When Carol Gee turned 55, she made a new
friend: 4 a.m. In the past, she usually slept through it. But
once she entered menopause, it became her new wake-up time. “I
would go to sleep and wake up every morning around the same
time, almost like you set the clock,” says Gee, who is now 68.
She’s not the only older adult to have experienced an
exasperating shift in her sleep cycles. In 2017, a national poll
conducted by the University of Michigan found that 46 percent of
adults 65 and older have trouble falling asleep on a regular
basis.
As people age, the body changes in all sorts of predictable
ways. Joints stiffen. Brains can slow. Wounds take longer to
heal. And sleep patterns shift, too. This can come as news to
many, says Michael V. Vitiello, a psychologist at the University
of Washington who specializes in sleep in aging.
The most noticeable — and often most aggravating — changes are
how sleep and wake-up times change and sleep gets lighter, often
beginning in middle age. Gone are weekend snoozes to 11 a.m. and
the ability to sleep through a noisy garbage truck down the
block.
The most common shift is a tendency to rise with (or before) the
birds. Circadian rhythm researchers call it “morningness,” and
have found that, not surprisingly, it tends to happen as
people’s preferred bedtime skews earlier with age. Scientists
have documented the changes in circadian rhythms that occur with
aging, but they are still learning why they occur, Vitiello
says.
Sleep architecture — the stages and depth of sleep — also
changes with age. Older adults take longer to fall asleep, and
they wake up more often. They tend to linger in the deepest
phases of sleep for less time than younger adults, and they get
less rapid eye movement sleep, too. While the exact purpose of
REM sleep is still unclear, it appears to be important for
memory and learning. Less restorative sleep at night can lead to
a tendency to nap during the day. (As long as naps aren’t so
long that they interfere with falling asleep at night, they’re
considered part of a normal sleep pattern.)
But not every restless night is benign. Studies have found that
poor sleep can pose a particular threat to older adults: Falls,
depression and anxiety, problems with memory, and increased
suicide riskare among the impacts of sleep issues in this
population group that researchers have found.
Some sleep disorders — REM sleep behavior disorder in which
people act out vivid dreams, circadian-rhythm sleep-wake
disorder, which causes a mismatch between a desired bedtime and
the body’s interest in sleeping, and sleep apnea, which causes
breathing to stop repeatedly during sleep — have been associated
with increased risk of Parkinson’s disease, Alzheimer’s and
dementia.
But as with changes in sleep architecture and timing, scientists
are still unsure why those risk associations exist. Kristine
Yaffe, a neuropsychiatrist at the University of California’s San
Francisco School of Medicine who specializes in dementia, warns
that there are more questions than answers when it comes to
dementia and sleep.
“If people have dementia, they tend not to sleep well,” she
said. “Do sleep problems actually lead to dementia? Sometimes
that’s hard to tease out.”
In a 2017 study in the journal Sleep, researchers found that
people with disrupted sleep had a 1.68 times higher risk of
cognitive impairment and/or Alzheimer’s than those without sleep
disruptions. But as the researchers made clear, there was no way
of knowing whether the sleep disorders are a cause of dementia
or just a symptom of dementia.
What is clear is the association between good sleep and
psychological well-being in older adults. A 2010 study
documented that association when it came to sleep quality, but
sleep quantity didn’t show the same effects.
And therein, experts say, may lie the key to understanding sleep
as you age. If you’re sleeping less, but don’t feel negative
effects out of bed, the changes you notice may just be normal
age-related. If you experience a sudden change in your sleep, or
poor or inadequate sleep is interfering with daily life,
altering your personality, or your bedmate says you stop
breathing when you snore, that could be a sign of something more
serious and it’s worth visiting your doctor.
Sometimes figuring out sleep is just trial and error, however.
Florine Salierno, 81, found that years of trying
over-the-counter products such as melatonin did nothing for her
insomnia, and she didn’t like the various medications she’d been
prescribed. Now, she follows her doctor’s suggestion of
meditating when she can’t get back to sleep, which she says
sometimes helps. Salierno can feel annoyed or even depressed by
a sleepless night but mostly she tries not to let it bother her.
Which matches up with what researchers say. Our bodies change
over the years and it’s normal for sleep to change, too.
“I think of it as tissue over time,” says Vitiello. “Can you run
the 100-yard dash or the 100-meter dash as fast as you could
when you were 18?”
Over time, he says, sleep patterns simply change. “A lot of
older adults recognize that they don’t sleep the same as they
did when they were 18, but they can still function and they’re
okay. And all is well with the universe.” |
