Sleep in the Elderly: Problems and Solutions

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Author:

Lauren Broch, Ph.D.

Sleep Disorder Institute of Good Samaritan Hospital

Rochelle Zak, M.D.

New York Presbyterian Hospital-Cornell Campus, New York City, NY

Medically Reviewed On: March 31, 2006

Changing Sleep Patterns

Sleep changes as we age ? as any one over the age of 50 knows. Not only do changes in sleep patterns occur, but there is also an increased incidence of many sleep disorders.

Frequent awakenings
One of the most common changes in the elderly is the occurrence of frequent awakenings during the night. While these awakenings are sometimes caused by physical conditions (pain, the need to urinate) it has been shown that the aging process itself causes sleep to become more fragmented.

Changes in the biological clock
Another change that can occur with aging is a shifting of the biological clock. Many elderly people are surprised that they fall asleep earlier in the evening and may awaken before sunrise. The biological clock ? the part of the brain that regulates sleep, temperature, and certain hormones ? shifts sleep and wake times, so that it becomes more difficult to stay awake in the evening and easier to wake up early in the morning.

Changes in the level of sleep
In addition to the timing of sleep, the levels of sleep change as you age. There is less of the very deep sleep known as delta or slow wave sleep and more light sleep. While the level of sleep may change, the total number of hours of sleep may not change much from when you were younger.


Hormonal changes
The hormones involved with sleep also change in the elderly. You have probably heard of melatonin, which is sometimes referred to as the "hormone of darkness" because it is produced in the absence of light. The role of melatonin in sleep is controversial. We know that melatonin levels decrease with age but we do not know the significance of this reduction, or if melatonin pills help elderly people (or others, for that matter) who have trouble falling or staying asleep. Also, many people who try melatonin take it an incorrect times, and may not reap its benefits.

Sleep Hygiene

Ironically, many of the above symptoms are made worse by the things that people do to try to compensate for their changing sleep patterns. At any age, it is important to have proper sleep habits ? what we refer to as "good sleep hygiene". But as we grow older, it becomes increasingly vital to maintain healthy sleep hygiene, since many older people unknowingly violate it trying to correct their altered sleeping habits.

The following are five important points to remember about sleep hygiene:

Do not spend too much time in bed and avoid naps when you can: It is important to spend only the time in bed you truly need. When you have had a poor night's sleep and feel awful the next morning, you might believe that if you spend more time in bed you will get more sleep.


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