You’re wide awake at 2 a.m. and trying to remember the last time you had a good night’s sleep. You remember sleeping well -- and a lot -- when you were young. Since then, you started working, had children, and perhaps moved into menopause. Having trouble sleeping is just part of getting older, right?
Well, yes and no. How much sleep you need, your ability to get enough sleep, and the quality of your sleep changes a lot throughout your life. But you shouldn’t compromise your sleep habits just because you’re getting older.
General Sleep Needs
“Sleep needs vary from individual to individual, and changes can occur at any stage in the lifespan,” says Michael Vitiello, professor of psychiatry and behavioral sciences at the University of Washington in Seattle. The amount of sleep you need is the number of hours necessary to wake up without an alarm, refreshed and alert.
But many adults find themselves stealing only a few hours of sleep each night during busy work weeks. Is that OK?
“A big myth is that people can learn to adapt to only five or six hours of sleep and they’re functioning ‘fine,’” says Donna Arand, PhD, clinical director of the Kettering Sleep Disorder Center in Dayton, Ohio and a spokeswoman for the American Academy of Sleep Medicine. “People aren’t functioning fine with five or six hours of sleep. You really don’t adapt to that. Most adults need between seven and eight hours of sleep.”
It’s not clear yet whether adults 65 years and older need seven to eight hours of sleep. One poll found that seniors felt like they needed more sleep than that. There’s no evidence that older people can function well on less, but some recent studies indicate that they might.
“There is probably a small reduction in total sleep time that occurs across the lifespan,” Vitiello says. “Most of that probably occurs after puberty and by retirement age, say in the 60s. If you make it into your 60s or 70s and you stay healthy, your sleep probably doesn’t change as much.”
Are you getting the sleep you need? You might require more sleep if you:
- Need a stimulant like coffee to wake up or get going
- Feel down, irritable, or tense after not getting enough sleep
- Have poor short-term memory
- Have a hard time staying focused and productive after you’ve been sitting for awhile
What Affects Your Need for Sleep
In addition to age, your sleep needs change due to:
- Internal clock (circadian rhythm)
- Quality of sleep
- Recent lack of sleep
Gender. Women undergo more sleep changes and challenges than men because of their reproductive hormones. Women who are pregnant need more sleep in the first trimester. Pregnant women also struggle to get enough sleep because of heartburn, snoring, and uncomfortable sleep positions. Arand says that once women become mothers, they tend to have problems sleeping because their children wake them up or cause them to worry.
Later in life, as women enter menopause, they face new sleep challenges. These come from drops in hormone levels, hot flashes, night sweats, and insomnia. “Women tend to report difficulty with insomnia more than men,” Arand says. “We don’t know if it’s a social issue or if women are more willing to report it than men.”
Genetics. Genes may play a role in some sleep disorders, such as narcolepsy and insomnia. There hasn’t been enough research to know how your family tree affects your sleep. Arand thinks that the treatments for sleep problems will work despite any genetic flaws.
Biological clock. Each of us has an internal clock, which makes some people “night owls” or “early birds.” A process in the brain called circadian rhythm controls this. This process influences when we wake up and go to sleep. It also determines how sleepy and alert we are. (It’s because of teenagers’ circadian rhythms that they’re geared to stay up later and to wake up later.)
Our internal clock makes us drowsy naturally between midnight and 7 a.m. and between 1 p.m. and 4 p.m. [As people age, changes in circadian rhythm eventually make older people feel sleepy earlier in the evening and wake up earlier in the morning.
Quality of sleep. The type of sleep people get changes most between ages 19 and 60. Children and teens experience a lot of deep sleep, which is believed to restore the body. This also fuels their growth. Arand says that children spend about 50% of their night in deep sleep. By the time they’re 20 years old they get half that amount. She said some people as young as 40 may lose the ability to go into that restorative sleep. Older people spend little time in that sleep stage. As a result, they are more easily awakened.
The most obvious change in sleep to older people is how light their sleep becomes. They also notice how broken up sleep is because of waking during the night and staying awake awhile before going back to sleep. Half of seniors complain of these changes as well as waking early in the morning and feeling sleepy during the day. “The problem for this age group is that it’s very difficult to get an uninterrupted seven to eight hours of sleep,” Arand says.
Recent lack of sleep. If you haven’t been sleeping well or have had insomnia, the lack of sleep affects how much sleep you need. If you’re over 65, the chance for poor sleep and insomnia is high. “The older people get, the more common insomnia becomes,” Arand says. A National Sleep Foundation poll found that 44% of older people had at least one symptom of insomnia two or more nights a week.
Sleep Challenges for Older Adults
Seniors have certain sleep changes due to aging, but sleep problems aren’t part of getting older. Vitiello says the key for better sleep when you’re older is staying healthy. Most seniors’ sleep problems are because of an illness or a medication. Seniors have poor sleep due to:
- Illness, such as arthritis or another condition that causes pain, heart or lung disease, enlarged prostate, acid reflux, or depression. In people aged 65 to 84, 20% have four or more medical conditions. Eighty percent of them say they have problems sleeping.
- Medications, especially those for high blood pressure and asthma.
- Sleep disorders such as insomnia, sleep apnea, or restless legs syndrome.
- Behavioral or social changes: retirement, lifestyle change, death of a loved one, napping, using social drugs.
- Sleep environment: Noise, heat, bright lighting, or bothersome bedding in the bedroom; moving to a new home or a nursing home.
An older person in excellent health will still probably have a harder time falling asleep and staying asleep than when they were younger. Otherwise, they can expect to sleep fairly well. Vitiello studies older adults in good physical and mental health. “None of them sleep the same as they did when they were 18. I know that their sleep is radically different than younger people’s,” he says. Yet most of the healthy aging group has no sleep complaints.
Meeting Your Sleep Need
For older people with health problems, napping during the day may be the only way to get enough sleep because their sleep at night may be disrupted. For healthy older adults, napping isn’t a great idea. It might make falling asleep or staying asleep at night more difficult.
Vitiello says people assume all older people nap because of their age. “While napping does increase with age, it never penetrates more than one third of the population – even out into the 80s,” he says.
If you have a medical condition and have trouble sleeping, tell your doctor. Your doctor can determine whether you have a sleep disorder, such as insomnia, or if your health condition or other medical treatment is affecting your sleep. For example, if one of your medications makes you sleepy during the day, talk to your doctor about changing the time you take it. Or ask if there’s a different medication that would work. (Never change your medication without talking to your doctor.)
Know the Basics
“Probably around age 60 or so, adults really need to be careful about having good sleep hygiene and watching side effects of medication, what they’re eating and drinking in terms of stimulating beverages or foods,” Arand says.
Arand and Vitiello agree that staying physically and mentally active is vital for a good night’s sleep. “After the age of 40, or especially after the age of 60, individuals who are very physically active can tend to sleep deeper and have better quality sleep at night than individuals who may not be very active,” Arand says.
Kick Insomnia Out of Bed
If you’ve had difficulty sleeping for more than a month, the problem has become chronic. Be sure to tell your doctor, who may refer you to a sleep clinic. If you have insomnia, you need to act. It usually doesn’t go away on its own.
You may not have realized all the changes that can affect your sleep. Now that you know what to expect, you can work on getting the best sleep possible.