music, until you feel sleepy. Do not try to solve your work or personal problems at this time. Keep your mind as clear as possible.

Don't look at the clock during the sleep period. Obsessing about how long you have been trying to sleep causes anxiety and will further disrupt sleep.

Use your bedroom only for sleep or sex.

Televisions in bedrooms contribute to insomnia.

Do not fall asleep in a sofa or chair. A sleepy feeling should be reserved for the bed so that a strong association between sleep and the bed is made.

While it may take several nights to establish a connection between the bed and a sleepy feeling, this practice is quite successful when consistently applied.

Spend at least 15 minutes each day in bright, early morning sunlight. This "sets" the biological clock and trains it to the twenty-four-hour light/dark cycle