Sleep Changes in Older Adults
By Alan Peterson, M.D.
What Sleep Changes are Common in Older Adults?
Older adults might get sleepy earlier in the evening, or they may have trouble falling asleep when they go to bed. They might not stay asleep all night. They might wake up very early in the morning and not be able to go back to sleep. These problems can make older people very sleepy in the daytime.
What Causes Sleep Problems?
Many things can cause sleep problems. By the time an adult is 65 years old, his or her routine asleep/awake cycle may not work as well as it used to. Some habits like smoking and drinking alcohol or caffeine can cause sleep problems also. Sleep problems may be caused by being sick or by pain that keeps a person from sleeping.
Medicines also can keep a person awake. People of all ages can have a sleep disorder such as sleep apnea, restless leg syndrome, or periodic limb movement disorder.
What Is Sleep Apnea?
People with sleep apnea stop breathing for 10-30 seconds during sleep. Then they start breathing again with a usual gasp. This can happen hundreds of times in a night. Every time this happens, it makes the person wake up a little bit. People with sleep apnea usually snore very loudly.
Sleep apnea can cause daytime sleepiness. It also can make high blood pressure and heart disease worse. Also during the apnea episodes, the oxygen content of the blood can dip, sometimes severely. This can sometimes increase the possibility of heart arrhythmias. These heart irregularities can sometimes be severe enough to cause death, in the most severe cases.
If you have sleep apnea and are overweight, it might help to lose weight. Sleeping on your side and not drinking alcohol and not using sleep medicines can also help. Many people with sleep apnea need to wear a special breathing mask at night to keep their airways open. This is called “continuous positive airway pressure” or CPAP for short. It can help you breathe normally during sleep. Surgery can help some people with sleep apnea.
What Is Restless Leg Syndrome?
This is a “creepy-crawly” feeling, mostly in the legs. It makes you want to move your legs or walk around. It may be worse in the evenings when your legs are at rest. It usually happens every night and may start after you get in bed. This feeling may keep you from falling asleep. Older adults are more likely to have this problem.
If you have restless leg syndrome, using hot or cold packs on your legs or taking a hot or cold bath might help. If you have other significant medical problems such as arterial disease, or diabetes, or blood pressure problems, you may want to discuss some of these with your physician before you try them. Some people find it helpful to do exercises or stretching to relax. You can try rubbing your legs, feet, and toes before going to bed. Certain medicines may help people who have restless leg syndrome. Your doctor will decide if using medicine is the right treatment for you.
What Is Periodic Limb Movement Disorder?
A person with this disorder kicks one or both legs many times during the night. Often the person doesn’t even know about the kicking unless a bed partner talks about it. It can get in the way of good sleep and cause daytime sleepiness. Some people with restless leg syndrome also have periodic limb movements during sleep.
What Can I Do to Sleep Better?
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.