67 percent of older Americans report trouble sleeping

Sep 14 2004

The National Sleep Foundation’s 2003 Sleep in America poll found that 67 percent of older Americans report trouble sleeping.

Sleep for people over 55 often involves waking up several times during the night, not being able to get back to sleep and waking up earlier than desired in the morning. Sleep recordings show that the sleep of older adults is shallower than that in younger adults, with less deep (slow-wave) sleep and frequent awakenings during the night.

There are important consequences of disordered sleep in older adults, according to Susan Benloucif, research associate professor of neurology at Northwestern University Feinberg School of Medicine.

“Disrupted or unrefreshing sleep frequently leads to fatigue and can have a negative effect on the way you feel, and on social interactions, job performance and other important areas of daytime functioning,” Benloucif said.

Older adults usually get less sleep than younger adults; however, it is not clear whether the need for sleep diminishes or simply that the ability to sustain sleep declines. Recent research suggests that medical illnesses, or the treatments for those illnesses, are more likely at fault than age itself.

The need to urinate is the most common sleep disrupter in late life. The NSF poll reported that nearly two in three adults get up to use the bathroom at least a few nights a week.

Specific sleep disorders, such as restless leg syndrome, periodic limb movements in sleep and sleep apnea or sleep-disordered breathing also are more common with increasing age.

In addition, the biological clock, the internal timekeeper, is set earlier in many older adults than in younger adults, Benloucif explained. This causes an increased tendency to fall asleep earlier and awaken earlier.

The biological clock, which uses light and other natural signals to help keep the right time, needs around two hours of daylight-intensity light exposure a day for stable rhythms, but older adults average only 45 minutes of bright light exposure each day.

In addition, physically fit individuals sleep better than those who do not exercise regularly. But many older adults do not participate in as much physical activity as younger adults.

What can you do to improve your sleep? First, said Benloucif, don’t accept the notion that is normal to have disrupted sleep as you get older.

The NSF poll found that only one in eight people with disordered sleep had been diagnosed by a physician.

Discuss your sleeping problems with your physician, and, if needed, schedule a visit with a sleep specialist to rule out specific sleep disorders such as sleep apnea or restless legs/periodic movements in sleep.

Second, maintain proper sleep hygiene. Sleep hygiene recommendations include:

• Sleep in a familiar bedroom that is kept dark, quiet and at a comfortable temperature during the night.
• Use a bedtime ritual, such as reading before lights-out.
• Avoid strenuous exercise after 7 p.m.
• Do not eat or drink heavily for three hours before bedtime, and if you have trouble with regurgitation, avoid heavy meals and spices in the evening.
• Limit caffeine use after 10 a.m., avoid alcoholic beverages and smoking after 7 p.m. or give up smoking entirely.
• Drink a warm non-caffeinated drink to help you relax and warm you.
• Limit exposure to light if you have to get up at night, but get at least 30 minutes of exposure to sunlight during the day. Exposure to artificial bright light between 7 and 9 p.m. via a home light box can promote evening alertness.
• Avoid naps, except for a brief nap in the afternoon.
• Get regular exercise each day, preferably 40 minutes each day of an activity that causes sweating.