What the Most Recent Medical Research Says about Insomnia in Older Adults

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What the Most Recent Medical Research Says about Insomnia in Older Adults

Older adults sleep less than they used to. And they are often told that’s how things should be. The first statement is a reality. The second is a stubborn myth, sometimes even spread by our own physicians.

Sleep deprivation bothers nearly half of all adults in the U.S. over the age of 60. One in four older adults report daytime drowsiness that interferes with daytime plans on a regular basis.

These reports do not mean that older adults need less sleep. Far from it. In reality, older adults need 7 to 9 hours of restful sleep. Solid, restorative slumber remains the accessible fountain of youth. Among other things, healthy sleep helps delay the onset of many diseases, enables our bodies to heal, assists in putting difficulties and stress in context, and aids in the creation and retention of memories. The reverse is true as well: Insufficient sleep triggers or worsens conditions including mental fog, memory decline, heart disease, obesity, diabetes, and stroke.

Science is becoming increasingly clear on the matter: “Nearly every disease killing us in later life has a causal link to lack of sleep,” said Matthew P. Walker, the senior author of a recent article on older adults and sleep, “Sleep and Human Aging,” and a UC Berkeley professor of psychology and neuroscience. “We’ve done a good job of extending life span, but a poor job of extending our health span. We now see sleep, and improving sleep, as a new pathway for helping remedy that.”

According to the article by Walker and his fellow sleep medicine researchers, which appeared in the April edition of the journal Neuron, sleep deprivation in the elderly is common and it causes harm—but it can and should be addressed and remedied. The authors concluded that “older adults do not have a reduced sleep need, but rather, an impaired ability to register and/or generate that unmet sleep need.” If an older adult’s sleep suffers from issues such as frequent bathroom trips, periods of wakefulness, hip pain, sleep apnea, worry over matters related to health or retirement, that is a sign that these matters need to be attended to.

Another reality that makes sleep at a later age difficult is that as we age it gets harder to regulate the neurochemical that stabilizes sleep (galanin) and the neurochemical that helps transition from sleep to waking states (orexin). “A disruption to the sleep-wake rhythm commonly leaves older adults fatigued during the day but frustratingly restless at night,” according to Walker’s colleague Bryce Mander.

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Image: UC Berkeley

What parts of sleep get more difficult as we age? All of them, unfortunately: the quality and the quantity. The sleep becomes more fragmented, and we get less of it—especially the health-inducing slow-wave sleep. But, contrary to a popular saying, you cannot sleep when you’re dead. The time to get sleep is now, so you can lead as healthy and long a life as possible.

What Can Older Adults Do to Get More Sleep?

The good news is that there are always things to tweak in your sleep routine that can help you catch some zzs. Of course, you can be like 20 percent of older adults do, and rely on sleeping pills. Prescription medications like Ambien do work in the short run, so if you are dealing with a crisis, they can be of help. But in the long term, your body’s tolerance to them goes up and they lose their potency (plus the side effects can be troubling).

Instead, do what you can to follow a healthy sleep hygiene. Even minimal adjustments can go a long way toward sleeping better.

  • Talk to your doctor about secondary insomnia, or sleep deprivation brought on by various illnesses, ailments, or medication side effects. “Insomnia is more common for seniors, partly because of health issues, partly because of the anxiety and the concerns of aging, and sometimes because of medication,” says Jack Gardner, a sleep medicine neurologist at Baylor Medical Center in Waxahachie, Texas.
  • Sleep medicine specialists advise putting lit screens (computers, tablets, phones) away two hours before bedtime. At the very least, set your devices on night shift mode or use an app that curbs the wakefulness-inducing blue light.
  • Aim to go to bed at the same time each night.
  • Try to empty your bladder before falling asleep.
  • Do not use alcohol as a sleeping aid. Two drinks or more can help you fall asleep faster, but it will backfire: the arousals that happen after you metabolize alcohol can wake you up in the middle of the night and undermine the quality of your sleep.
  • Sleep in a dark, quiet, and cool room. If you share a bed with a partner who snores, use earplugs designed specifically for sleeping with a snorer or other options, like white noise, to prevent waking up.
  • Invest in a comfortable mattress. If you have arthritis or back pain, pay attention to proper alignment and pressure points when choosing a mattress.
  • Consider mindfulness meditation, which has been linked to deeper and more restful sleep because of how it trains us to disconnect from stress and worry.
  • Exercise during the day. You are never too old to practice safe weight-bearing exercise. The higher your muscle volume, the better your body’s thermoregulation, which plays a role in helping you fall and stay asleep. (When the body’s temperature goes down slightly, it results in drowsiness. When it slightly goes up in the morning, it wakes us up.)
  • Ask your doctor about natural supplements such as melatonin, valerian root, and medical marijuana.
  • Do something before bed that rarely fails to make you feel calm—light a candle, take a bath, talk with a friend, read a book, sit on the bench outside your home. You are more resourceful than you might think.

Agnes Green is a researcher for the sleep hub Tuck.com. She holds two master’s degrees in the social sciences from the University of Chicago and Northwestern University. She sleeps best after a kettlebell workout, with a window slightly cracked in a dark room, and on a medium-firm mattress in Portland, Oregon.

Tuck Sleep Foundation is a non-profit community devoted to improving sleep hygiene, health and wellness through the creation and dissemination of comprehensive, unbiased, free web-based resources. Tuck has been featured on NPR, Lifehacker, Radiolab and is referenced by many colleges/universities and sleep organizations across the web.

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