The Science of Sounder Sleep
Why you may be tossing and turning like never before — and how research shows you can change that
En español | It’s a common refrain that older people need less sleep, contentedly staying up until the wee hours or cheerfully waking up long before everyone else. Yet it’s simply not true.
“That is actually a myth,” said Daniel A. Barone, M.D., an assistant professor of neurology at Weill Cornell Medical School and the coauthor of Let’s Talk About Sleep. “What happens is that as we get older, our ability to stay asleep does go down.”
If a person needed eight hours of sleep at 30, he still needs that much at 70. But roughly half of older adults report problems with insomnia, according to the American Psychological Association. Sleep troubles have been linked to health problems such as cardiovascular issues and depression. For many older adults, a good night’s sleep is increasingly elusive, the result of an unfortunate mix of changes that happen as we age and the side effects of health woes that plague us later in life.
As we get older, the quality of the sleep we get decreases. In our 50s our ability to produce melatonin, a powerful sleep hormone, may begin to slow. And our circadian clock, the internal meter that tells us when to go to bed and when to get up, often shifts earlier when we age, sending us to bed in the early evening and awakening us in the early hours, whether we want to get up at that time or not.
Many age-related health problems, and the medications taken to treat them, also make it harder to get quality shut-eye. An enlarged prostate may send you to the bathroom all night long. Menopausal hot flashes may cause rest-ruining hot flashes. Sleep apnea, for which people are at higher risk of at age 40 and older, disrupts slumber. Chronic pain, too, may make it difficult to get comfortable enough to fall asleep. And eye conditions like macular degeneration can affect our circadian rhythm.
“As we get older, things get more complicated and our system itself is going to be compromised,” said Michael J. Breus, a clinical psychologist and sleep specialist. “The quality of that sleep is going to be less.”
Anyone who’s ever carried a sleeping baby from a car seat to a crib knows that infants fall into deep slumbers. That kind of sleep, known as slow-wave sleep, represents a rebalancing function for the brain. Slow-wave sleep increases in response to the amount of prior wakefulness. As we age, this sleep state seems to decline.
“Older people are not as able to generate as much slow-wave sleep as young people,” said W. Vaughn McCall, M.D., chair of the department of Psychiatry and Health Behavior of the Medical College of Georgia at Augusta University.
This phenomenon may be linked to changes in the fluctuations in our core body temperature. “For a whole variety of reasons, as we age we simply don’t have these wide swings in our activity level during the day, and, correspondingly, we have smaller swings in our body temperature,” McCall said.
How much your circadian rhythm shifts may vary. While some may feel sleepier in the evening, others will grapple with advanced sleep phase disorder, a condition that means your body thinks it’s bedtime as early as 7 p.m. — which is not a terrible thing until you wake at 3 a.m. And even if you force yourself to stay up a few hours later to enjoy a night out with friends, you may still wake up in the middle of the night feeling far less than rested.
As elusive as those z's may be in our later years, there are strategies to manage sleep, from paying closer attention to our circadian rhythm to making subtle and positive changes to our behaviors and environment.
Brush Up On Your Sleep Hygiene
Not all sleep problems are health related. Sometimes it’s your schedule, or lack of one, that throws you off. If you no longer have to get up in the morning to go to work or get the kids off to school, you may feel no reason to go to bed at a reasonable hour, or not bother to set your alarm clock. Soon enough, you’re binge-watching The Marvelous Mrs. Maisel until 2 a.m. and not waking until noon.
As unpleasant as it may sound, go to bed at a reasonable hour, even if you have no place you need to be the next day. And arise at the same time every morning, even if you’d rather sleep in — say, on the weekend.
“People probably think I’m cruel and unusual,” McCall said. “But I think pretending like you’re still going to work is not a bad idea.”
You can also reset a biological clock that’s out of whack with the correct exposure to light. Researchers at the University of Colorado, Boulder found that a weekend spent camping, waking and sleeping with the natural light could reset your biological clock. So plan a camping trip free of artificial lights and electronic devices.
According to experts, using a light box, as prescribed by a doctor, can also help resynch your sleep schedule, and just getting outside as early as possible in the morning may help, too.
Exercise and eat for sleep
• Exercise not only improves your health but also enables you to snooze better at night. An early-morning workout can help you sleep deeply, and an afternoon routine can reduce insomnia. Avoid physical activity too close to bedtime, though, since exercise raises your body temperature and your heart rate, which can make it harder to wind down.
• If trips to the bathroom keep you up, avoid drinking two hours before bedtime. A light bedtime snack may help you sleep, but don’t eat a big meal late at night, as it could cause indigestion.
• Avoid alcohol and caffeine, both of which can affect slumber.
• A warm bath before bed may relax sore muscles. (But keep the temperature in your bedroom cool, as heat can inhibit sleep.)
See a sleep professional
Your shut-eye woes could be a sign of a bigger health problem, like sleep apnea. A sleep specialist can help you diagnose an underlying issue or recommend medication (or melatonin, an over-the-counter supplement) that may help you rest easy again.