Sleep and Aging

Last week I gave an in-service at a rehab facility about sleep and aging. I thought I would put the highlights here.

There are several changes in sleep structure and quality that occur with aging. For many people, especially after age 65, they develop more problems starting and staying asleep. Their sleep is less deep, making it easier to wake up in the middle of the night. There is a shift in their sleep times, going to bed earlier and getting up earlier - the morning lark. Sleep amount does not go down, as is commonly thought. In fact, people over age 65 sleep a little more due to napping. Most of use will sleep the least from age 35-55, which is usually our most productive working years.

There are several sleep disorders that occur more frequently with age. The most common one is insomnia. Medical illness like chronic pain, diabetes, prostate disease, COPD, heart disease, reflux disease, dementia, and psychiatric disorders like depression can contribute to insomnia. Caffeine, alcohol, and nicotine intake close to bedtime can make it difficult to sleep.

Restless legs are more frequent as we age and can be made worse by certain medications, anemia, kidney disease, rheumatoid arthritis, or neuropathy.

Finally, snoring and obstructive sleep apnea (OSA) increase with age, regardless of weight. In those with underlying heart or neurological disease (like stroke), some patients develop central sleep apnea, which is different than the more common OSA.

My point to the residents and employees of the rehab hospital is that it can be difficult to tell if the sleep problem is from aging or an underlying sleep disorder. Hopefully, patients will seek appropriate medical care to figure that out.