Reviewed for Accuracy Dr Jason Ellis
We all know that good sleep is essential for a healthy lifestyle. But as you get older, you may find sleep more difficult to come by. And there are many reasons for this, such as medication, aches and pains, changing biological rhythms, etc.
So, whether you’re old, young, middle-aged or a teen, join us as we dig into why sleeping patterns change with age and what you can do about it.
Throughout your life, your sleep patterns are controlled by circadian rhythms or your “body clock”. This rhythm is connected to the day and night cycle and works on a similar 24-hour duration. Light inhibits the production of the “sleep signalling hormone” melatonin, and darkness stops this hormone from being inhibited. This hormone signals to your body that it’s time to sleep. However, as we age, our circadian rhythm “shifts” – this is called phase advance. This shift can be most substantial when you’re 60-65 years old.
When experienced naturally, this shift is a slow process, and you may wake up about half an hour earlier every decade. It means you will start feeling sleepier earlier in the evening and be more alert in the morning. Be aware that this isn’t the case for everyone, and some people may have different changes due to lifestyle and environmental factors.
Phase advance can affect your sleep pattern in several ways. Firstly, you’re likely to want to go to sleep and wake up earlier. It’s not uncommon for older adults to head to bed between 7-8 pm and then wake between 3-4 am. Because of this waking up earlier, regardless of when you go to sleep, daytime napping is often used as a coping mechanism, affecting your ability to sleep at bedtime.
Regarding sleep quality, older adults tend to have less SWS (Slow Wave Sleep), the deep sleep you need to rest. Instead, older adults spend more time in the lighter sleeping phases. This change in sleep pattern can have a knock-on effect. As you try to stay awake later, still wake up early, and nap during the day, you lose quality sleep. Therefore, insomnia is more common as you get older. And this has led to the myth that older adults need less sleep despite still needing around 7-8 hours per night.
According to the Sleep Foundation, the recommended hours of sleep for different ages are:
That said, sleeping more and less than these guidelines can still be normal for you.
It’s not yet known why this phase advance, causing a shift in sleep patterns, occurs. It’s likely to be a combination of environmental and biological factors. According to the Sleep Foundation, some factors that could cause this change include:
From caffeine intake to mental health and through unavoidable bodily changes that come with ageing, there is a wide range of factors, including:
As we age, our circadian rhythm becomes less and less consistent. They generally centre around the sun’s rising and setting, but they’re more liable to disruption as we age and spend more time indoors.
If you’re struggling with insomnia and have recently changed or taken a new medication, you may want to speak with your GP about the side effects. Common medicines that may cause insomnia include anti-depressants, steroids, and those prescribed to lower blood pressure (alpha agonists and beta-blockers).
For those who suffer from mental health conditions such as depression or schizophrenia, insomnia is, unfortunately, more likely. The same is true for those who regularly experience stress and anxiety.
Physical health plays a role too. If you have heart problems or suffer from several other health conditions, you are more likely to experience episodes of insomnia.
According to mayoclinic.org, the following medical conditions may increase your chances of insomnia:
Another significant factor in insomnia for the elderly is diet and lifestyle. Caffeine and alcohol are known stressors regarding how well we fall asleep, and cutting these out where possible is essential if you’re struggling to sleep. Our nutrition is also important. As with most health concerns, an unhealthy, unbalanced diet can cause problems.
The time we spend outdoors is also crucial to how well we sleep at night. The more our body is exposed to sunlight, the more melatonin it produces. Melatonin is commonly referred to as the sleep hormone, so anything that can boost it is worth considering – especially for those who are older and struggling to get to sleep.
The easiest way to deal with this circadian shift is to accept it and go to bed when you feel tired and wake up naturally. Although, this can be very hard to fit in with modern life as most of society doesn’t go to bed until much later than 7 pm. Instead, there are ways to improve your sleep with minor changes in sleep hygiene, such as:
Quite simply, preventing insomnia as you get older boils down to how well you limit the effect of the causes mentioned in the above sections. So, here are our top tips for preventing insomnia as you age.
Whether it’s a gentle jog, a walk to the shop, or simply a stroll around the garden, absorbing daylight will do wonders for your body clock and keep your routine as close to normal as possible.
Nicotine, alcohol and caffeine are all known to limit our ability to fall asleep. As you age and insomnia becomes more likely, the impact of what you put in your body also strengthens. If you can’t cut them out completely, try to cut them out as you wind down for bed in the evening.
Psychology is more effective than most of us realise. Having a bedtime routine and sticking to it tricks the body into recognising when it’s time to sleep and when it’s time to stay alert. Make yours luxurious and incorporate a warm bath before sipping a sleep-inducing lavender tea.
If it’s not too close to bedtime, exercise is excellent for helping us sleep. And it’s not just about nodding off but about preventing insomnia too. The John Hopkins Medical Centre states: “Recent research indicates that exercise decreases sleep complaints and insomnia in patients. The effects of aerobic exercise on sleep appear to be similar to those of sleeping pills. However, more research is needed to compare physical exercise to medical treatments for insomnia.” Here’s a quote from their Medical Director, Charlene Gamaldo:
“We have solid evidence that exercise does, in fact, help you fall asleep more quickly and improves sleep quality.
But there’s still some debate as to what time of day you should exercise. I encourage people to listen to their bodies to see how well they sleep in response to when they work out.”
When looking to treat or manage insomnia, your first port of call should always be your GP. The internet is not quite as qualified and personally responsive as your doctor. But don’t disappear just yet. Plenty of natural or non-pharmacological treatments work great for people with insomnia, and we’ll discuss some of the most popular ones below.
Stimulus control therapy is about reducing an individual’s anxiety when they approach bedtime. It involves a set of instructions and rules to ensure the bedroom becomes a place for sleep. According to the Society of Clinical Psychology, these rules include:
While it may sound a little obvious, educating people about how to get to sleep is often considered one of the most effective insomnia treatments. Small steps like limiting caffeine and avoiding blue light before bed can often significantly impact. So for those with insomnia in their later years, a good port of call is to educate yourself on sleeping habits.
These are part of what may be prescribed if you speak to a cognitive behavioural therapist. Sleep restriction and compression are about understanding precisely what your body needs and how your habits match up. Here’s what the Sleep Foundation had to say about the two:
“Two methods (which) aim to improve sleep quality and quantity by reducing the amount of time a person lies in bed. A CBT-i practitioner can use records from a patient’s sleep diary to determine how much time they sleep each night compared to the amount of time they lie in bed awake. Sleep restriction involves a sharp curtailing of time in bed while sleep compression is a more gradual process, but both techniques are intended to achieve the same goal: less time in bed awake each night.”
