HAD a rough night’s sleep? You’re not alone. Around half of all Australians over 55 have some form of sleep problem.
But the good news is there are steps you can take to help you sleep soundly, according to Sleep Health Foundation chair, Emeritus Professor Dorothy Bruck.
“Part of dealing with sleep problems is realising that this is quite normal as we age,” Professor Bruck said.
“Your sleep does become a bit more fragmented as you get older. The problem is really if the lack of sleep affects you the next day.”
She said along with the physical changes that occur as we get older, changes to sleep patterns are all part of the normal ageing process. This includes getting to sleep as well as staying asleep.
Why is older people’s sleep different?
As we age our body makes less melatonin (the hormone that promotes sleep) so its more difficult to get off to sleep. Other factors may interfere with sleep and cause wakenings during the night.
These include hot flushes in post-menopausal women, the need to go to the toilet during the night and other medical problems such as arthritis that make it difficult to stay in one position for the whole night. In addition, after retirement many people find it convenient to take a short nap during the day.
Many diseases can also make it harder to sleep. Some that are common in older people are dementia and Alzheimer’s disease, arthritis, osteoporosis, Parkinson's disease, incontinence, indigestion, heart disease and lung diseases such as asthma or COPD.
The drugs used to treat these conditions may also interfere with sleep.
Anxiety and depression can both interfere with getting off to sleep as well as cause wakefulness during the night.
Some sleep disorders are more common in older people, including sleep apnea and periodic limb movement disorder, which affects about a one in four older people.
Insomnia is seen in four in 10 older people.
What can you do?
Luckily there are many simple things you can do to improve your sleep.
- Keep regular sleep hours. Try to go to bed at about the same time every night and get out of bed about the same time every morning. An alarm clock can help with this. Don’t go to bed too early and avoid sleeping in, even if you have had a poor night's sleep and still feel tired. “The important thing is to think about how many hours’ sleep you need and only stay in bed for that amount of hours,” Professor Bruck said. “People are often just spending too long in bed.”
- Turn off the TV. “Often we find that people start to get tired in the evening, so they either go to bed too early or fall asleep watching the TV,” Professor Bruck said. “Both are no-nos when it comes to good sleep hygiene. If you use the TV to get to sleep, then wake up, you don’t know how to self-soothe and get back to sleep.” She suggests planning what you’re going to do in the evening can help.
- Open the curtains. If you happen to wake early, think about getting out of bed and starting your day. “Open the curtains and get a bit of sunlight on your eyes,” Professor Bruck said. Regular sleep habits strengthen the internal body clock’s sleep-wake rhythm.
- Take care with naps. Most people sleep between seven and nine hours each day. However, older people may not have all their sleep at night, with around four in 10 older people taking at least one nap every day. Professor Bruck advises just taking a 20-minute nap, and no later than after 4pm. “We build up a sleep drive during the day, and it is important to stay awake in the evening.” Note that that sleep needs patterns change with age and circumstances.
- Take regular exercise. “Studies have shown how important physical activity is in getting good sleep, particularly for people with insomnia,” Professor Bruck said, adding that any form of exercise is better than no exercise, regardless of the time you do it.
- Try mindfulness. “As a sleep psychologist I recommend patients download free mindfulness apps such as Smiling Mind and Breathe2relax,” Professor Bruck said. “Studies have also looked at mindfulness and found they do really help when it comes to getting to sleep.”
When should I seek help?
“There is a high prevalance of sleep apnea after the menopause, so this is something that affects older women and men,” Professor Bruck said.
If your bed partner has overheard you having discontinuous breathing or loud snoring, it might be worth seeing a GP if the problem is persistent.
“Or if you’re waking up with a headache and feeling like you haven’t rested also see your doctor.”
Dr Bruck said sleeping tablets should be a last resort. “While they may be good for people who can’t sleep due to post-operative pain, or someone who is grieving, it’s not a good idea to go seeking them out.
“Instead think about good sleep hygiene, mindfulness and exercise.”
For more help, go to sleephealthfoundation.org.au