Sleep Disorders and Aging
Carmel Armon, MD, MHS, MSc
Sleep Disorders and Aging Overview
Are you one of millions of seniors in the US who think life would be pretty good….if you could just get some sleep?
Sleep disturbances are very common in older people. Changes in sleep patterns may be a normal part of aging, but many other factors common in older people contribute to sleep problems. These include physical illness or symptoms, medication side effects, changes in activity or social life, and death of a spouse or loved one. Sleep disorders decrease quality of life in older people by causing daytime sleepiness, tiredness, and lack of energy. Poor quality of sleep also can lead to confusion, difficulty concentrating, and poor performance on tasks. Sleep disorders also are linked with premature death.
The biggest sleep problem in older people is a feeling of not getting enough sleep (insomnia) or not being rested.
- Many take longer to fall asleep than they did when younger.
- Elderly people actually get the same amount of sleep or only slightly less sleep than they got when younger, but they have to spend more time in bed to get that amount of sleep.
- The sensation of insomnia often is due to frequent nighttime awakening. For example, older people tend to be more easily wakened by noises than younger people.
- Daytime napping is another cause of nighttime wakefulness. Older people are more likely to be sleepy during the day than younger people, but too much sleepiness during the day is not part of normal aging.
Normal sleep has different stages that cycle throughout the night. Sleep specialists classify these as rapid eye movement (REM) sleep and non-REM sleep.
- REM sleep is the stage in which muscles relax most completely. Dreaming occurs during REM sleep.
- Non-REM sleep is subdivided into 4 stages. Stages 1 and 2 constitute light sleep; stages 3 and 4 are called deep sleep. Deeper sleep generally is more refreshing.
Sleep changes with age. Older people are less efficient sleepers and have different patterns of sleep than younger people.
- The duration of REM sleep decreases somewhat with aging.
- The duration of stage 1 sleep increases, as does the number of shifts into stage 1 sleep. Stages 3 and 4 decrease markedly with age in most people, especially men. In people aged 90 years or more, stages 3 and 4 may disappear completely.
In the United States, insomnia is the third most common reason for a medical visit, behind only headaches and the common cold. Approximately 15% of adults have insomnia severe enough to seek medical attention. About 1.7% of Americans receive a prescription
for a sleeping medicine annually, and another 0.8% purchase nonprescription sleep aids. Fifty million Americans occasionally take some form of sleep medication.
Among older people, women are more likely to have insomnia than men. More than half of people older than 64 years have a sleep disorder. The rate is higher among long-term care facility
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