A Good Night's Sleep
National Institute on Aging
Since he retired, Edward dreads going to bed at night. He's afraid that when he turns off his light he will just lie there with his eyes open and his mind racing. "How can I break this cycle", he asks. - "I'm so tired - I need to get some sleep."
Just like Edward, you want a good night's rest. Getting enough sleep helps you stay healthy and alert. But many older people don't sleep well. If you're always sleepy, it may be time to see a doctor. You shouldn't wake up every day feeling tired.
Sleep and Aging
Older adults need about the same amount of sleep as young adults - between 7 - 9 hours each night. But older people tend to go to sleep earlier and get up earlier than they did when they were younger. And they may nap more during the day. If you sleep too much during the day, it may be hard to fall asleep at night. Also, feeling sick or being in pain can make it hard to sleep. If you don't get a good night's sleep, the next day you may be:
- likely to have more falls or accidents
There are two kinds of sleep - REM (rapid eye movement) sleep and non-REM sleep. We dream mostly during REM sleep, and have the deepest sleep during non-REM sleep. As people get older, they spend less time in deep sleep, which may be why older people are often light sleepers.
Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling and staying asleep. Insomnia can last for days, months or even years. If you're having trouble sleeping, you may:
- take a long time to fall asleep
- wake up many times in the night
- wake up early and be unable to get back to sleep
- wake up tired
There are many causes of insomnia. Some of them you can control, but others you can't. Insomnia may be a sign of other problems. If you are excited about a new activity or worrying over your bills, you may have trouble sleeping. Sometimes insomnia is a side effect of a medication or an illness. Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. Worrying doesn't help, and it may make insomnia worse.
Older adults who have trouble sleeping may have memory problems, be depressed, have more nighttime falls, use more over-the-counter sleep aids, or feel very sleepy during the day. Using prescription medicines for a short time may help. But remember, these medicines aren?t a cure for insomnia. You need to develop habits that will help you get a good night's sleep.
Sleep apnea is another serious sleeping disorder. A person with sleep apnea pauses in his or her breathing while sleeping. These pauses may happen many times during the night. Waking up over and over each night makes you feel very tired the next day.
You may not even know you have sleep apnea. But your loud snoring and gasping for air can keep other people awake. Feeling sleepy during the day and being told you are snoring loudly at night are signs that you may have sleep apnea.
If you think you have sleep apnea, see a doctor who knows about sleep problems. Treatment may include learning to sleep in a way that keeps your airways open. Sometimes a medical device called Continuous Positive Air Pressure (CPAP), a dental device, or surgery can help. If not treated, sleep apnea can lead to other problems such as high blood pressure, stroke, or memory loss.
Restless legs syndrome and periodic limb movement disorder are common in older adults. Some people have both problems. These movement disorders can rob you of needed sleep. People with restless legs syndrome, or RLS, feel tingling, crawling, or pins and needles in one or both legs. It's worse at night. Moving the legs brings some relief, at least for a short time. RLS tends to run in families. See your doctor for more information about a new medicine called ropinirole to treat RLS.
Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20 - 40 seconds during sleep. Some people have hundreds of these movements each night, which may result in loss of sleep and feeling tired and sleepy the next day. Medication, warm baths, exercise, and learning to relax can help.
A Special Problem -Alzheimers Disease and Sleep
Alzheimer's disease often changes a person's sleeping habits. For example, some people with Alzheimer's disease sleep too much; others don't sleep enough. Some people wake up many times during the night; others wander or yell at night. The person with Alzheimer's disease isn't the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired and out of sorts.
If you're caring for a loved one with Alzheimer's disease, there are steps you can take to protect his or her nighttime safety. Try the following:
- Put a gate across the stairs.
- Make sure the floor is clear of objects.
- Lock up any medicines.
- Put grab bars in the bathroom.
- Put a portable toilet in the bedroom.
Suggestions for a Good Night's Sleep
Being older doesn't mean you have to feel tired all the time. There are many things you can do to help you get a good night's sleep. Here are some ideas.
- Follow a regular schedule. Go to sleep and get up at the same time each day, even on weekends. Napping in the late afternoon or evening may keep you awake at night.
- Develop a bedtime routine. About 30-45 minutes before bedtime do the same things each night so your body will know that it's time to sleep. Some people watch television, read a book, listen to soothing music, or soak in a warm bath.
- Your bedroom should be dark, not too hot or too cold, and as quiet as possible.
- Be sure you have a comfortable mattress, a pillow you like, and enough blankets for the season.
- Exercise at regular times each day but not within 3 hours of your bedtime.
- Make an effort to get outside in the sunlight each day.
- Be careful about when and how much you eat. Large meals close to bedtime may keep you awake, but a light snack in the evening can help you get a good night's sleep.
- Stay away from caffeine late in the day. Caffeine (found in coffee, tea, cola, and hot chocolate) is a stimulant that can keep you awake.
- Drink less liquid in the evening. Waking up to go to the bathroom and turning on a bright light breaks up your sleep.
- Remember that alcohol won't help you sleep. Even small amounts make it harder to stay asleep.
- Use your bedroom only for sleeping. After turning off the light give yourself about 15 minutes to fall asleep. If you're still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.
Try to set up a safe and restful place to sleep. Make sure there are smoke alarms on each floor and lock up the house before going to bed. Other ideas for a safe night's sleep are:
- Keep a telephone with emergency phone numbers by your bed.
- Have a good lamp that turns on easily within reach.
- Put a glass of water next to the bed.
- Use nightlights in the bathroom and hall.
- Don't smoke, especially in bed.
- Remove area rugs so you won't trip if you get up in the middle of the night.
- Don't fall asleep with a heating pad on; it may burn.
There are some tricks to help you fall asleep. You don't really have to count sheep - just try counting slowly to 100. Some people find that playing mental games makes them sleepy. For example, tell yourself it?s 5 minutes before you have to get up and you're just trying to get a few extra winks. Other people find that relaxing their body puts them to sleep. You might start with your toes, and tell yourself that your toes are relaxed and sleepy. Work your way up the rest of the body saying the same words. You may drift off to sleep before getting to the top of your head.
Sleep problems can cause you to feel bad, but there are changes you can make to get a better night?s sleep. If you feel tired and unable to do the things you usually do for more than 2-3 weeks, see a doctor.
For more information on health and aging, contact:
Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This simple-to-use website features popular health topics for older adults, including information on using medicines safely. It has large type and a 'talking' function that reads the text aloud.
National Institute on Aging U. S. Department of Health and Human Services Public Health Service National Institutes of Health December 2005 Web page last updated: February 23, 2006