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How do sleep patterns change with age?

Dr. Aruna V. Josyula, MD
Geriatric Medicine Specialist

Sleep patterns change with normal aging, and insomnia is a common complaint among seniors. As an older adult, you may find you lie in bed longer but don't sleep the whole time. You may also fall asleep earlier in the day yet wake up sooner than you'd like.

Quality sleep is important for a quality lifestyle. Without good sleep, you cannot rejuvenate yourself. However, if you are not as active as you had been, don't expect to require the same amount of sleep. You may need to increase your activity level to allow you to be tired and ready to sleep. If you spend several hours in front of the TV, you will not be able to sleep well.

Dr. Kelly Traver
Internist

Sleeping patterns at various ages are given as follows:

Newborns sleep 18 hours a day and spend 50 percent of their sleeping time in rapid-eye-movement (REM) sleep, consolidating the new information to which they have been exposed. Adults spend only 20 to 25 percent of their sleep time in REM sleep.

Children have extremely high melatonin levels at night. They pass really quickly into stages three and four sleep. Have you ever tried to wake a sleeping child? Children go right into deep sleep in no time!

Adolescents need one hour more of sleep than they did as children. Body temperature curves shift to the right in adolescence; some high schools now recognize this phenomenon and are starting classes later in the morning, when adolescents are more alert.

Young adults (20-40 years) begin to lose the ability to descend into the deeply restorative stages three and four sleep in their 20s and 30s. By age 40, stage four NREM sleep disappears altogether. For women, hormonal fluctuations right before the menstrual cycle can also disrupt these sleep stages.

The midlife (40-60 years) years show a further decline in the time spent in stage three sleep, and there are more nighttime awakenings. Body temperature variation starts to flatten in this stage of life, producing more shallow sleep.

Exercise is always a great way to promote deeper sleep at any age, but in midlife and the later years, it can be especially helpful. Exercise increases the magnitude of daily body temperature fluctuation, so it helps people sleep more deeply.

Those who are physically fit have deeper, more restorative sleep and fewer nighttime awakenings. Exercise is the only way adults can increase the amount of time spent in the deeper stages of sleep; fortunately, this benefit continues into the later years as well.

In later years (60 years and beyond), men and women continue to spend 20 percent of their sleep in REM, but only 5 percent of NREM sleep is spent in stage three. Also, as previously mentioned, the ability to enter stage four disappears by age forty. The body temperature curve typically shifts to the left at this time of life, so it is more common for older people to fall asleep sooner in the evening and awaken earlier in the morning. Advanced sleep stage syndrome occurs in 25 percent of people in this age group and causes them to awake early in the mornings.

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Dr. Michael Breus, PhD
Psychology Specialist

The time from the onset of sleep until waking up in the morning does not appear to change with age. However, as we age the number of times we awaken can change, so the total sleep time can also change. As we get older we get sleepier and may nap more frequently during the day then we did when we were younger. Thus the total amount of sleep in a 24 hour period may be constant over the course of our lives, but as we age this amount is less likely to come from one sleep period. In addition as we age the amount of deep sleep (stages 3 and 4) we experience will decrease in both duration and power. These changes appear to be more pronounced for men than women. In fact, some research shows that a man’s deep sleep could decrease by about seventy-five to eighty percent, and is replaced by lighter sleep.

As people age, they're more likely to experience a bad night's sleep for a variety of reasons. Insomnia is a common complaint, striking 1 in 4 people over the age of 65. Awakening during the night, perhaps to use the bathroom, becomes more frequent. Medication can affect sleep habits as well. Biologically, older adults need less sleep, but their sleep cycle shifts so that they feel sleepier earlier in the evening and awaken earlier in the morning. They also take longer to fall asleep. Some adults reporting a poor night's sleep might just be trying to fall asleep like they used to instead of adjusting to their body's new rhythms.

While adults on average need seven to nine hours of sleep per night, older and younger adults’ quality of sleep differs. Older adults experience more light sleep, less deep sleep and more awakenings. However, sleep difficulties are not a normal part of aging.

Dr. Dawn Marcus
Neurologist
As adults age, there's a common myth that they no longer need much sleep. Older adults still need about 8 hours of sleep, although they may have to adjust their sleeping patterns to get it. Chemicals that regulate sleep (like cortisol, growth hormone, and melatonin) vary with age, causing significant changes in our sleep patterns. As we age, we usually begin feeling sleepy earlier and need to take advantage of an earlier bed time to easily get to sleep. By middle age, we should plan an earlier bed time. We will also notice that our sleep will be lighter and we'll wake up more often during the night. Seniors tend to have more episodes of waking up during the night and usually an earlier time when their body feels ready to end the night's sleep. Older folks, therefore, usually have to adjust their sleep habits to avoid getting too little sleep during the night and then feeling excessively sleepy during the day. People who don't adjust their sleep habits often find themselves napping excessively during the day, which can further disrupt good night time sleep.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.