Is This Just Aging, or a Sleep Problem?

As we age, our bodies change and our habits change. This may seem self-evident, but it is perhaps especially important to remember when we consider our sleep. As many as half of older adults report chronic sleep concerns. And yet these concerns arise against a background of normal, age-associated transformations in sleep patterns. Circadian rhythms shift, causing corresponding alternations in the regulation of sleep hormones and of body temperature. The total duration of sleep is often shorter, and nighttime awakenings more frequent.

This can be perplexing: How do we know what to expect of our sleep as we age? Where is the line between normal and abnormal, between minor changes and serious concerns about those changes? There are a couple of key considerations as we navigate our needs and expectations.

First, it is important to know that most of our normal bodily changes in sleep occur before the age of sixty. A seventy-two year-old who is experiencing new disruptions in sleep compared to three years prior, therefore, should reach out to her healthcare provider out of concern for abnormal changes.

Second, while there are some general parameters for sleep consistent across many age groups–for instance, for many adults across decades a target of 7-8 hours of sleep nightly remains appropriate–it is also true that sleep quality can be quite subjective. The most important question is always: do you feel rested? A sense of rest helps us function–cognitively and physically–at our highest levels. Our sleep goals, therefore, should always be individualized to our specific needs–at whatever age.

So what are the abnormal causes of sleep disruption among older adults? While there are many, here are a few of the most common contributors to poor sleep:

1. Medication side effects: This one is commonly overlooked, as LOTS of medications can cause sleep problems, including ones that are beneficial to us for other reasons. Talk to your primary care provider or pharmacist about your medications.
2. Increased sensitivity to caffeine, alcohol, and other inputs that affect our brains (including screen time!): This is due to the simple fact that our metabolism changes as we age, as does our brain's response to these inputs. Less is usually more.
3. Inadequately controlled medical conditions: The Alula Way focuses on whole-person care because we experience life, inclusive of waking and sleeping, as whole persons. Sleep is profoundly interconnected with everything about us. Those living with certain heart conditions may have disruptions in breathing patterns that affect sleep. Pain affects sleep. Daytime physical and cognitive function affects sleep. Caregiving burden often has marked impact on sleep. Oftentimes, therefore, we need to focus on optimizing other aspects of our care in order to optimize our sleep.