By Erin Blakemore | Washington Post
When Carol Gee was 55, she made a new friend: 4:00. Previously, she normally slept through it. But when she entered the menopause, it became her new wake-up time. "I would go to bed and wake up every morning around the same time, almost as if you were setting the clock," says Gee, who is now 68.
She is not the only older adult who has experienced an exciting shift in her sleep cycles. In 2017, a national study by the University of Michigan found that 46 percent of adults 65 and older have difficulty falling asleep on a regular basis.
When people get older, the body changes in all kinds of predictable ways. Collections solidify. Brains can slowly. Wounds take longer to heal. And sleep patterns also change. This can come as news for many, says Michael V. Vitiello, a psychologist at the University of Washington who specializes in sleeping in aging.
The most noticeable – and often most aggravating – changes are how sleep and waking times change and sleep becomes easier, which often begins in the Middle Ages. Gone is the weekend snoozes for 11am and the ability to sleep through a noisy wastebasket down the block.
The most common shift is a tendency to increase with (or before) the birds. Circadian rhythm scientists call it "morningness" and have found that it does not surprisingly tend to happen as people's preferred bedtime bends earlier with age. Scientists have documented the changes in circadian rhythms that occur with aging, but they still learn why they occur, Vitiello says.
Sleeping architecture – the stages of sleep and depth – also changes with age. Older adults take longer to fall asleep and they wake up more often. They tend to dwell on the deepest stages of sleep for less time than younger adults, and they also have less rapid eye movement sleep. While the exact purpose of REM sleep is still unclear, it seems important to memory and learning. Less restorative sleep at night can lead to a tendency to deceive during the day. (As long as they are not so long as to interfere with falling asleep at night, they are considered part of a normal sleep pattern.)
But not every restless night is benign. Studies have shown that poor sleep can pose a particular threat to older adults: falls, depression and anxiety, problems with memory and increased suicide risk are among the consequences of sleep problems in this population group found by researchers.
Some sleep disorders – REM sleep behavior disorder where people appear living dreams; circadian rhythm sleep monitoring disorder, causing a mismatch between a desired bedtime and the body's interest in sleeping and sleep apnea, causing repeated breathing repeated breathing – has been associated with increased risk of Parkinson's disease, Alzheimer's and dementia.
However, as with changes in sleep architecture and timing, researchers are still uncertain as to why these risk associations exist. Kristine Yaffe, a neuropsychiatrist at the UC San Francisco School of Medicine who specializes in dementia, warns that there are more questions than answers when it comes to dementia and sleep.
"If people have dementia, they tend not to sleep well," she said. "Do sleep problems actually lead to dementia? Sometimes it is hard to justify."
In a 2017 study in Sleep, researchers found that people with disturbed sleep had a 1.68-fold higher risk of cognitive impairment and / or or Alzheimer's than those without sleep disorders. But as scientists made it clear, there was no way to know if sleep disturbances are the cause of dementia or just a symptom of dementia.
What is clear is the relationship between good sleep and psychological well-being in older adults. A 2010 study documented that association, when it comes to sleep quality, but the amount of sleep did not show the same effects.
And in that, experts say that it can be the key to understanding sleep when you grow old. If you sleep less but do not feel negative effects out of bed, the changes you notice may be just normal age-related. If you experience a sudden change in your sleep, or poor or insufficient sleep disturbs daily life, changes your personality or your bedmate says you stop breathing when you snore, it could be a sign of something more serious and it is worth visiting your doctor.
Sometimes finding out sleep is just trials and mistakes. Florine Salierno, 81, found out that many years of attempts at over-the-counter products like melatonin did nothing for her insomnia, and she did not like the various drugs she had been prescribed. Now she follows her doctor's suggestion to meditate when she can't get back to bed, which she says helps at times. Salierno may feel irritated or even depressed by a sleepless night, but for the most part she does not attempt to interfere with her.
Which corresponds to what scientists say. Our bodies change over the years and it is normal for sleep to change as well.
"I think of it as tissue over time," Vitiello says. "Can you run the 100-yard dash or 100 meter dash as fast as you could when you were 18?"
Over time, he says that sleep patterns simply change. "Many older adults recognize that they are not sleeping the same as they did when they were 18, but they can still work and they are OK. And everything is good with the universe."