Aging worsens sleep; see how to sleep better – 03/10/2023 – Balance

As I get older, I find it increasingly difficult to fall asleep and stay asleep. Why does it happen?

Abhinav Singh, medical director of the Indiana Sleep Center and professor of sleep in the College of Osteopathic Medicine at Marian University, likes to answer this question with an analogy. Think of your ability to sleep like a car, he says. As it ages and drives more miles, the vehicle starts to wear out, needs more repairs, and becomes less smooth to drive.

The same thing happens with sleep, says Singh.

The researchers found that sleep quality actually does get a little rusty with age: Older adults are more likely to take longer to fall asleep, wake up more frequently during the night, and spend more time napping during the day, compared to younger adults. younger adults. They also spend less time in deep, restorative sleep, which helps bone and muscle grow and repair, strengthens the immune system, and helps the brain reorganize and consolidate memories, says Singh. Your melatonin levels, which play an important role in sleep-wake cycles, also change with age, he says.

It’s no surprise, then, when researchers surveyed more than 9,000 people age 65 and older in a landmark study published in 1995 and found that 57% of them reported at least one sleep complaint over the course of three years. These issues included trouble falling or staying asleep, waking up too early, feeling restless, and napping during the day. In another study published in 2014, scientists found that just over half of the 6,050 seniors who took part in the survey had had one or two symptoms of insomnia in the past month.

The work suggests that in general women are more likely than men to report poor sleep quality. They start having problems earlier in life, often around the time of the menopause transition (or in the years leading up to it), which typically begins between ages 45 and 55, according to the US National Institute on Aging.

What exactly causes these changes?

The truth is, nobody knows for sure. “We are just beginning to understand why all this happens,” says Luis de Lecea, professor of psychiatry and behavioral sciences at Stanford University.

One explanation is that it may have to do with the aging of the brain. In a recent study, Lecea and his team found that a specific group of neurons responsible for wakefulness became overstimulated in elderly mice, disrupting their sleep cycles. This change “probably happens in humans as well,” he points out, because the part of the brain that regulates sleep in mice, called the hypothalamus, is similar to that in humans. (Many sleep studies are conducted in mice for practical and ethical reasons.)

The researchers also found that the suprachiasmatic nucleus, another brain region that regulates the body’s circadian rhythms, deteriorates with age in mice. This results in sleep disturbances, including trouble falling asleep at regular times.

Certain lifestyle changes can also lead to sleep disruption later in life, points out Adam Spira, professor and sleep researcher at the Johns Hopkins Bloomberg School of Public Health. As people retire, their days become less structured and routine. They may wake up later or take a nap during the day, which can make it difficult to fall asleep at night, creating a vicious cycle.

The researchers also found links between depression, loneliness, grief over the loss of a loved one and lack of sleep in older adults. In a 2014 study, Spira found that seniors who had difficulty with certain activities or household chores, such as doing laundry, shopping, meeting friends, or taking a walk, were more likely to report symptoms of insomnia than seniors who could. participate in these activities.

For women, hot flashes, night sweats and higher rates of depression, anxiety and stress — common symptoms of the menopausal transition — are also correlated with poor sleep. But researchers still aren’t sure why these perimenopausal symptoms may be more severe and frequent in some women and how best to address them.

Of course, certain medical conditions that are more prevalent in older people can also wreak havoc with sleep, Singh points out. Weight gain, for example, can increase your risk of developing conditions like sleep apnea, which can make you snore, pant, or feel like you’re suffocating while you sleep. And medications like blood pressure diuretics can also disrupt sleep because they can trigger more trips to the bathroom. They really can “act like darts on your sleep board,” Singh said.

Are sleepless nights a fate?

The good news is that the same habits that improve sleep in general people also work for older adults with changing sleep patterns, says Spira. Going to bed and waking up at the same time each day, avoiding naps and late-afternoon caffeine, following a healthy diet and exercising regularly will help your sleep, research suggests.

In fact, a small study published in 2022 showed that at least 40 minutes of aerobic or resistance training four times a week helped seniors fall asleep faster and stay asleep longer.

Keeping a consistent meal schedule each day can also help create a routine, which in turn can help regulate sleep, says Singh—as can spending time outdoors in sunlight, which helps. to keep melatonin production and the body’s circadian rhythm under control.

Seniors taking medication should also check with their doctors to see if the substances could be interfering with sleep and if there are alternative options or a different dosage, he adds.

Translated by Luiz Roberto M. Gonçalves