Sleep often gets lighter with age, making it harder to feel well-rested. Photo / 123rf
It’s not a secret that sleep can get more difficult with age – research suggests that up to half of older adults complain of sleep problems.
Health problems, prescription medication side effects and changes in circadian rhythms are among many reasons people struggle with getting good rest.
After the age of 50, people often suffer “more frequent arousals from sleep”, said Brienne Miner, a specialist in geriatrics and sleep medicine at Yale Medicine and assistant professor of medicine at Yale School of Medicine.
“Because of the increased arousals, there is a tendency to shift to more lighter stages of sleep and less deep and less [rapid eye movement]” sleep.
Miner said people 65 and older need six to eight hours of sleep a night, just like their younger counterparts.
“You shouldn’t sleep less as you get older, but also, if you sleep too much, that might be a sign there is an underlying issue that needs to be addressed, and oftentimes that’s a sleep issue,” she said.
She pointed to sleep obstacles that can be modified, including lack of a regular schedule and getting up and going to bed at different times, lack of exercise or staying in bed too long, and alcohol and caffeine consumption. Developing good sleep hygiene habits can make a difference, she said.
“We understand it is hard work, but what people need to realise is their healthy lifestyle is important for a lot of things, including their sleep,” she said.
The many prescriptions older people often take can play a part in upsetting sleep. In 2021-2022, 88.6% of older adults said they took prescription medication in the previous 12 months, according to federal health data. And 54% of adults 65 years and older reported taking four or more prescription medications in a KFF Health Tracking Poll.
AARP published a list of medications that can interfere with sleep, including asthma medications, decongestants and blood pressure medicines. If you suspect that medications are upsetting your sleep, experts recommend talking to your doctors to determine whether dosages or the times a drug is taken could be tweaked, or whether a different medication might work better for you.
Other health problems that make sleeping difficult include arthritis and chronic pain; heart disease, which can cause shortness of breath when people lie flat; diabetes, which can cause blood sugar dips during the night; and acid reflux. A well-balanced snack before bedtime can help head off problems for diabetics, the Mayo Clinic says, while raising the head of your bed may help those with acid reflux. Parkinson’s disease and dementia also can disrupt sleep-wake cycles.
Miner recommended contacting your doctor for issues including the following:
Restless legs syndrome is sometimes caused by an underlying health problem, such as iron deficiency, the Mayo Clinic says. If there isn’t an underlying cause, lifestyle changes such as warm baths or massages, heat or cold packs, and avoiding caffeine can help. If not, medications that increase dopamine in the brain to regulate muscle movements, calcium channel blockers that relax muscles, muscle relaxants, sleep medicine or opioids may be prescribed.
Miner also discouraged prolonged use of sedatives like Ambien and Lunesta because of side effects.
Amy Goyer, AARP’s national family and caregiving expert, learned more about lifestyle and alternative health remedies while taking care of family members.
Goyer said her father, who had Alzheimer’s disease, struggled with confusion and agitation in the late afternoon and evening, so she encouraged him to make several changes, including exercising more during the day, adopting a regular sleep schedule, avoiding daytime naps, and adding room-darkening curtains for his bedroom and a lightbox for winter’s shorter days.
She also kept his bedroom temperature at 18C and used an essential oil diffuser with lavender to help him relax. A geriatric psychiatrist she consulted suggested a higher dose of melatonin, which helped him sleep.
She played a meditation tape every night to help calm him, and her, as she dealt with the pressures of caregiving. Twice a month acupuncture for her and her father also helped.
“I found anxiety was a big problem for him, and it became one for me because of the caregiving stress. … It made a huge difference for both of us,” she said.
Goyer, like other experts, said people should consult their doctors before trying new medications or supplements.
Sandra Darling, a preventive medicine physician at the Cleveland Clinic Centre for Integrative & Lifestyle Medicine, has told older patients to try skipping caffeine and alcohol for a few weeks to see how much better they sleep.
She also suggested melatonin for help getting to sleep and recommended magnesium for help staying asleep, easing muscle cramps and relaxing. Darling added that it’s important to check with a doctor before taking magnesium if you have kidney disease because large doses of the supplement can worsen kidney damage.
Valerian root in both supplement form and tea can be calming, as well as chamomile, lavender and passionflower, she said, adding that L-theanine is another supplement that can help people with anxiety or stress to relax.
Darling also recommended eating seven pistachios before bed because that amount contains enough melatonin to help with sleep.
“Other foods that may help with sleep because of their antioxidants are tart cherries, tart cherry juice and kiwifruit,” she said. “Avoid high-sodium foods in the evening like pizza and potato chips. … The excess sodium can elevate blood pressure and cause swelling, which can disrupt sleep.”
Mind-body therapy like yoga, meditation and mindful breathing is a big help for people with racing thoughts, she said.
“Yoga is a great one. I consider that meditation in motion, a way to slow down and focus on breath while stretching muscles, slowing heart rate and inducing the relaxation response – a great way to wind down for sleep,” Darling said.
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