As we age sleep patterns change. In this article, caregivers can find some helpful advice for dealing with age related sleep changes in the elderly.
Sleep is divided into two states:
- Rapid Eye Movement or REM sleep, which is associated with dreaming
- Non-Rapid Eye Movement or non-REM sleep, which is further divided into stages 1, 2, 3, and 4 and progresses from light sleep (stage 1) to deeper stages of sleep (stages 3 and 4)
REM and non-REM sleep alternate throughout the night in a cyclical fashion, however, this sleep architecture is known to change with age.
Baby Sleep Patterns - When we are babies, we sleep often and the sleep pattern is not very regular—ask any mother. Then gradually a pattern of sleep develops partly through routine and partly through a natural sleep rhythm called “circadian rhythm.”
Adolescent Sleep Patterns – Today’s research suggests this circadian rhythm sleep pattern changes again when we are adolescents—where sleep is delayed until late at night and extends into the daytime hours requiring about seven to nine hours of sleep. Adolescents experience deeper sleep and they are not usually disturbed by noise.
As we get older this circadian rhythm sleep pattern changes again.
Elderly Sleep Patterns – Older adults and seniors spend more time in stage 1 than younger adults so are awake more often during the night. Older adults also experience a decrease in stages 3 and 4, the periods of deep sleep that provide the most restorative sleep. The amount of time in REM sleep stays about the same but occurs earlier in the sleep cycle.
The strength of the circadian rhythm declines with age because of diminished body temperature and melatonin. So, as we get older, we experience lighter and more interrupted sleep and this may cause early awakening. These disturbances may result in coping problems for the older adult and lead to the use of over-the-counter sleep aid medications.
Sleep change in the elderly is common and some red flags for sleep disturbance that caregivers can keep on the look out for include:
- Elders who are having difficulty getting to sleep
- Early morning awakenings
- The inability to get back to sleep during the night (lasting longer than an hour)
These are red flags and should be reported to your care person’s physician as they are often associated with depression, pain, and/or other medical conditions that the elderly may be experiencing and can be easily treated.
Caregiver Tips: How to Improve Sleep
Here are some suggestions for caregivers on good sleep hygiene from the Sleep Foundation:
- Keep to a good sleep routine even on weekends
- Have a bedtime ritual
- Exercise daily
- Sleep on a comfortable mattress
- Avoid alcohol and caffeine before sleep
- Turn off electronics before bed
- Get at least two hours of sunlight a day to stimulate the production of melatonin, which helps regulate your sleep
- Sleep in a cool and dark room
- Use the bedroom for sleep and intimacy only
In adults, the normal recommended amount of sleep time is generally about 7-9 hours of sleep per night depending on the individual. Elderly sleep patterns can also be affected by health issues.
National Sleep Foundation
National Institute on Aging