From the time we’re born, our bodies are in a constant state of change. Chronologically, age is just a number, but the way your body changes as you age can depend on many factors, including genetics, diet, health history, lifestyle, and yes, of course, sleep.
Not only that, but sleep itself also changes as you age. While some adults may sleep just as well as they did as a child, others may find that sleep becomes more challenging with older age. While it’s recommended that adults get seven to nine hours of sleep each night, many older adults get much less than that. Here’s how sleep changes and which factors could most affect sleep as people age.
Age changes our bodies and our sleep
While there’s no way to know if you will struggle with sleep as you get older, sleep does change as our bodies age.
Since our bodies technically begin aging at birth, aging is often broken into three categories: the earliest years of development; the maturation of older children, teenagers, and young adults; and the aging that occurs beginning in our 30s — called senescence. However, most research specific to aging focuses on people ages 65 and older, which is when the body begins to slow, affecting many internal systems, as well as the senses.
Your sleep time is never higher than as a newborn. “With every decade of age from childhood to age 60, we sleep about 10 minutes less than the previous one,” says Dr. Jacob Teitelbaum, sleep specialist and author. “In addition, as people age, it’s harder to fall — and stay — asleep, and they spend less time in the deep restorative stages of sleep. But these changes plateau once we reach about 60 years of age, without further worsening. On the other hand, when we get over 60, we are more likely to add a nap during the day to compensate.”
Why sleep changes as we age
Though the amount of sleep we need does not decrease with age, as people age, they may find it more difficult to get to sleep, stay asleep at night, or stay awake during the day. This is often the result of physical, hormonal, and psychological changes that occur in the body over time.
Dr. Chester Wu, a Houston-based psychiatrist and sleep specialist, adds that many of the physical changes that come along with aging can impact sleep, such as decreased sensitivity to light, which causes a shift of the circadian rhythm to an earlier bedtime and wake time. Sleep disruptors for older people often include waking during the night to use the bathroom. Aging also leads to loss of muscle mass and bone density, which can make it more difficult to get comfortable in bed. The changes that occur with our circadian rhythm as we age can cause fluctuations in the levels of the hormones that regulate our sleep.
“Older adults tend to wake up more frequently throughout the night and frequently spend more time in lighter stages of sleep and less time in deeper, more restorative stages of sleep,” says Wu. “More nighttime awakenings and greater daytime sleepiness come from a ‘flattening’ of circadian rhythms that lessens the circadian drive for sleep, which helps keep us asleep during the night.” Ultimately, the circadian rhythm is disrupted by frequent waking, which causes melatonin levels to become misaligned.
Melatonin is the sleep hormone that is made by the pineal gland in the brain and helps bring on sleep. Cortisol, the stress hormone, also helps control sleep-wake cycles by decreasing in the evening and rising as your body nears wake-up time. Cortisol levels increase as we age, causing decreased sleep.
Changing habits during the day can also affect sleep at night, including decreased activity levels or exercise, and, for some, less exposure to the sun.
How health and lifestyle changes can impact your sleep
Common health conditions can also put a strain on the sleep cycle, including arthritis and restless leg syndrome.
“Chronic health conditions, such as heart disease, arthritis, and sleep apnea, make getting to sleep and staying asleep more difficult due to pain, difficulty breathing, or difficulty getting comfortable,” says Wu. “Medications like some antidepressants, blood pressure medications, and pain relievers can interfere with sleep.” Additionally, typical biological processes can affect sleep. “Menopause may usher in its own set of sleep problems that include insomnia, hot flashes, and sleep apnea,” he explains.
Sadness and routine changes may not be directly health-related but can bring about sleep issues. “Changes in daily routines, say from retirement, and social engagements, whether due to retirement or loss of friends, can affect sleep patterns,” continues Wu. “A lack of physical activity (voluntary or involuntary) can lead to poorer sleep quality due to a decrease in energy used by the body.”
“Untreated pain makes it hard to fall and stay asleep, but most pain can be effectively treated. Lack of sleep then triggers a vicious cycle with worsened pain,” Teitelbaum says. “Other common conditions that disrupt sleep are prostate enlargement and bladder spasticity, which cause frequent nighttime urination.”
Good practices for healthy sleep as you get older
The good news is that creating good routines and consistent sleep hygiene can help sleep come easier, even as you age.
Set a bedtime routine
Teitelbaum suggests creating a soothing routine: “Develop a calming sleep routine to help you fall asleep and signal the body to shift into sleep. We know the importance of this bedtime routine when raising children but often fail to realize that it is equally important in adults.”
Wu also stresses the importance of a consistent sleep/wake schedule. “Maintain a regular sleep schedule: Going to bed and waking up at the same time each day can help regulate your body's circadian rhythms. Create a restful sleeping environment: Keep your bedroom dark, quiet, and cool. Use a fan or white noise machine if needed. Create a relaxing bedtime routine that helps you wind down before bed: This may include taking a warm bath, reading a book, or listening to calming music.”
Make small adjustments in your lifestyle
Sometimes the solution to your sleep problems may be as simple as making a small change to your daily routine. Exercising regularly can help you fall asleep faster and enjoy deeper sleep. Turning off the TV earlier could help cue melatonin production.
Limit daytime naps
Long daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to about 20 to 30 minutes and make it during the mid-afternoon, not too late. If you find yourself wanting to nap in the morning or sleep for longer periods, bring this up to your health care professional.
Limit alcohol and caffeine
Caffeine is a notorious stimulant, and while alcohol can make you drowsy, it diminishes the quality of your sleep, decreasing your rapid eye movement (REM) sleep.
Try adding a supplement
“Adding melatonin, a cup of chamomile tea (not teabags that have chamomile dust, but rather the loose-leaf tea that has the active buds), and numerous other herbals can be very helpful for sleep in those who need them,” says Teitelbaum. “These are less likely to pose the risks seen using sleep medications in the elderly.”
Talk with your doctor
If you struggle to get enough quality sleep, talk to your doctor about what you can do. Wu notes there may be a medical problem or medication causing the sleep disruption. You should be evaluated by your health care provider to rule out or treat any underlying problems. You can also determine whether there is a need for sleep medications or natural efforts to help improve your sleep.
There are a number of factors that impact sleep as people age. While not every aging adult is losing sleep, many do. Health, lifestyle, and other problems can directly impact sleep. Many find sleeping through the night challenging and making it through the day awake even more difficult. Fortunately, there are steps you can take that may help improve your sleep. Remember to contact your health care provider if you are concerned about your health or sleep status.
