As people age, they tend to complain of difficulty falling asleep or not getting enough sleep, commonly known as insomnia, especially at night. With reduced sleep, elders face issues in day-to-day activities, and the quality of their life gets affected. This need not be related to aging, but more due to primary causes such as an underlying medical or psychiatric disorder. Hence, as our near and dear ones, elders in our family must be encouraged with kind words that a few lifestyle changes maybe all that it takes to get a good night’s sleep, so as to start a new day feeling healthy and fresh.
Sleep requirement and changes
Ideally, older people (65 years and above) need the same amount of sleep, as youngsters require, around seven to nine hours per night. This will keep them alert and going the next day. However, with age, a person’s sleep and awake cycle does get affected, with a decrease in deep sleep and more awakenings between sleep cycles. During sleep, there is the rapid eye movement (REM) phase, when dreams occur and non-REM phase when deep sleep occurs. With age, adults spend more time in REM sleep, making them light sleepers. Another change is becoming ‘morning larks’ (early to bed, early to rise), from night owls (late to be, late to rise), which could be due to hormonal reasons.
Factors responsible
Insomnia is the most common sleep problem faced by older adults, and factors that can aggravate this problem include:
- Poor sleep hygiene – Irregular sleeping hours, daytime napping, caffeine or alcohol consumption prior to bedtime.
- Illness or pain – Diabetes, arthritis, menopause and conditions like Alzheimer’s disease.
- Medications – Taking more medicines or a combination of drugs can make one remain awake.
- Sedentary lifestyle – Not exercising enough can impair sleep.
- Psychological stress – Anxiety or sadness resulting in emotional disturbances.
- Sleep disorders – Sleep apnea, restless leg syndrome (RLS), and periodic limb movement disorder (PLMD).
Having trouble falling asleep is more common among women, those who are divorced or widowed and having financial difficulties.
Sleep apnea
Here, people stop breathing for 10 to 30 seconds when asleep, and start breathing again with a gasp. Sleep apnea can happen numerous times (20 or 30 times an hour), and awaken the person, causing disturbed sleep throughout the night. A common form is obstructive sleep apnea, seen in over weight or obese people, when air entering the nose or mouth gets blocked, resulting in less oxygen intake. Snoring is very loud and there is a risk of developing high blood pressure, stroke or other heart problems. To cope with this condition, there is a special breathing mask to keep the airways open, known as continuous positive airway pressure (CPAP). A doctor may also suggest some other device or surgery to solve the problem.
Movement disorders
Such disorders cause people to move the limbs while asleep, resulting in poor sleep and drowsiness during the day. These include restless leg syndrome (RLS) and periodic limb movement disorder (PLMD), both of which often occur together. In RLS, there is a tingling, crawling or pins and needles sensation in one or both legs, especially when sitting or lying down. Caffeine, alcohol and tobacco consumption worsen the symptoms. Moving around and walking can bring some relief. At times, medicine might be required on consulting a doctor. In PLMD, there is a jerking or kicking of the legs every 20 to 40 seconds while sleeping, resulting in hundreds of such movements. Many times, the person is not aware of these movements until the partner voices concern about it. Lifestyle changes such as regular sleep habits, moderate exercise and some relaxation techniques can help reduce these symptoms.
Getting sound sleep
Many times improving sleep hygiene will help overcome insomnia and related sleep disorders. Incorporating the following lifestyle changes can help get a good night’s rest:
- Keep a regular sleep schedule – Go to bed and wake up at the same time each day.
- Being busy – Try to be socially active or engaged with some chore, so that the body get’s tired out.
- Exposure to sunlight – Helps regulate the sleep-awake cycles.
- Curb snoring
- Quit smoking – If quitting is not possible, avoid smoking 3 hours prior to bedtime.
- Reduce caffeine – Avoid caffeinated drinks after lunch
- Bedtime rituals – Try taking a bath, reading a book or listening to music to help wind down.
- Limit use of sleeping aids and pills
- Restrict napping – Avoid day naps longer than 20 minutes
- Exercising – Physical activity helps get better sleep, but not within 3 hours of bedtime
Instead of staying in bed for a long time (up to 30 minutes) and waiting for sleep to come, it is better to get up and engage in a light activity, and try to fall asleep afterwards.
Even though you are getting older, and sleep problems are inevitable, you can still make an effort by practicing good sleeping habits and stopping any bad ones.
Any mental stress or depression should not be neglected and where required, medical help must be taken. Remember that with age, the amount of deep sleep decreases, but the amount of sleep required remains the same. Getting adequate sleep is essential for good health and a better quality of living.
