Staying Alert to Age-Related Sleep Changes
Age-related Changes
Just as other physical changes occur over the life course, so do the patterns of “normal” sleep. Two sleep states, REM (Rapid Eye Movement) and NREM (nonREM), occur in four stages. Stages three and four bring the deepest sleep (also known as delta sleep), followed by the dreaming state known as REM sleep. As we age, our “sleep architecture” – or the way the stages cycle, may change and affect the quality of sleep. Older people also spend less time in the deep stages, which may leave some singing the delta sleep blues.
But researchers say that despite changes related to aging, healthy seniors are likely to have healthy and restful sleep. In fact, good sleep in elderly persons is often correlated with overall good health. Research has shown that the sleep habits of older Americans are often good indicators of overall health status. But the opposite is often true too; poor sleep in the elderly often occurs because of other health challenges, like chronic illness.
A Thief in the Night
Insomnia, defined by researchers and clinicians as a symptom and not a disease itself, can leave those who suffer from it feeling robbed of precious energy. It can be caused by physical, psychological or emotional problems. Bouts of insomnia may last days or weeks, although in the worse cases it can be chronic. For some, falling asleep is difficult, while for others, staying asleep is the problem. But no matter what kind of insomnia, those who suffer from it know how troubling sleep loss can be.
But insomnia may not be the only reason for sleep loss, and for seniors, it may be secondary to other sleep complaints. For instance, the risk of sleep apnea, where breathing is interrupted during sleep, rises substantially with age, particularly in men. Snoring too may increase with age and can disrupt sleep, especially for those partners who are “light” sleepers to begin with.
Health problems associated with aging, such as high blood pressure and heart disease may be the culprit and even the medications used to treat those illnesses may account for some of the rise in sleep complaints among the elderly.
Evidence is mounting that says poor sleep can either worsen or create its own health problems. This is especially true for older people. Doctors often dismiss sleep complaints in the elderly, believing that it is a normal part of aging. But perhaps it is not. Determining if sleep loss is caused by illness or medication should always be addressed and older patients need to stay alert to any changes. New sleep research is helping doctors reexamine how they treat illness in older patients, since hearing complaints about sleep may offer better cues to healing. In turn, better sleep may be part of the new prescription.
Sleep Aids: Are They Helpful?
Most doctors and researchers agree that in the short-term, “sleeping pills” – often hypnotics, can be useful. But for long-term treatment of insomnia, few medications are FDA approved. Indeed, some doctors suggest taking antihistamines, which can be obtained without a prescription, but there is little evidence supporting its efficacy for long-term use. The lack of safe, non-addictive treatment for sleep loss remains a problem.
Find the Cause: Make the Change
When sleep loss is caused by age-related illness, researchers agree that the first line of attack is to look at the illness as a whole process and not assume that the sleeplessness is just part of getting old. Treating the sleep loss first without medication may be best for older patients, since taking excess medications can lead to other problems.
Lifestyle changes can be useful over the long term. For instance, sleep apnea can be helped by losing weight. A change in dosing times for certain medications (like those for hypertension or arthritis), or exercising earlier in the day can also support sounder sleep. For those newly retired who enjoy an afternoon nap, a simple intervention of shortening naps may be enough to restore sound nighttime sleep.
Research confirms that if you are not getting enough restful sleep, don’t assume it’s simply a normal part of aging. If you are taking medications or you suffer from an illness, then it is just as likely to be those health problems that are robbing you of sleep than any age-related changes. Indeed, changes in sleep occur as we age, but that doesn’t mean we can’t get a good night’s sleep.
