Adults over the age of 65 should be getting seven to eight hours of sleep nightly. However, many elderly folk have sleeping problems.
This is largely due to the deterioration of hormones such as melatonin and cortisol, and cells that are responsible for the body’s internal clock and circadian rhythm. When this happens, the body cannot process signals efficiently and the sleep-wake schedule is disrupted.
We explore some sleep conditions, how they affect elderly people and tips on how to improve shut-eye quality.
Problems Sleeping in The Elderly
Most sleep disorders are preventable or treatable, yet less than one-third of those affected seek professional help. Without proper sleep, you risk detrimental effects on your attention span, memory and health.
These are 5 common sleep disorders that are most common among elderly folk.
Insomnia is when you’re constantly faced with difficulty falling or remaining asleep at night. This includes feeling resistant to going to bed. You’re likely to experience fatigue, sleepiness and concentration problems during the day.
There are two types of insomnia, which can be categorised as acute or chronic:
- Acute (short-term): Lasting from one night to a few weeks for less than three months
- Chronic (long-term): Lasting at least three nights a week for more than three months
Insomnia is the most common sleep disorder, affecting 10% to 30% of adults worldwide. Women and people above 60 are known to be more susceptible to this disorder for various reasons. It is also often associated with many other medical conditions such as depression, diabetes, Alzheimer’s disease, and Parkinson’s disease.
Restless legs syndrome (RLS)
Restless legs syndrome, or RLS, is a neurological movement disorder that causes an unpleasant sensation in parts of your legs, such as itching, crawling or tingling. It may be caused by an imbalance of the brain’s chemical dopamine that controls muscle movement. This creates an irresistible urge to move your legs to relieve the discomfort.
It usually takes effect in the evening or night whether you’re sitting or lying down and lasts for about 15 to 40 seconds. If you have RLS, you’ll find difficulty sleeping well at night because it kicks you out of deep sleep and you don’t get quality rest.
RLS can affect anyone at any age but typically, the onset of symptoms is before age 40. Middle-aged and older adults experience it more frequently and women are more likely to have it than men.
Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms, especially during the last trimester. However, symptoms usually disappear after the baby is delivered.
Obstructive sleep apnoea (OBS)
Obstructive sleep apnoea (OBS) is a sleep disorder characterised by momentary interruptions in your breathing during sleep. It occurs when the muscles in the soft tissues surrounding your throat are relaxed, blocking the upper airway for about 10 seconds at multiple intervals. This can go on for about an hour.
Sleep apnoea is like snoring but amplified and might point to a serious medical condition. How? The lack of breathing lowers the oxygen levels in your blood and could contribute to or worsen major heart complications like hypertension and heart attacks.
OBS is common in people with diabetes, obesity, women post-menopause, and those with Parkinson’s disease.
REM sleep behaviour disorder (RBD)
RBD, short for Rapid Eye Movement Sleep Behaviour Disorder, is a type of parasomnia (disturbing disorders that happen just before you fall asleep, while you’re sleeping, or as you’re waking up). This disorder causes you to have vivid dreams and enact them out, which can be sudden and violent behaviours like yelling, punching and kicking.
RBD typically happens during REM sleep, a stage of sleep that occurs at intervals of 90 to 120 minutes after you fall asleep. During this stage, your brain is active, you have a dream, and your eyes move rapidly. In RBD however, brain activity is intensified and the nerve pathways controlling your muscles fail to function properly.
RBD primarily affects men above 50 years old. It can progress over time, and if untreated, can affect the health of those who have RBD and their bed partners’ well-being.
Narcolepsy is a chronic sleep disorder where your brain has difficulty controlling wake-sleep cycles. You can get “sleep attacks”—where you may suddenly fall asleep or collapse during the day—due to extreme tiredness or sleepiness.
This can be dangerous if it happens while you’re in the middle of eating or driving because it may lead to injuries, accidents or even death.
Narcolepsy can occur from as young as seven years old and can progress with age. The good news is that the symptoms generally become stable across adulthood and rarely develop after 55.
How to Improve Sleep in Elderly Folk
Good quality and restorative sleep are essential for your overall health and well-being. On top of that, it can have a significant impact on your daily activities and social interactions, which in turn, influence your family life and relationships.
These five tips can help you reprioritise healthy sleep and clock in some much-needed ZZZs.
Develop a disciplined routine
Go to bed and wake up at the same time. Resist the urge to make any sudden changes in your sleep schedule like sleeping in for too long. Studies reveal that sleep quality is more important than sleep quantity in improving your quality of life and daytime functioning.
If you find it hard to wake up, set alarms or reminders on your phone.
Reduce lighting or sounds at night
Dim the lights and block out the noise before bed. The quiet darkness signals your body to increase its melatonin levels to facilitate sleep. This way, your body knows it’s time to transition into bedtime.
Perhaps you need a little more help with making your environment “sleep-ready”. These three practical things could be worth the investment:
- Ambient lights: Replace your white overhead lights with warm, ambient lights that will lull you to sleep.
- Earplugs: Whether you’re living in a noisy urban area or have a snoring partner, earplugs can help block out sounds for restful sleep.
- Blackout blinds: Replace your curtains with dark blinds if you are sensitive to bright lights.
In addition, it’s a good idea to stop using electronic devices at least half an hour before bedtime.
Adjust room temperature
If your room environment is too hot or too cold, it can affect the quality of your sleep as well. The best temperature for sleep is said to be between 15 to 19 degrees, but you can adjust this based on your personal preference. Another tip is to wear light sleepwear and avoid heavy blankets or multiple layers.
Unwind with a relaxing activity
Find activities that help you wind down physically and mentally like taking a nice warm bath, reading a good book, or meditating before you sleep. Not only can this help slow the activity in your brain, but it can set the tone for the rest of your night.
If you find that your thoughts are racing, write them down in a journal to bring some clarity to your mind. Once your mind is clear, you’ll be able to sleep soundly through the night.
Watch what you eat or drink
There are some diet changes you can make to improve sleep:
- Limit your caffeine, sugar, alcohol and nicotine intake
- Avoid eating large meals
- Eat your last meal of the day at least four hours before bedtime
- Avoid spicy foods
- Minimise your liquid intake
Sleep problems can plague anyone, especially elderly folk so it’s important to get to the root of the issue. Follow the above tips if you’re looking to get a good night’s rest.
This article is an adaptation of Sleep Problems in The Elderly: Types, Causes & Tips from Homage.my.
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- Bhaskar, S. Hemavathy, D. & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of Family Medicine and Primary Care, 5(4): 780–784. doi: 10.4103/2249-4863.201153
- Billiard, M. (2010). Narcolepsy in the elderly. In S. R. Pandi-Perumal, J. M. Monti & A. A. Monjan (Eds.), Sleep Disorders in the Elderly (pp. 227–23). Cambridge University Press. DOI: https://doi.org/10.1017/CBO9780511770661.023
- National Institute of Neurological Disorders and Stroke. (2017). Restless Legs Syndrome Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet#8
- National Organization for Rare Disorders, Inc. (n.d.). Narcolepsy. Retrieved from https://rarediseases.org/rare-diseases/narcolepsy/
- Neel, A. B. (n.d.). 10 Types of Meds That Can Cause Insomnia. Retrieved from https://www.aarp.org/health/drugs-supplements/info-04-2013/medications-that-can-cause-insomnia.html
- Suni, E. (2021). Stages of Sleep. Sleep Foundation. Retrieved from https://www.sleepfoundation.org/stages-of-sleep
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