Nearly 50% of older adults report having sleep problems, compared to about 20% of the general population, according to Dr. Akhil Vallabhaneni, a pulmonary and sleep specialist at Northside Hospital.
They complain about one of three things: problems falling asleep, problems staying asleep and feeling tired even after seven or more hours of sleep.
“I’ve seen firsthand how it can disrupt their life,” he said.
Why sleep changes with age
Normal, healthy sleep is marked by sleeping for seven to nine hours at approximately the same time each night, experts said. You fall asleep easily, sleep through the night with few interruptions, and feel refreshed in the morning.
“As part of the natural aging process, sleep becomes more fragmented and lighter with an increased number of arousals and awakenings,” Vallabhaneni said.
The shift is due at least partly to the brain’s timekeeping mechanism in the hypothalamus, which becomes less sensitive to sunlight and other environmental cues that help the body regulate sleep. Additionally, older adults tend to spend more time in lighter sleep stages where they are more likely to be awakened by any number of stimuli, Vallabhaneni said.
Sneaky sleep stealers
Many factors can impact sleep.
“If you have non-sleep problems, they can disrupt the sleep pattern — and vice versa,” Vallabhaneni said.
Obstructive sleep apnea, for example, is a condition in which the throat muscles block the airway, and can cause waking. Restless leg syndrome can keep individuals awake as can REM sleep behavior disorder, a condition in which the person physically and vocally acts out dreams in their sleep. Additionally, medications, pain, anxiety, and a whole range of physical problems can come into play.
Vallabhaneni advises getting professional help if any of these conditions are present.
“If you act out during REM sleep, it’s a very strong predictor for Parkinson’s and Parkinson‘s-like diseases,” he added.
Risks of poor sleep
Losing sleep for one night can make a person feel irritable. Losing sleep for months or years can wreak havoc. In addition to significantly impacting the way you think, it can cause disorientation, balance problems, increased risk of falls and fractures and cardiovascular problems.
Dr. Julie Grant, a clinical psychologist specializing in behavioral sleep medicine at Atlanta Insomnia and Behavioral Health Services, said good sleep protects against mental health problems, but the opposite is also true. She warns against buying into the myth of needing less sleep. With a few exceptions, everyone needs seven to nine hours every night, she said.
Daytime patterns are often the strongest indicators of healthy vs. problematic sleep. If you’re powering through on 60 ounces of coffee, napping to the point it disrupts nighttime sleep, or often feel groggy, you’re not getting enough good sleep, according to Grant.
How to improve sleep
Occasionally using melatonin, antihistamine-based sleep medications, or other aids is usually safe and healthy, Grant said. But taking them every night for months or years can invite other medical issues and create dependency. Instead, experts advise addressing the root of the problem.
At Vallabhaneni’s clinic, providers often begin with a dual treatment — medication plus behavioral therapy and lifestyle changes, followed by phasing out the medication. Vallabhaneni said patients typically see improved sleep after six to 12 weeks, so consistency is key.
“Multiple studies have shown cognitive behavioral therapy is the first line of treatment rather than adding more medications,” Vallabhaneni said.
Sleep tips from Dr. Akhil Vallabhaneni
- Stick to a consistent schedule.
- Get morning sunlight exposure.
- Avoid blue light from television and other electronics at least an hour before bedtime.
- Don’t exercise close to bedtime.
- Keep your bedroom dark and cool.
- Use breathing techniques for relaxation.
- Don’t lie in bed awake. If you can’t sleep, get up and sit in a chair under low-wattage light.
- Seek help if problems persist.
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