How ageing affects sleep?
What cause sleep disturbances in older age?
A number of factors can results in poor sleep in older age. First, poor sleep hygiene are difficult to change. Secondly, a medical or mood disorder that adversely affects sleep becomes more likely and the medications to treat it may also lead to sleep disturbances. Thirdly, the incidence of primary sleep disorders like sleep apnea increase and can contribute to sleep disturbance (this includes a bed partner who can affect your quality of rhythms, hormone secretion, and body temperature, and so can lead to less refreshing and more disrupted sleep.
Can lifestyle factors influence sleep in ageing?
Yes. Evidence from a number of studies suggests that sleep difficulties are greater in the older person who has little or no exposure to natural light, has a poor diet, does not exercise and is not mentally stimulated. This means that as far as you are able, you should keep yourself active, involved in life and with others (family, friends, volunteer activities, or work), keep up exercise regimen suited to your physical needs, and eat a healthy and balanced diet.
The older I get the earlier I tend to wake up in the morning is this normal?
As your circadian rhythm changes with age, you tend to feel more tired toward the early evening, thus bringing your bedtime forward. When this occurs, you tend to wake up earlier and so the cycle continues. There is nothing wrong with this, unless your bedtime has advanced to the degree that you are suffering from advance sleep phase syndrome and it is impairing your day to day functioning.
What are the changes that lead to sleep disruption in older age?
As we age, the body’s production of growth hormone (produced during slow wave sleep), sex hormones, and melatonin begins to decline. The changes, especially in growth hormone levels, coincide with the reduction also occur. Serum cortisol levels rise with the observed reduction in REM sleep with age. Levels of inflammatory neurochemicals (cytokines) in the bloodstream also tend to be more elevated in elderly as compared to younger people who sleep poorly. Some of these cytokines can cause symptoms of daytime sleepiness and fatigue.
What are the most common primary sleep disorders?
The most common sleep disorders in the elderly are insomnia, sleep apnoea, restless legs syndrome, and advanced sleep phase syndrome.
Is it normal to be tired during the day in old age?
No. although stamina, endurance levels, and organ function start to decline from about 30 years of age, if you are otherwise healthy, sleep well, take no medication, and have a balanced lifestyle, there is no reason to be tired.
What about all the pills I’m on could they be affecting my sleep?
Many medications can disrupt sleep. A list of commonly prescribed drugs is provided on p44. The time at which you take medication can also affect sleep, so talk to your doctor if you think that a drug is causing sleep disturbances. Many elderly people take vast numbers of prescribed drugs for various ailments if you are unsure why you are on certain medications and what they should be doing, discuss this with your doctor. Don’t be shy about discussing your health with the appropriate professional.
My bladder keeps me up all night what can I do about it?
As your bladder ages, it is less likely to retain as much urine over your longer periods of time. It is important to discuss your symptom with a medical professional and sometimes a specialist (urologist) who can help diagnose and manage your problem. Incontinence affects over 6 million people in the UK. Men who get up to pass urine during the night and have problem with stream or with dribbling should have their prostate checked. Tell your doctor if you have burning or stinging sensation on passing urine and ask about exercise for the pelvic floor and medications for incontinence.
What can I do to minimize sleep disruption?
Cut down the amount of fluid you drink in the evening and just before going to bed. If you are on a diuretic medication, take it in the morning and the last dose at lunchtime. If you have a primary bladder problem, make sure you have comfortable incontinence pads. Sometime the need to pass water during the night is associated with a sleep disorder such as sleep apnoea.
Dr. Samantha Hement has 10 years experience in neurology. She is specialty concerned with nervous system function and sleeping disorders. She has created a website to deal with insomnia and provided some information on how to deal your insomnia without medications.
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