Sleep Well At Every Age

By Madeline Vann, MPH
Medically reviewed by Farrokh Sohrabi, M.D.

Sleep patterns often change with age, even though little has changed but the increasing number of candles on your cake. You might get tired early, wake up early, and feel like napping in the afternoon -- and worry that you aren't sleeping well or getting enough rest. Some of your concerns can be allayed just by learning which changes are actually quite normal and adopting strategies to get better sleep.

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Sleep needs do change over the course of a lifetime. Babies sleep for 16 hours a day, for example. Although for most of your adult years you probably aimed for (and generally got) seven or eight hours a night, as you get older, the amount of sleep you get goes down.

“A meta-analysis demonstrated that the amount of sleep we have decreases by approximately 10 minutes per decade up to the age of 60, and that this decline is more pronounced in men compared with women,” said Bradley Edwards, Ph.D., sleep expert, CJ Martin Overseas Research Fellow, and instructor in medicine in the division of sleep medicine at Brigham and Women's Hospital and Harvard Medical School in Boston.

Having realistic expectations is key. The normal changes in sleep for seniors can include:

• Sleeping for less time
• Taking longer to get to sleep
• Waking up more often at night
• Waking up earlier
• Feeling sleepy earlier
• Napping in the afternoon

The problem for many older adults is that they don't expect or accept these changes. Instead, “they begin to worry about their sleep, which can lead to real concern, even when their sleep is not at all abnormal,” said Dan G. Blazer, M.D., Ph.D., geriatrician, psychiatrist and vice chair of faculty in the department of psychiatry and behavioral sciences and in academic development at Duke Medicine in Durham, N.C. Worry is also an enemy of optimal sleep. Sleep remains essential to mental and physical health even as the decades roll by, he pointed out.

But one of the most inconvenient sleep changes, explained Edwards, is that older adults have an advanced sleep phase. This is what causes you to want to go to bed early in the evening -- as early as 7 p.m. -- and get up early in the morning. For many people, this schedule conflicts with the general sleep/wake cycle everyone else is on. So for sociable individuals who have dinner and evening plans with friends or family, this sleep trend can become a big conflict. Staying up past the time when you want to go to sleep can lead to difficulty with your sleep cycle and daytime sleepiness and a desire to nap.

To Nap or Not to Nap?
Napping in the afternoon has been hotly debated amongst sleep and aging experts. Afternoon sleepiness isn't unusual as you get older, but not everyone should give in to a nap, said Edwards. “The recommendations for whether napping during the day is advisable will depend on the individual's medical history,” he explained.

In general, people who want better sleep at night should avoid napping, regardless of age, and should focus on better sleep at night. You should avoid napping if you've been diagnosed with insomnia because it interferes with your body's natural sleep rhythms. However, for many older adults, especially those who just aren't getting enough sleep at night, napping during the day is fine as long as the naps are relatively short -- 30 minutes or so -- and you take one early in the afternoon, closer to lunch than dinner. Otherwise, you can fall into a cycle of daytime napping and poor nighttime sleeping.

How to Get Better Sleep
Sleep specialists often talk about sleep hygiene, a term that refers to the habits you can develop for quality sleep. Try these sleep hygiene tips to make the most of your shuteye:

Limit naps. Keep them early in the afternoon and short, if you really need them.

Keep a consistent sleep/wake schedule. Accept that you want to sleep less, but stick to a set bedtime anyway. Going to bed early one night and then late the next makes sleep more difficult over time.

Avoid alcohol, caffeine and tobacco. Alcohol is a depressant, while nicotine and caffeine are stimulants, but they all can add up to poor sleep quality. Keep caffeine to morning hours only and cut back or quit the other two items.

Be active during the day. “Exercise is important, but not after 7 or 8 at night,” said Blazer.

Use your bed for sleep or sex only. Don't watch TV, work, or do projects in bed.

Turn the clock away from you. Avoid looking at the clock when you wake up at night. Knowing what time it is, and how often you are waking, just makes you feel worse.

Keep your bedroom cool. “The mid-70s is a reasonable goal,” advised Blazer. Cooler is fine, if you prefer. We all sleep better in cooler air at night. The problem is that many older people keep their homes warmer and have to make a point of cooling it off at night.

Organize your worrying. Worry can keep you up late and wake you up as well. If worries are interfering with sleep, try writing them down well before bed and promising yourself you'll get back to them after you're rested.

Keep your room dark. You might want a flashlight nearby in case you have to get up at night, but your sleep will be best if you keep your room dark and avoid strong light (including blue light from screens) in the hour or so before bed.

Talk to your doctor. Sometimes sleep problems aren't simply due to age, but rather to health issues, such as chronic pain, depression, or true sleep disorders. Talk to your doctor about getting these conditions under control.

“If you can stay away from sleep medications, do so,” Blazer advised. But for some people, a small dose of an appropriate medication can help. You'll probably get the best results if you work with your doctor to find the best match rather than just popping an over-the-counter medication that promises some Zs.

You can't avoid the sleep changes that occur naturally with age, but with a little effort, you can get the most from the sleep you do get.

"The Seniors' Guide to Sleeping Well" originally appeared on Everyday Health.