Sleep is a basic human right. We all do it, and by the time we’re 65 we will have slept approximately 22 years! But as we get older sleep typically becomes lighter and more fragmented. Many also experience early morning awakenings and increase in daytime sleepiness or napping. This has been related our changing physiology and an increased likelihood of clinical sleep disorders, as well as the impact of other health conditions, waking habits, and changing lifestyle.
We all have an internal body clock in the brain which helps keep our sleep, among other things, in time with the outside world. It is regulated by our exposure to light, activity, eating and so on. With ageing, the internal body clock deteriorates so the timing of sleep becomes less regular and we are more likely to wake up in the night as well as fall asleep in the day. Across the night we go through stages of light, deep and dreaming sleep. As we age, sleep typically becomes lighter in quality which means we’re more easily woken in the night and can feel less alert in the day.
Around 20-30% of the New Zealand population report a sleep problem. The most common problems are insomnia and obstructive sleep apnoea. Insomnia is defined by not being able to get to sleep or stay asleep. This can increase with ageing because of sleep being lighter and more easily disturbed. How we use medications, bright screens or caffeine and other stimulants can also make it harder to get to sleep. Furthermore, changes to lifestyle or responsibilities for example with retirement, caregiving or bereavement can lead us to become worried sleepers. Often insomnia is a short-term issue, related to something happening in waking life but for some it can become a long-lasting issue.
Obstructive sleep apnoea is defined by pauses in breathing during sleep typically accompanied by snoring and daytime sleepiness. As we age this becomes more likely due to softening of the airway, hormonal changes, as well as impacts of weight gain and other respiratory conditions. This can be more difficult to recognise as it occurs while you’re asleep! Other issues people report with their sleep include restless or twitchy legs, confused awakenings, sleep-talking, or increased toilet visits.
The importance of sleep
Disrupted sleep not only causes daytime sleepiness but also effects our mood, eating habits, memory and functioning. Poor sleep can contribute to other medical conditions like cardiovascular disease and dementia. Furthermore daytime sleepiness increases the likelihood of social isolation, driving accidents or falling. In our increasingly round-the-clock society, sleep time is often compromised for other activities we need or want to do. But sleep needs to be recognised as a natural tonic for us to lead healthy and productive lives. Prioritising our sleep can not only improve our feelings of alertness but also helps with our body’s metabolic processes and healing, our brain’s ability to learn and maintain memories, and supports good mental health and social wellbeing.
It is important to try and preserve good sleep to maintain healthy ageing. This can be achieved through keeping a regular routine across the week and making sure you spend some daytime in bright light and exercising to strengthen the internal body clock. Some people use medications in an attempt to resolve insomnia. Although these may be useful for a short period, their success rate is varied and the side effects can outweigh the benefits so it is always worth consulting your doctor before using. Instead consider adjusting routines, behaviours or thought processes to try and help. Some hints and tips for promoting good sleep include:
- Avoid eating or drinking too much before bed (but also avoid going to bed hungry)
- Avoid alcohol, cigarettes or caffeine before bed
- Have a relaxing pre-sleep routine to help mind and body relax and fall asleep
- Keep the bedroom a “safe sleep” zone for example:
- appropriate lighting for sleep and safety
- block out disturbing noise
- avoid watching TV, or listening to radio in bed
- make the bed nice and comfortable
- check your bedroom is a comfortable temperature
- If you don’t fall asleep in about 20 minutes, get out of bed and spend a little time doing a relaxing activity before going back to trying to sleep
Source: National Sleep Foundation
If you have a long-lasting sleep condition, feel excessively sleepy in the day or think you have obstructive sleep apnoea consult your doctor who can advise and refer you to a sleep clinic if necessary.
Dr Rosie Gibson is a Researcher at the Sleep/Wake Research Centre, Massey University, Wellington, where she conducts projects related to sleep and healthy ageing as well as the changes to sleep with dementia and family care. Sleep awareness week is in March. Rosie will be presenting on the topic of sleep and ageing across Wellington.