Common Sleep Problems in the Elderly

Everyone has trouble sleeping from time to time. Stress, a large meal, too much coffee or even too much time spent watching TV can lead to a night or two of lost sleep. As we get older, it’s normal to experience some changes in sleep habits. You may get tired a little earlier in the evening, start waking up earlier in the morning or feel like you spend less time in deep sleep.

But some sleep problems in the elderly, especially if they happen frequently, indicate a more serious issue. If you are waking up tired every day or finding it difficult to fall asleep (insomnia) or stay asleep most nights, you may experience mood swings and memory problems, find yourself withdrawing from favorite activities due to tiredness, and even experience physical aches and pains. Sleep is very important to your physical, mental and emotional health.

With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly,  researchers are focused on determining associations between sleep and cognitive decline. If you are one of the estimated 60 million Americans who suffer from insomnia, early research investigating a potential link between a lack of sleep and Alzheimer’s disease might be troubling.

What Causes Lack of Sleep in Elderly People?

It’s a good idea to look at lifestyle first if you or an elderly loved one is not sleeping at night. Large amounts of coffee are often linked to insomnia and other sleep problems, anxiety and agitation. All of these conditions are also known to contribute to high blood pressure. 

Can certain beverages and snacks fight fatigue? Many people think that drinking lots of caffeine or loading up on sugary snacks can compensate for stress and too little sleep. In addition to caffeine’s known sleep-disturbing effects, studies show that eating less fiber, more saturated fat and more sugar throughout the day was linked with lighter, less restorative sleep and more awakenings throughout the night.

Lack of exercise can also be a factor in elderly sleep disorders. Moderate-intensity aerobic exercise, like walking, has been shown to reduce the time it takes someone to fall asleep and increase the length of time a person sleeps before waking. Exercise can improve your mood and reduce stress. It can also strengthen your circadian rhythms, promoting daytime alertness and sleepiness at night. Plus, if you’re not staying active, it may mean you’re spending too much time in front of the TV, computer or smartphone. Not only can these devices distract you from quality sleep late at night, but they emit blue light, which your body interprets as daylight, signaling you to stay awake. 

Drinking alcohol before bed, taking too many naps during the day or staying in bed when you’re not sleeping can also negatively affect sleep patterns. If you take medications, ask your doctor if they may be affecting your sleep quality and, if so, what you can do to offset that side effects.

Certain physical conditions can also lead to sleep problems in the elderly. These include:

• Sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts
• Restless legs syndrome, which causes unpleasant or uncomfortable leg sensations and a strong urge to move 
• Periodic limb movement disorder, which causes repetitive cramping or jerking of the legs during sleep
• Circadian rhythm sleep disorders, which involve a problem in the timing of when a person sleeps and is awake
• REM sleep behavior disorder, in which you physically act out vivid, often unpleasant dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep

In some cases, ongoing sleep problems can be a sign of medical conditions like Parkinson’s disease, Alzheimer’s disease or other forms of dementia, cardiovascular disease, neurological conditions, lung or respiratory conditions, gastrointestinal conditions, chronic pain from conditions like arthritis, or bladder problems. 

If you suspect one of the more serious sleep problems mentioned above or have symptoms of another medical condition, talk to your doctor.

When to Be Concerned

While occasional sleep problems are perfectly normal, you may want to talk to a doctor if you or an elderly loved one are not sleeping at night, are frequently tired during the day despite seven or more hours of sleep or have a reduced ability to perform regular daytime activities. 

Red flags of a more serious elderly sleep disorder, or a medical condition affecting sleep, include:

• Difficulty concentrating
• Memory problems
• Slowed physical and mental responses
• Poor emotional control
• Changes in your physical appearance
• Falling asleep while driving
• Struggling to stay awake while reading, watching TV or relaxing
• Other symptoms like chronic pain, clumsiness, trouble breathing or visiting the bathroom excessively

Managing Elderly Sleep Deprivation

If you suspect a sleep problem in an elderly loved one or yourself, look at lifestyle and sleep environment factors first. Avoid excessive amounts of caffeine, alcohol, sugar and fatty foods, especially late in the day. Try to eat a healthy diet and get some moderate exercise. Make sure your sleeping environment is a comfortable temperature, dark and free of distractions. Try to reserve your bed for sleep, instead of watching TV or reading. If you can’t fall asleep, get up and go elsewhere in your home to do a relaxing activity.

Consider if there are any unusual stresses or worries that may be playing a part in your sleep problems. If so, talk to a family member, friend, doctor or therapist. Yoga, meditation, long walks and hobbies also help some people manage stress more effectively. Try to relax before bed with a warm bath or shower or by listening to calming music.

Keep a sleep diary to identify patterns and problems you can share with your doctor, if needed. Your doctor may recommend a sleep study if you or a loved one is having frequent issues, which can lead to a diagnosis and better forms of treatment for your problems. If other symptoms are present, make an appointment for a physical examination.