Aging and Sleep: Adjusting to New Sleep Patterns
How to handle sleep challenges as we age and it becomes more difficult to fall and stay asleep
Difficulty developing and maintaining proper sleep habits is an ever-growing issue in the busy world that we live in, so I developed this three-part series on sleep habits that you can practice at any age:
As pointed out in my first article on sleep hygiene, only 10% of Americans prioritize sleep over other daily activities such as exercise, diet, work, and even hobbies (National Sleep Foundation, 2018). This means roughly 90% of people could be getting better quality sleep.
Though the vast majority of us struggle with proper sleep habits, unfortunately, these struggles only increase as our lives progress.
Sleep Changes as We Age
The strategies for promoting good sleep patterns don't change much as we age, however, our relationship with sleep does. As we grow older and enter into our elderly years, it can become increasingly difficult to fall asleep, stay asleep, and as a result experience good sleep quality (Espiritu, 2007).
A paper by Wolkove et al. (2007) discusses some of the normal changes that can be expected as we age.
Our circadian rhythms (or "biological clock" as some people call it) shift as we age resulting in earlier sleep times and wake times.
Sleep duration also shortens, with the average person over 60 sleeping only 6.5 hours per night (compared to an average of 7-8 hours for all other adults).
These changes in sleep patterns can result in sleep disorders such as insomnia; according to Wolkove's paper, close to half of people over the age of 65 suffer from insomnia.
It makes sense that shifts in natural sleep cycles could result in sleep disorders. Though our internal clock may shift, our behaviors often don't. Changes in sleep patterns and needs occur subtly over time, and it can be easy to ignore or fail to notice the cues our body is giving us.
Rather than adjusting to our changing sleep needs, many of us may try to continue living our lives as we always have. The problem is that our natural cycles don't necessarily respond to our stubbornness. Though staying up late is possible as we age, sleeping in will become more difficult. This will result in losing sleep late in the day and no longer being able to make up for it the next morning as we once could.
The Dangers of Poor Sleep
Without adjusting our sleep habits, it can become easier and easier to fall behind on sleep. Some concerns with this are obvious, such as feeling more tired during the day and losing the energy and motivation to engage in our normal activities.
The real issue, however, is that sleep disturbances can lead to serious mental health problems. Depression is a condition that also increases with age, and the relationship between depression, sleep, and aging may be more than just correlational. Though depression is a known cause of insomnia, research has shown that insomnia itself can also lead to depression, making poor sleep a risk factor for a condition that is already widely prevalent in the elderly (Buysse, 2004). The insomnia-depression cycle is one to be avoided at all costs.
Adjusting to Sleep as We Age
The obvious question is, what can we do to mitigate the effects of aging on sleep?
The answer is sleep hygiene, but with a little twist. Most of the behaviors that lead to better sleep when we're younger work just as well when we're older. Strategies like avoiding exercising at night, caffeine, bright lights, and too many fluids, setting up a good space for sleep and having a good morning routine all apply no matter what your age. The changes that need to be made as we age center around timing. As discussed above, the main change to our sleep patterns that we can expect as we age relates to an earlier sleep-wake cycle. We should adjust our routines accordingly.
Two of the main points that I emphasized in my previous articles were to set a consistent sleeping time and a consistent wake-up time. Though I recommend continuing this as we age, the exact times you choose may need to shift a bit. It's not necessary to wait until a certain age to do this.
If you notice that you're consistently waking up an hour or more before your alarm every morning, adjust for this change at bedtime (i.e. consistently go to bed an hour or more earlier at night).
The resistance I often see around this suggestion is the fear of losing productivity and/or recreation at night. Yes, you'll have less time at night to do the things you want and need to do, however, there's very little you can do at night that you can't do in the morning. It's okay to leave some dishes in the sink, not lay out your clothes for the next day, or not watch your favorite show at night if you can make up for these activities in the extra hour or more you now have in the morning.
Growing older is something that we should all be fortunate enough to experience in our lives, but age comes with new challenges. It's okay to adjust to these new challenges if it means maintaining health and wellness. Whatever your age may be, practicing good sleep hygiene will lead to a better quality of life.
2018 Sleep in America Poll — Sleep Prioritization and Personal Effectiveness Sleep Health: Journal of the National Sleep Foundation, Volume 0, Issue 0
Buysse, Daniel J. (2004). Insomnia, depression and aging. Assessing sleep and mood interactions in older adults. Geriatrics, 59(2):47-51
Espiritu, Joseph Roland D. (2007) Aging-Related Sleep Changes. Clinics in Geriatric Medicine , Volume 24 , Issue 1 , 1 — 14
Wolkove, N., Elkholy, O., Baltzan, M., Palayew, M. (2007). Sleep and aging: 1. Sleep disorders commonly found in older people. CMAJ 176(9):1299-304