Washington Irving's story of Rip Van Winkle is about a man who managed to sleep away 20 years of his life, returning home as an old man to find that his nagging wife was dead and the Revolutionary War had occurred. At the end of the story, the reader learns that Rip Van Winkle recounts the narrative of his long nap to everyone passing through town; some village residents believe it's true, and many a henpecked husband wishes it to be true, but there are some men, women and children that Rip Van Winkle never convinces.
Indeed, it might be hard to convince a child who's heard a grandparent complain of waking at 5 a.m. that an old person could sleep that long, and those middle-aged adults may have already figured out that nightlights are now an essential feature for those hourly trips to the bathroom. Sure, Rip Van Winkle may have had a long doze -- likely in front of a sporting event in the afternoon in a recliner -- but 20 years of sleep? That seems like a dream to most other people of advanced age.
Rip Van Winkle is indeed an anomaly among people in his age group. Though newborns sleep for most of the day, and though many teenagers may try to, most adults get by on about seven to nine hours of sleep. However, as people age, they're more likely to complain of a bad night's sleep and of sleep conditions including sleep-disordered breathing and insomnia. While insomnia is the most common sleep complaint at any age, it strikes 1 in 4 people over the age of 65 (as compared to 1 in 8 people in their 20s) [source: Elias].
Many things about sleep are still unsolved mysteries to scientists, including what goes on when we dream and why we need to sleep at all. Here's are some more puzzles for sleep researchers: Why does sleep change when we age? And is there any way for aging adults to recapture that ol' Rip Van Winkle magic? Let's take a look at what we know so far.
Sleep Problems and the Elderly
Even the healthiest elderly people find that their sleep habits change. Sleep tends to become much lighter as we age, with less time spent in deep sleep cycles, and also shorter, with people over the age of 65 sleeping about half an hour less. Awakening during the night becomes more frequent, so that on a given night, a healthy older person sleeps only about 85 percent of the night [source: Kolata]. The aging tend to get sleepier earlier in the evening and awake earlier in the morning. It also may take longer for an older person to fall asleep, which, in combination with the decrease in hours of sleep and the shifted schedule, may make aging people feel as though they suffer from insomnia. In reality, they need less sleep, but may be lying in bed waiting to sleep as they used to.
These are all normal changes brought about by aging. While they may take some time to get used to, you should ultimately be able to get a satisfying night's sleep. However, it's important to note that getting older doesn't mean that you're due for a whole night of tossing and turning, and that insomnia is a very real sleep complaint for the aging. Insomnia and other sleep problems tend to occur most often in those people who have health conditions or who take medications.
Conditions such as heartburn, arthritis, cancer, Parkinson's and depression are but a few of the disorders and diseases that can leave a person in too much pain to sleep. Medications used to control blood pressure or treat cancer and depression can also have an effect on your shut-eye. The combination of aging and being overweight puts you at additional risk for problems like sleep disordered breathing, which includes sleep apnea and snoring, and movement problems, such as restless legs syndrome (RLS) and periodic leg movements in sleep (PLMS).
We mentioned that even the healthiest elderly individuals report waking up in the middle of the night; that may be for periods of about three to 10 seconds. However, the most common reason that older adults wake up in the middle of the night is the need to go to the bathroom, and studies have shown that it's the most common cause of a bad night's sleep. On the next page, we'll examine the consequences of these sleep problems and consider some tips for these tired adults.
Tips for Improving Sleep in the Elderly
Sleep presents a classic catch-22 scenario for the aging: A bad night's sleep in an elderly adult is usually caused by a condition or its medication, but a lack of sleep only worsens the condition, thus making satisfying sleep an even more impossible prospect. In one study, researchers found that a night of fragmented sleep caused major problems in the body's response to pain, so that subjects felt pain more easily, demonstrated increased inability to deal with it and developed additional pain in the form of headaches and backaches [source: Kolata]. This is just adding insult to injury if chronic pain is the factor that kept you from sleeping in the first place.
In another study, which followed nearly 3,000 women over the age of 70, subjects who got less than five hours of sleep per night were 47 percent more likely to fall at some point during the year they were monitored [source: Bakalar]. A lack of sleep can also cause memory problems and depression, not to mention the decreased quality of life that comes with being tired and grumpy all day.
Are the elderly doomed to march on, bleary-eyed and sleep-deprived? Of course not. If you experience sleep problems that are related to another medical condition, speak to your doctor about the problem -- making a minor tweak, such as the time you take your medications, could make a huge difference.
Many elderly people and their doctors are too quick, however, to turn to another medication to address the sleep issue. According to a study conducted by the Pennsylvania Department of Aging, sleeping pills are commonly overused and abused by the elderly [source: Kolata]. Sleeping pills are more likely to have adverse side effects in this group, in part because the elderly are usually taking so many other medications, raising the risk for negative drug interactions. Some side effects of sleeping pills can also mimic the symptoms of dementia.
Rather than popping another pill, consider some of the reasons that you may not be able to get to sleep, remembering that you sleep less as you age. Are you depressed and bored, using sleep as an escape from the world? Do you take a long afternoon nap and follow it up with a giant cup of coffee? Consider your habits, as well as these sleep tips:
- Follow a regular sleeping schedule, so that you go to bed and rise at the same time each day.
- Avoid long or frequent naps during the day.
- Get regular exercise.
- Go outside or sit in natural light; it regulates your body's sleep-wake cycle.
- Minimize caffeine and alcohol.
- Use your bed for sleeping only; if you don't fall asleep in 15 minutes, get up, move to a chair and try another activity.
For more on how aging affects the human body, see the links on the next page.
Related HowStuffWorks Articles
- "A Good Night's Sleep." National Institute on Aging. June 25, 2007. (April 27, 2009)http://www.niapublications.org/agepages/sleep.asp
- Bakalar, Nicholas. "Study Links Falls to Lack of Sleep." New York Times. Sept. 16, 2008. (April 27, 2009)http://www.nytimes.com/2008/09/16/health/research/16agin.html?scp=7&sq=sleep,%20aging&st=cse
- "Changes in Sleep with Age." Harvard Healthy Sleep. Dec. 18, 2007. (April 27, 2009)http://healthysleep.med.harvard.edu/healthy/science/variations/changes-in-sleep-with-age
- Elias, Marilyn. "Age and sleep play catch-up." USA Today. July 28, 2005. (April 27, 2009)http://www.usatoday.com/news/health/2005-07-27-age-and-insomnia_x.htm
- Kolata, Gina. "Elderly Become Addicts to Drug-Induced Sleep." New York Times. Feb. 2, 1992. (April 27, 2009)http://www.nytimes.com/1992/02/02/weekinreview/ideas-trends-elderly-become-addicts-to-drug-induced-sleep.html?scp=21&sq=sleep,%20aging&st=cse
- Kolata, Gina. "The Elderly Always Sleep Worse, and Other Myths of Aging." New York Times. Oct. 23, 2007. (April 27, 2009)http://www.nytimes.com/2007/10/23/health/23age.html?scp=1&sq=sleep,%20aging&st=cse
- Kryger, Meir, Andrew Monjan, Donald Bliwise and Sonia Ancoli-Israel. "Sleep, health and aging: Bridging the gap between science and clinical practice." Geriatrics. January 2004.
- Lloyd, Robin. "Elderly Don't Need as Much Sleep, Study Finds." LiveScience. July 24, 2008. (April 27, 2009)http://www.livescience.com/health/080724-older-sleep.html
- Lloyd, Robin. "Lack of Sleep Causes Old Men's Testosterone to Drop." LiveScience. April 2, 2007. (April 27, 2009)http://www.livescience.com/health/070402_sleep_testosterone.html
- "Sleep and Aging." NIH Senior Health. April 10, 2009. (April 27, 2009)http://nihseniorhealth.gov/sleepandaging/toc.html
- Yoon, In-Young, Daniel F. Kripke, Jeffrey A. Elliott, Shawn D. Youngstedt, Katharine M. Rex, and Richard L. Hauger. "Age-Related Changes of Circadian Rhythms and Sleep-Wake Cycles." Journal of the American Geriatrics Society. August 2003.