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StumbleUponThe Myths of Elder Sleep
Until recently, most of us simply assumed that getting old meant nodding off in our chair during the day and sleeping less at night. After all, that’s what our aging parents have been complaining about, right?
But scientists have recently begun to question our assumptions about what’s keeping our aging parents up. In fact, they’re beginning to think that insomnia is not a natural consequence of aging but is actually the result of some very specific problems that have very specific solutions.
The problems seem to fall into four areas, says researcher Sonia Ancoli-Israel, Ph.D., a professor of psychiatry at the University of California at San Diego and a recent president of the Sleep Research Society.
For one thing, “the older we get, the more problems we have with our health,” she explains. “Depression, pain from arthritis or from cancer, neurological disorders like Alzheimer’s, and organ system failures that are a result of heart disease, pulmonary disease, and kidney failure—all these things will interrupt sleep.”
Second, “all the medications we give older adults to treat all these medical and psychiatric illnesses can also interfere with sleep—particularly medications that are stimulating or activating when taken in the evening.”
A third cause is the increase in sleep disorders (see page 180) that seems to occur with aging—restless legs syndrome and sleep apnea, in particular—and a fourth is changes in our biological clocks.
“Changes in our body’s circadian rhythms make the ability to get the sleep we need more difficult,” explains Dr. Ancoli-Israel. “As we get older, our biological rhythm advances such that older people get sleepier earlier in the evening—around 6:00, maybe 7:00 or 8:00 P.M.
“If they went to bed at that hour, they would sleep their regular amount of time—that is, about seven or eight hours. But do the math: That means that they would wake up at 3, 4, or 5 in the morning, which, of course, is the biggest complaint of older adults: I’m waking up in the middle of the night, and I can’t get back to sleep.
“The reason that they can’t is that their biological clock is waking up,” says Dr. Ancoli-Israel. “Their physiological night is over.”
In many cases, however, our aging parents are not going to bed at 7:00 or 8:00 P.M., when they first get sleepy. Instead, they try to stay awake until the more acceptable bedtime of 9:00, 10:00, or 11:00 P.M.
What that frequently means, however, is that they sit down after dinner in front of the TV and doze off. “They might sleep for half an hour or hour,” says Dr. Ancoli-Israel. “Then they wake up.”
She chuckles. “But if you ask them if they nap in the evening, they say no, because sleeping in front of the TV doesn’t seem to count.”
Unfortunately, once our elders get into bed, they find that they can’t sleep. Since they’ve just slept for an hour, why should they? The chemical pressure to sleep from your biological clock just isn’t there. So they toss and turn for hours—then wake up at 4:00 A.M. Their nap time, plus the hours in bed, have equaled a full night’s sleep.
One other thing that frequently keeps our elders from a restorative sleep are life stressors. Just because our parents are old, it doesn’t mean they don’t have as much stress as we do, says Cathy A. Alessi, M.D., a professor at UCLA and associate director of clinical health services research at the Los Angeles Veterans Administration Healthcare System.
They may not be worrying about childcare or a demanding employer, but they are facing major stressors, such as retirement, trying to make ends meet on Social Security or a retirement plan crafted in World War II, downsizing into smaller homes, transferring to assisted-living facilities, the loss of friends and partners through illness and death, even their own mortality.
In some ways the things our aging parents have to face are the toughest challenges life will ever demand.
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