There are changes in sleep as you get older. It’s not the same as it was as a young adult.

Sleep as we get olderSleep changes as you get older in a number of ways.  It can feel different, not being as long or robust as when you are younger and things can happen during sleep such as snoring, movements, pain or restlessness that can impact on sleep quality and affect energy levels throughout the day. Other physical or mental health problems, as well as medications can also have an impact on sleep.

Sleep changes across life

Across life sleep gradually shortens such that in early adult life most people need around nine hours of sleep per night, whilst during the working years this reduces to a minimum of seven hours per night and in retirement years can be around a minimum of six hours per night.  It is important to recognise that the need for sleep changes so that we do not maintain that expectation of sleep feeling like it did when we were a teenager as we get older.

How much sleep do we needIt is not uncommon for me to see people in my practice who wish for eight hours of uninterrupted sleep even in their 60s as they can recall having this when they felt they were in good health in early adult life.  However, sleep is a biological process, generated from the brain, so we should expect that it doesn’t work quite as well and changes as we get older. In the same way as our joints don’t work the same in our 60s as in our 20s or our blood pressure is not the same later in life, sleep also differs as we get older.

As well as sleeping shorter, sleep often feels lighter as we get older.  Most people can recall as a teenager sleeping like “the dead”, barely awakening to anything.  However, as we get older even the slightest noise can disturb sleep or we can have awareness of things around us more commonly.  This is a normal part of sleep and in fact 30% of the night it is normal to be aware of things around us during sleep.  It is also normal to awaken reasonably often during the night, with the average for women in their 50s awakening 3.7 times per night and a similar number for men.

Feeling sleepy is not part of healthy aging

sleep as you get olderAlthough some people feel tiredness is a part of getting older, in healthy aging, sleepiness or tiredness is not something that is generally seen.  Therefore, if you are feeling sleepy despite getting enough sleep it should flag that there may be an underlying problem either with physical or mental health or sleep itself that warrants further evaluation.  As such, if you feel that you are getting enough sleep but still feeling tired as you get older it is important to discuss it with your health professional.

Your health professional will look at any other physical illnesses or issues with mental health or medications that may be adding to tiredness.  If nothing is apparent they may consider that a sleep disorder is contributing to tiredness and sleepiness symptoms and therefore, think about referring you on to a sleep specialist for a clinical assessment and possibly a sleep study. Just doing a sleep study to find a cause for tiredness without getting an assessment from a sleep specialist often doesn’t provide enough information to work out what is causing your symptoms.

Sleep disorders are more common as we get older

Problems with sleep itself become more common as we get older.  Sleep disorders such as sleep apnea are particularly common. 1 in 20 men, and 1 in 30 women have sleep apnea severe enough to cause sleepiness during the day. Sleep disorders can disturb sleep itself or sometimes just present with symptoms of feeling more tired than people would expect.  Because of this and because tiredness and sleepiness is not a part of healthy aging, if people are feeling more tired or sleepy as they get older and there are not other factors identified that can account for this, it is important to discuss these with your health professional.

Diagnosing sleep disorders requires referral to a sleep physician for a clinical assessment and usually then some form of measurement of sleep to look at breathing, movements and sleep patterns that can give insight into sleep disorders.

Tips for improving sleep as you get older

As sleep is somewhat more fragile as you get older, it can be more important to be careful about sleep in a way that you didn’t have to when you were younger.

  • Allow sufficient time to wind down before trying to sleep
  • Go to bed when you’re sleepy. Not when you’ve run out of energy and are tired, or there’s nothing more that you want to watch on TV.
    • A common problem that I see in older adults is spending too much time in bed as they are not as busy as they were in their working life and can fill that space with increased time in bed.  However, increasing the time spent in bed during a stage in life when there is less sleep can often lead to more time spent awake during the night getting frustrated about not being asleep.  If you find this happening it is important not to be spend too long in bed and find activities or interests that you can do out of bed in the evening and morning so that the time spent in bed better matches your sleep need.
  • Keep physically active. Exercise, particularly soon after getting up in the morning is not just good for general health, but helps to synchronise the circadian rhythm and keep sleep and energy levels more regular
  • If other health problems are interfering with sleep, work with your health professional on strategies to manage symptoms as best as possible, particularly during sleep
  • Recognise that you are at higher risk for sleep disorders such as sleep apnea or insomnia, so that if you are having trouble with sleep despite doing what you can, talk to your health professional about getting a referral to a sleep specialist

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