Senior Sleep Guide – A Safe Sleeping Guide for Seniors
Many people think that seniors need less sleep than the rest of the population. This myth is often perpetuated by the fact that many older people tend to get up earlier than average in the morning.
However, the truth is that seniors have the same sleep needs as other adults. This is somewhere between 7 and 9 hours a night depending on the individual. However, when people age changes in the body can make getting enough sleep far more difficult.
Insomnia is a common problem for seniors, which can quickly lead to feelings of exhaustion. All this sleep deprivation is not good for the health. The impact on individuals can be even greater if the person also has an underlying illness or is taking medicines known to interfere with sleep.
Although this may all sound like bad news if you’re a senior citizen struggling to get some much-needed shut-eye, there are plenty of safe and easy ways to improve sleep safely. Some methods involve making simple changes to lifestyle, while others require you to purchase certain products specially designed to improve sleep for seniors.
However, before we start looking at ways to improve sleep, we need to understand why your sleep needs change as you age. This allows seniors, and those that care for them in some circumstances, plan how best to address any sleep issues as they arise.
What Changes With Sleep as We Get older?
From the moment we’re born, our sleep requirements gradually change. New-born babies may sleep for around 17 hours a day. As we mature, we begin to need less and less sleep until we reach adulthood. By this stage, most people need somewhere between 7-9 hours of sleep per night.
Despite a common belief to the contrary, we continue to require this amount of nightly sleep in older age. However, there are various factors that make it harder for seniors to get the right amount of sleep than the rest of the population.
One of the reasons that it’s harder to get to sleep and stay asleep is that changes occur in our brains as we age. Some of the neurons responsible for sleep regulation die away. This makes it tougher to nod off in the first place and to maintain a state of deep sleep.
In comparison to young adults, it takes most seniors considerably longer to fall asleep at the beginning of the night. Unfortunately, they also enjoy less deep sleep altogether and are more likely to wake during the night.
Other factors affect sleep in seniors as well. Certain illnesses and health conditions can play a role as well. Some women experience issues with sleep during their menopause, and these can continue once the menopause is complete. Illnesses such as arthritis can disrupt sleep due to uncomfortable symptoms. Furthermore, medications prescribed to manage symptoms of some of the illnesses commonly experienced in older age can cause sleep issues as one of their side effects.
Seniors are also likely to be more sedentary than their younger counterparts. However, it’s important to remain physically active in old age, both in terms of sleep and your overall health. A sensible amount of exercise helps to tire your body out and prepare you for a good night’s sleep.
Seniors may also experience emotional issues which may contribute to lack of sleep or a reduction in sleep quality. Many seniors experience stress and anxiety as a direct but unexpected side effect of the life changes brought on by retirement. Older people are also more likely to experience bereavement. This can lead to feelings of grief, loneliness and social isolation, all of which are known to have a negative impact on sleep.
Why Does Sleep Matter for Seniors?
Good sleep is important for seniors for all the same reasons that it matters for the rest of the population. Although occasional sleep disruption is normal, regular disruption can make you sleep deprived.
Sleep disruption can make it harder to learn and remember information. It can also have a negative impact on mental and emotional health, leading to low or changeable mood and trouble with decision making.
Lack of sleep can affect physical health as well. People who regularly do not get enough quality sleep are more likely to fall foul of illness or injury. In fact, it is now known that chronic sleep deprivation includes the likelihood of an individual developing several serious illnesses including cancer and diabetes.
For seniors, these risks are even more serious. At a time in life where developing illness is more likely in any event, sleeplessness can compound the issue. Seniors who are sleep deprived are also more likely to experience falls, which can lead to long-term disability. Where a person is already experiencing feelings of depression, anxiety, grief or loneliness, poor sleep quality can make these even worse.
Is Sleep Quality More Important Than Hours Slept?
Sleep quality is all about how well you sleep once you catch some shut-eye. In general, good quality sleep means falling asleep quickly with no more than one night-time awakening. On the other hand, people experiencing poor quality sleep often spend more than 30 minutes trying to nod off and wake multiple times in the night.
Sleep quality is just as important as sleep quantity. This is because people who sleep well at night are more likely to feel restored and refreshed by their sleep. For this reason, you should try to aim for sleep in the correct quantity and of high quality
Seniors and Sleep Problems
Seniors are more likely to experience certain sleep problems than other people. These include:
• Sleep apnea
• Insomnia
• Restless leg syndrome
• Periodic limb movement disorder
• REM sleep behaviour disorder
Seniors and insomnia
Insomnia is very common in seniors. Women are more likely to be affected by age-related insomnia than their male counterparts. Seniors with insomnia tend to experience:
• Difficulty falling asleep
• Unwanted night-time waking
• Waking too early
• Reduced total sleep hours
Insomnia doesn’t just affect seniors at night. Disrupted and reduced sleep is likely to make the person feel extremely tired during the day. This leads the person to take naps to compensate. However, this makes it even harder to fall asleep when they go to bed, compounding the issue.
Seniors with insomnia may also start to feel very tired early in the day. This can lead to social isolation if they are too tired to take part in evening activities which they previously enjoyed.
Although insomnia can be debilitating, it can be treated. Lifestyle changes, supplements and therapy may be helpful. Some people need medication to help manage their insomnia.
Seniors and Snoring
Although snoring is very common in adults of any age, it is particularly common in seniors. This is because the muscles controlling the airways are likely to be weaker in older adults, causing them to collapse. Snoring in itself is not dangerous. However, it can be a sign of more serious health concerns such as heart disease or sleep apnea.
Seniors and Sleep Apnea
Sleep apnea causes problems with breathing while a person is asleep. The person will stop breathing for short periods of time while they sleep. This causes the brain to become more alert in order to resume breathing, which can affect the quality of a person’s sleep.
For this reason, people with sleep apnea often experience insomnia at the same time. Even without insomnia, people with sleep apnea often experience debilitating tiredness during the day. Tell-tale signs that a person has sleep apnea are daytime sleepiness in conjunction with problematic snoring.
Sleep apnea disproportionately affects seniors. This may be partly due to a decline in strength in the muscles responsible for controlling breathing. This can result in closed airways and very loud snoring. Seniors with sleep apnea usually get less deep and REM sleep than other people.
Sleep apnea is also associated with other health problems. People with the condition are more likely to have a stroke, high blood pressure or other serious medical problems. For this reason, anyone who suspects they have sleep apnea should consult their healthcare provider as early as possible.
Sleep apnea is often treated using a special machine designed to keep the airways open. This is called a CPAP (continuous positive airway pressure) machine. Lifestyle changes may also be necessary to combat sleep apnea.
Restless Leg Syndrome (RLS)
Restless leg syndrome is a type of movement disorder. People with this condition often feel a burning or tingling sensation in their legs, especially when they lie down in bed. This causes them to move their legs around to relieve the sensation, making it tough to nod off to sleep.
RLS disproportionately affects seniors. In many cases, this condition is caused, or significantly contributed to, by an iron deficiency. Therefore, some people may find relief from taking additional iron supplements.
Periodic Limb Movement Disorder (PLMD)
PLMD causes a person to make jerking movements with their arms and legs that they are unable to control while they sleep. This can make falling asleep difficult and may also cause night time awakenings.
PLMD is particularly concerning in seniors because it can cause the person to fall from their bed. This can be particularly dangerous for older adults and can result in serious injury.
PMLD usually requires medication to keep it under control. However, certain lifestyle changes can help to improve symptoms in some people.
Narcolepsy
The sleep disorder narcolepsy causes a person to suddenly fall asleep at any given moment without any signs that sleep is imminent. It can also make a person feel very tired and sleepy during daytime hours. This can be dangerous, as the person may fall asleep in a hazardous situation such as when crossing the road.
Some people have a similar, milder condition called hypersomnia. This causes the person to be excessively sleepy, regardless of the quantity and quality of night-time sleep they are getting. These conditions can affect anyone, including seniors.
Narcolepsy is incurable and requires medication to control its symptoms. However, making healthy lifestyle choices and practicing good sleep hygiene can help.
Excessive sleepiness in seniors
Feeling excessively sleepy during the day is common in seniors. While it isn’t a sleep disorder in itself, it can be a sign that the person is not practicing good sleep hygiene. For example, they may:
• Get an insufficient quantity or quality of sleep during the night
• Sleep in an irregular routine
• Suffer from a sleep disorder
• Experience sleepiness as a side effect of medication
• Have a medical condition affecting their sleep quantity or quality
Excessive sleepiness during the day can cause various problems in seniors. These include:
• Fatigue
• Feeling irritable
• Low or changeable mood
• Low concentration span
Feeling very sleepy during the day can negatively impact a person’s quality of life. It may also cause them to withdraw from social activities, leading to isolation and mental health problems.
Sleep and Alzheimer’s disease
Alzheimer’s disease is a progressive neurological condition causing dementia. This can lead to memory loss and problems with thinking and speech. It can develop in middle age but is most common in seniors.
This condition often causes problems or changes with a person’s sleep. Alzheimer’s can cause seniors to get too much or little sleep. It also typically causes frequent night-time awakenings and is a leading cause of wandering or becoming confused at night.
Sleep problems caused by Alzheimer’s can be stressful for caregivers to cope with as well. Their sleep may suffer if they are frequently woken in the night to provide care or reassurance.
There are specific steps that should be taken to keep people with Alzheimer’s disease safe and secure at night. These include:
• Removing any stray objects or trip hazards from the bedroom floor
• Locking away medications
• Locking external doors to prevent the person wandering away from home and getting lost
• Installing stairgates
• Installing grab rails around the bed and in the bathroom
Seniors and Night-Time Safety
In some situations, a risk can be posed to seniors by their bedroom environment. If a person has a neurological condition such as dementia or a physical disability affecting their mobility, their bedroom may pose certain dangers that don’t apply to other people.
By making themselves aware of these possible dangers, caregivers can help to make bedrooms for seniors as safe as possible. This ensures that seniors are less likely to sustain avoidable injuries during the night.
Falls and night-time wandering are the two main dangers to some seniors during the night.
Seniors and Falls
Technically, anyone could experience a night-time fall in their bedroom. However, seniors are more likely to fall than other people, even if they have no underlying health condition. These accidents can lead to serious injuries and even fatalities.
Seniors fall in their bedrooms more often than many other locations, possibly due to poor lighting during the night. Common trip and fall hazards in the bedroom include:
• Rugs
• Misplaced objects
• Cables from electronics
• Pets
Luckily, most of these hazards can be managed. Anti-slip rugs are safer than regular ones. The edges can be taped down to avoid tripping, as can power cables. Ensuring that the floor is cleared before the person gets into bed at night is also advisable.
As many falls at night are due to poor lighting, motion sensor lights are a good solution that allow the person to see where they are going when they get up but turn off when they are back in bed. This allows the amount of darkness necessary for decent sleep without it posing a risk to safety.
Senior Wandering
Wandering at night is more likely in seniors with dementia or other degenerative neurological conditions such as Alzheimer’s disease. People who wander at night may go some distance from home and become highly confused and lost. This can result in serious injury or even death if they are not recovered. Any senior experiencing problems with their memory may be at risk of night-time wandering.
Incidence of wandering can be reduced by ensuring that people at risk are occupied well during the day. Some safety measures may need to be taken, including wearing a personal medical alarm and locking all doors to the outside, if appropriate.
How Can Seniors Sleep Better?
There are plenty of measures that seniors and their caregivers can take to improve their sleep quality. Many are simple behavioral changes to develop good habits around sleep. This is often referred to as good ‘sleep hygiene’. Here, we review some of the best methods.
1. Improve diet
What you eat and drink affects how well you sleep at night. Seniors with sleep problems should eat a healthy, balanced diet while cutting down on saturated fats and sugars.
Eating the heaviest meal of the day at lunchtime may be helpful. A lighter meal at night can cause digestive pain and worsen acid reflux, which can lead to interrupted sleep.
Avoiding or significantly cutting down on both alcohol and caffeine can help improve sleep quality. In particular, try not to consume either of these too close to bedtime.
2. Take plenty of exercise
Exercise in general helps to promote and maintain good health, therefore avoiding some of the ailments common in seniors which can negatively affect sleep. A little exercise a day, ideally outside, can be very helpful. This applies even if the exercise is very gentle. Outdoor exercise helps because sunlight promotes a healthy sleep cycle.
3. De-stress
High levels of stress are associated with insomnia in seniors. Therefore, reducing stress should be prioritized in order to improve sleep problems.
Some people may need help from a professional counsellor or therapist to combat their high stress levels. However, some self-help measures can be useful as well. Activities such as mindfulness, yoga and meditation have been found to have stress-relieving benefits.
4. Keep a consistent sleep routine
Waking up and going to bed at the same time every day can be very helpful. This helps the body to regulate its sleep cycles. Although it may sound a little bring, maintaining this routine even during holidays and weekends is important for promoting good sleep.
5. Try not to nap
Although many seniors rely on naps during the day, this is a habit best broken. Daytime napping can make it even harder to sleep at night. If you absolutely must take a nap, try not to sleep for any longer than 20 minutes. Longer periods of daytime sleep are likely to be disruptive.
6. Create a restful bedroom environment
A bedroom environment that’s conducive to sleep should be cool, quiet and dark. This helps to send the brain the message that it’s time to wind down and go to sleep.
7. Keep the bedroom for sleep only
It’s best to only go to your bedroom when it’s time to go to sleep. That way, your brain associates it with bedtime and you’ll naturally become sleepy when you enter your bedroom. So, try to refrain from reading, watching TV or carrying out any activities in the bedroom other than going to sleep.
8. Follow a bedtime routine
Having a regular routine helps to build up sleep associations that give our brains the message that it’s nearly time to go to sleep. The right bedtime routine will differ from person to person. The important thing is to do the same thing every night so that your brain gets used to the pattern.
9. Reduce screen time before bed
Nowadays, more and more of us use screens for long periods of the day. However, this can interfere with sleep at night. It’s thought that blue light from screens stimulates our brains, making it harder for us to nod off once we put the device down.
For this reason, it’s best to avoid smartphones and screens for at least an hour before going to bed. Switching to a different calming activity such as reading may help.
10. Shower or bathe before bed
Taking a warm shower or bath just before hitting the hay is known to help people fall asleep. This is because the body cools rapidly after getting out of the bath or shower, enhancing the natural drop in temperature we experience when falling asleep. This makes it easier to nod off and may be of particular help to seniors with restless legs syndrome.
11. Don’t drink too much before bed
Many seniors find that they need to get up at night to use the bathroom, interrupting their sleep. For this reason, it’s sensible to limit fluid intake a couple of hours before going to bed. However, it’s important to make sure that plenty of fluids are taken for the rest of the day to compensate. Otherwise, dehydration may result, which can cause health problems.
12. Seek medical assistance
Seniors experiencing problems with their sleep should seek advice from their healthcare provider as soon as possible. This is because sleep problems in seniors are often caused by an underlying illness. They could also be caused as a troublesome side effect of medication. It requires a doctor to assess whether this is the case.
If the sleep problems are a medication side effect, the doctor may be able to suggest changes or an alternative medication that won’t interfere with sleep so much. Otherwise, the doctor may be able to diagnose a medical condition as the root cause of the insomnia. Treating the root cause or making medication changes is often what is needed to completely cure or at least radically improve insomnia.
It’s particularly vital to seek prompt medical help if sleep apnea is suspected. This is because sleep apnea is often a sign of a serious medical issue and can be dangerous in itself. Treating sleep apnea and any associated conditions will not only improve sleep issues but is important for safeguarding a person’s overall health.
How to Exercise to Improve Sleep for Seniors
As we mentioned above, exercise is known to help improve sleep in senior citizens. Aerobic activity is particularly helpful because it causes the body to release sleep-promoting chemicals. However, getting exercise is often more difficult for seniors, especially if they have mobility or joint issues that make physical movement restricted or painful.
However, there are plenty of exercise methods that are particularly suitable for seniors. It’s important to check with your healthcare provider first to make sure that your intended exercise regime is suitable and safe for your unique needs. Great exercise methods for seniors include:
• Swimming or aqua fitness: This is a great way to gently improve all-round fitness and can be helpful for those with restricted mobility or joint complaints. Many venues now offer special exercise classes specifically designed for seniors.
• Lawn bowls: This type of exercise encourages walking, which gradually builds fitness. It’s also a marvelous way to socialize and meet new friends, which can lift the mood, ease loneliness and combat some of the emotional causes of sleeplessness.
• Walking: Joining a ramblers’ society is a great way to keep fit and socialize at the same time. However, any walking will help to improve fitness and therefore sleep.
• Cycling: As long as there are no balance issues and the person is in reasonable fitness, there is no reason that seniors cannot continue to enjoy cycling. This could be done inside on a stationary exercise bike if preferred.
Creating a Pleasant Sleep Environment
A calm and relaxing sleep environment can be key for making it easier to nod off at night. The first port of call is to make sure that bed is a comfortable place to be. The most important aspect of this is to ensure the mattress is comfortable and suitable for your needs.
Often, the wrong mattress can make falling asleep difficult due to the discomfort it causes. This is particularly important to bear in mind for seniors, as an uncomfortable mattress can exacerbate common pain-causing conditions associated with old age such as arthritis. Of course, being in pain is no way to fall asleep.
It’s important to choose a mattress that’s supportive and that relieves pressure on sensitive joints. Many people find that memory foam or latex mattresses are ideal for this purpose.
Often, seniors sleep on orthopedic mattresses in the belief that they will provide relief from back or joint pain. In fact, an ‘orthopedic’ mattress is simply a mattress that is very firm. While a few people will benefit from orthopedic mattresses, the vast majority of people will find them too hard to be comfortable. This means that orthopedic mattresses may be doing some seniors more harm than good when it comes to falling and staying asleep.
Aside from the mattress, it’s a good idea to invest in some comfortable and luxurious bed linen to make the bed as cozy and comforting as possible. Many seniors find that an adjustable bed frame is a good investment. This can help to take pressure off sensitive areas and make it easier to get in and out of bed by adjusting the height of the frame.
Ensuring the room is a comfortable temperature is also important, as a room that’s too hot or too cold can impede sleep. Blackout curtains can help to stop night-time awakenings due to light disturbance, especially in city and suburban areas that have street lighting on all night long.
Talking Therapy for Sleep Problems in Seniors
When seniors are experiencing problems with sleep, their healthcare provider may issue a referral to a mental health counsellor in some situations. This may be an appropriate course of action if no medical cause can be found for person’s insomnia. In this situation, their sleeplessness may be caused by a psychological issue such as depression or anxiety. Even relatively mild mental health conditions can contribute to insomnia. Talking therapy can be very useful for treating the root cause of the person’s insomnia in these situations.
Cognitive Behavioural Therapy for sleep problems
A Harvard University study found that Cognitive Behavioural Therapy (CBT) is an effective way of treating insomnia. In fact, they found that it worked better than taking sleeping pills.
This type of therapy involves finding ways to change the thoughts and behaviours that stop individuals from getting the correct quantity and quality of sleep. Some people attend individual therapy sessions while others prefer group therapy.
For people who are housebound or have anxiety surrounding therapy, they can even access CBT services online. A key benefit of CBT is that it is completely safe and has no known side effects, making it an especially suitable method for treating insomnia in seniors.
Helpful Sleep Products for Seniors
Fortunately, there are plenty of helpful products available to allow seniors to improve their sleep quality. Some help the person sleep better and longer, and some address the various safety concerns which may be affecting senior sleep. Here are some products which we recommend:
• Blackout curtains: In order to sleep properly, most of us need to be in darkness. Blackout curtains create total darkness, making it easier to nod off to sleep and reducing the likelihood of waking up due to light-related disturbances
• Natural light alarms: You can buy alarm clocks nowadays which wake you up gradually by slowly flooding the room with natural light. This is more gentle than ‘shocking’ the system awake with traditional alarms
• Pressure-relief mattresses: These reduce areas of pressure on the body, helping to relieve pain from aching joints or bedsores which may be interfering with sleep. It’s a good idea to look for a supportive mattress to prevent body pain. You may check out our other mattresses for people who sleep in different positions (side, heavy), and also check out the 10 most comfortable mattresses for all age peoples.
• White noise machines: Some people find that white noise, like that from n untuned radio, helps them to fall asleep and stay asleep. It also helps to drown out any noises which may wake you during the night.
• Motion-activated lights: These can help to guide a senior person if they need to get out of bed during the night. However, they will dim once movement stops, allowing for a restful night’s sleep.
• Adjustable beds: An adjustable bed allows seniors to adjust their position for total comfort and are easier and safer to get in and out of than regular beds. Some come with state-of-the-art features including USB charging ports and built-in nightlights to reduce the need to leave bed during the night
• Safety pads: Padded bed rails and guards can reduce the risk of seniors falling from bed and sustaining an injury. A pad on the floor can also improve safety should the worst happen.
• Medical alert buttons: These are usually worn by the senior around their neck and can be used to summon help at the push of a button. So, should the person become unwell or injure themselves during the night, they can raise the alarm even if they are unable to reach the telephone. These can also be helpful for seniors who wander, as they can press the button if they become lost. Some come with GPS tracking so that the person can be located if they wander away from home
Seniors and Melatonin Sleep Supplements
Melatonin is a hormone produced by the brain that regulates sleep. Levels naturally become higher in the evening in preparation for the night’s sleep.
Many people, including seniors, choose to take supplementary melatonin to help with sleep problems. It is believed that this is a reasonably safe option for seniors. Melatonin is known to be an effective way to improve sleep length and quality in seniors.
That being said, melatonin supplements should be used with caution as they are unregulated. So, it’s worth checking with a doctor to ensure that a particular product is safe to take and to decide on a dosage which is high enough to be effective but low enough to be safe and avoid any unpleasant side effects.
Seniors and Sleeping Pills
In most circumstances, sleeping tablets are not recommended for seniors. Instead, most experts recommend that seniors choose natural treatments or lifestyle changes to treat any sleep problems.
This is for several reasons. Firstly, sleeping tablets are only intended to be a temporary measure for treating insomnia. They won’t treat the underlying cause and may even cause a dependency on the medication.
Sleeping pills may also interact in a dangerous way with many medications commonly taken by seniors. They can also cause problems with balance and make a person disorientated. This makes falls more likely, which is of particular concern in seniors.
Seniors should never take any kind of sleeping pill, prescription or otherwise, without agreeing it first with their healthcare provider. That way, they can be sure that any medicine they do take will not be putting them at risk.
Additional Sleep Resources for Seniors
Hopefully, the information in this article has already given you plenty of inspiration for better sleep, whether you’re a senior citizen yourself or a caregiver. Fortunately, there is plenty of help and support available for seniors struggling with sleep. Here are some additional resources you may find valuable:
1. https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959
The Mayo Clinic is a highly respected resource, offering a wealth of health-related advice. This article discusses sleeping pill use for seniors.
The Alzheimer’s Association is a supportive community providing help and advice to people with Alzheimer’s Disease and their caregivers.
3. www.rls.org
The Restless Legs Syndrome Foundation provide help, support and guidance to people suffering from the condition.
[email protected]
The American Sleep Apnea Foundation is a great resource providing health and sleep advice to those with sleep apnea and their caregivers
