According to the National Institute on Ageing, the common belief that older adults require less sleep than the young is a myth. The amount of sleep that a person needs can decrease from infancy to adulthood, but this trend appears to stop around age 60. Changes in sleep with advanced age are in fact more likely to be influenced by a reduced ability to sleep. The National Sleep Foundation guidelines advise that people over 65 should get seven to eight hours of sleep each night.

How Ageing affects sleep

While some older adults may have no significant disruptions in their sleep, others complain about getting less sleep and having worse sleep quality. Common sleep disturbances in older adults include a shifting sleep schedule, waking up more often during the night and increased daytime napping.

  • After around age 20, the circadian rhythm begins progressively advancing (i.e., shifting earlier), with older adults becoming sleepy earlier in the evening and waking earlier in the morning.

  • Older adults may experience disrupted circadian rhythms due to deteriorated function in the body’s internal clock as it ages.

  • Melatonin secretion is reduced and circadian rhythm amplitude is dampened in older adults.

  • Older adults spend a lower percentage of their sleep time in both slow wave (a.k.a., deep sleep) and REM sleep compared to younger adults, and the time it takes to fall asleep increases slightly as well. The number of arousals and total time awake after falling asleep also increases with ages.

Common Sleep Issues in Seniors

The prevalence of many sleep disorders increases with age. Researchers estimate that between 40% and 70% of older adults have chronic sleep issues and up to half of cases may be undiagnosed. Chronic sleep problems can interfere with older adults’ daily activities and reduce quality of life. Common sleep issues in older adults include:

  • Discomfort / Pain - Pain and sleeplessness can become a vicious cycle, in which less sleep can lead to more pain and discomfort.

  • Nighttime urination - Nighttime urination increases with age due to physical changes in the urinary system. This issue may affect up to 80% of older adults.

  • Insomnia - Having persistent difficulty in falling or staying asleep is one of the most common sleep issues in older adults.

  • Daytime drowsiness - Around 20% of older people experience excessive daytime sleepiness, which may be a sign of an underlying health condition rather than merely old age. Excessive daytime sleepiness in older adults may be a symptom of health issues including sleep apnea, cognitive impairment or cardiovascular issues.

  • Sleep Apnea - Obstructive sleep apnea can cause pauses in breathing during sleep. Sleep apnea causes fragmented sleep and can affect oxygen levels in the body, leading to headaches, daytime sleepiness, and difficulty thinking clearly. It is associated with cardio-and cerebrovascular disease as well as cognitive impairment.

  • Restless Leg Syndrome - Restless leg syndrome (RLS) affects 9% to 20% of older people, while periodic limb movements of sleep (PLMS) affects 4% to 11%. RLS causes an urge to move the legs while resting or sleeping. PLMS causes involuntary movements in the lower limbs, most commonly in the feet. Both disorders can significantly impact sleep and overall quality of life.

  • REM Sleep Behaviour Disorder - REM sleep behaviour disorder (RBD) primarily affects older people. While most people’s bodies are still while they’re dreaming, this disorder can cause people to act out their dreams, sometimes violently.

Sources: The Sleep Foundation | Wikipedia | National Library of Medicine | Sleep Science and Practice