Why It's Harder to Sleep As You Age

From verywellmind.com

So your sleep habits didn't age well... 

Feeling super restless at night? Maybe you used to be able to sleep 'til noon on the weekends, but lately, you’ve been waking up at the crack of dawn. Perhaps you used to snooze as soon as your head hit the pillow, but these days it feels impossible to drift off to dreamland.

There are lots of reasons why we have trouble sleeping, but if you've noticed that aspects of your sleep just aren’t the same as you’ve gotten older, we have, too. Just as our skin becomes more prone to wrinkles, and our joints grow more creaky and achy, our sleep can also be impacted by aging.

Our sleep duration, wakefulness, and the ability to fall asleep shift naturally as we get older. This is totally normal. While it can take some adjusting and sometimes can be challenging, it’s not all problematic. Understanding how sleep changes as you age can be empowering, and there are adjustments you can make to your routine so that you can feel more well-rested as the years tick by.

Read on for more about why sleep changes as we age, how to identify any sleep problems, and how to manage these changes and get the sleep you need.

How Sleep Changes as You Get Older

Most of the sleep changes we notice as we age can be blamed on biology. It’s well known that infants are wired to wake up frequently throughout the night, and need several daytime naps to get through the day. You probably remember being a teenager and having trouble waking up in the morning and going to sleep at a reasonable time at night. As we move through the different stages of life, our sleep changes, and the same is true as we get older.

In fact, studies have found that we tend to lose about 10-20 minutes of total sleep every decade starting from age 20 until about 60. Additionally, the type of sleep we get changes as we age, says Bijoy John, MD, board-certified sleep physician and founder and medical director at Sleep Fix Academy. “The sleep architecture of a 20-year-old is significantly different when compared to a 60-year-old, especially when it comes to deep sleep,” he says.

While adults aged 60 and older need approximately the same number of hours of sleep as younger adults (seven to nine hours a night), many have trouble getting the sleep they need, Dr. John notes. “When they can doze off, they spend more time in lighter stages of sleep,” he says.

The sleep architecture of a 20-year-old is significantly different when compared to a 60-year-old, especially when it comes to deep sleep.

— BIJOY JOHN, MD

Lighter sleep is one of several changes that happens to our sleep as we age. According to Chris Allen, MD, board-certified sleep medicine physician, paediatric neurologist, and sleep science advisor at Aeroflow Sleep, the following changes typically happen to our sleep as the years go by:

• We experience reduced sleep duration, spending less of our night sleeping than our younger counterparts
• Sleep becomes more fragmented, with more frequent night-waking
• There are changes in our sleep stages, with a reduction in deep sleep (slow-wave sleep), an increase in light sleep, and a slight reduction in REM sleep (dreaming)
• Our circadian rhythm shifts, leading to becoming sleepier earlier and waking up earlier in the morning

Although a lot of the sleep variations that occur as we age can be attributed to changes that happen in our bodies, sometimes lifestyle changes have impacts as well. “Older individuals who are retired may have more time to nap during the day and be less active, which subsequently affects sleep at night,” Abhay Sharma, MD, ENT, sleep physician and co-director of University of South Florida Sleep ENT and Snoring Center. “Changes in health, both physical and mental, also affect sleep as we get older.”

Could My Sleep Problems Be Something Else?

Although these changes in sleep patterns can be normal as we age, sometimes they are a sign of a sleep disorder or a medical condition that has crept up.

Many of the health conditions that affect middle-aged and older individuals can impact their ability to sleep well, Dr. John says. Some of these conditions include:

• Diabetes
• Congestive heart failure
• Emphysema (COPD)
• Acid reflux
• Prostate issues
• Urinary tract infections
• Anxiety
• Depression
• Alzheimer’s or dementia
• Menopause and perimenopause

It’s also important to consider that sleep disorders can impact sleep at any age. “Some common conditions like restless leg syndrome (RLS) and periodic limb movement disorder (PLMD) also should be ruled out as these conditions can result in difficulty initiating and maintaining sleep,” Dr. John says. Sleep apnoea is another condition that can impact sleep and that tends to get worse as we age, he says.

Finally, as we get older, we are more likely to experience a condition called advanced sleep phase syndrome (ASPS). “This is a condition where you go to bed early in the evening and wake up in the middle of the night with extreme difficulty going back to sleep,” Dr. John explains. “Lack of routine and exposure to sunlight, loneliness, boredom are all contributing factors.”

Maintaining Healthy Sleep Habits As You Get Older

The sleep changes that happen as we get older can be startling and distressing, but you are not powerless here.

It’s important that if you are experiencing symptoms that may be impacting your sleep, that you visit your healthcare provider. These symptoms may include:

• Trouble breathing during sleep
• Snoring
• Physical pain
• Tingling or “pins and needles” in your legs
• Jerking or kicking your legs in your sleep
• Serious problems falling asleep and staying asleep
• Anxiety or racing thoughts that make it difficult to fall asleep or stay asleep

If you are experiencing these, or any other concerning symptoms, connect with your healthcare provider to rule out any medical conditions that could be contributing. If it turns out you are healthy, then it’s likely the shifts that happen as we age are impacting your sleep. If so, there are things you can do to maximize sleep.

Dr. Sharma shared his top tips for maximizing sleep as we get older:

• Make sure you stay active during the day, even if you are retired or working less, because this sets the stage for sleep
• You can nap, but only do so for a short amount of time and make sure your naps occur earlier in the day
• Exercise daily, but stop exercising in the evening because this can stimulate the brain to stay awake longer
• Keeping a regular bedtime (even on weekends!) is important, but keep in mind that bedtimes shift as we get older
• Avoid all screens an hour before bed
• If you wake up at night, don’t look at your phone or a clock
• If you wake and can’t fall back asleep, get out of bed and go somewhere dark and quiet, consider reading a book for a short while, and go back to bed when you feel sleepy again

Screen time before and during bedtime is something to pay particular attention to as you get older, Dr. Sharma warns. “Though you may have been able to compensate in years prior, our circadian rhythm changes as we age,” Dr. Sharma says. “Specifically, it can be harder for the normal hormonal circuitry of the brain to allow you to fall asleep when the light from a device or television has caused some level of stimulation.” This is why he stresses the importance of avoiding lights from screens close to bedtime.

Improving Your Sleep Hygiene at Any Age

Sleep hygiene refers to having and maintaining healthy sleep habits. These are important at any age, but as we get older, we sometimes let these habits fall by the wayside, especially as the stresses and responsibilities of adulthood intensify.

Dr. Allen recommends keeping these sleep hygiene habits in mind to maximize sleep duration and quality at any age:

• Keep a consistent sleep schedule, going to bed and waking up at the same time each day, even on weekends
• Make sure the room you sleep in is quiet, dark, and kept at a cool temperature
• Avoid long or late napping
• Avoid stimulants, such as caffeine and nicotine, especially in the later parts of the day
• Avoid alcohol before bedtime
• Establish a relaxing bedtime routine, which can include reading, listening to calming music, and taking a warm bath
• Limit all screens (phones, TV, tablets) at least an hour before bedtime, as this prevents blue light from disrupting circadian rhythms

Will I Ever Be Able to Sleep Like I Used to?

Keep in mind that the decrease in total sleep doesn’t happen indefinitely. “The good news is the decline in age-related total sleep time stabilizes at around age 60,” Dr. John says. Furthermore, we can take steps to ensure that the sleep that we do get is the best quality possible. Things like prioritizing our sleep, setting a strict sleep schedule, and avoiding napping, all can help significantly, Dr. John adds.

Dr. Allen assures that although you won’t sleep exactly the same way as you did when you were younger, you can adjust your outlook and habits around sleep, both of which can help. “While sleep in older age might not be the same as in youth, there are many strategies to improve sleep quality and maintain good health at any age,” he says. “Understanding and accepting that sleep needs and patterns change with age can help manage expectations and reduce anxiety about sleep.”

Understanding and accepting that sleep needs and patterns change with age can help manage expectations and reduce anxiety about sleep.

— CHRIS ALLEN, MD

Another thing to keep in mind? Sleep actually might get better as you get older, if you are vigilant about your health and sleep hygiene. Having fewer life stressors and responsibilities in older age may help too. “Sleep patterns can go through cycles, and it's possible for sleep quality to improve with age, particularly if health conditions are managed well,” Dr Allen says.

Bottom Line

Change is never fun, but it’s completely normal for our sleep to change as we get older. This may include needing fewer hours of sleep, waking up more frequently at night, and not being able to sleep as late in the morning as we used to.

It can be jarring at first when we notice these changes, but there are things we can do to adapt, including paying extra attention to sleep hygiene, addressing any medical issues that may contribute, and adjusting our schedules and expectations around sleep.

https://www.verywellmind.com/why-its-harder-to-sleep-as-you-age-8668191