Along with the many complaints that may come with old age, insomnia ranks high on the list. Older people complain that they can’t get a good night’s sleep anymore, that they can’t sleep the way they did when younger — but their complaints may, in fact, be based on the faulty notion that they still require as much sleep as they did decades earlier. New research indicates that in fact, people over the age of 60 naturally sleep less than younger folks do. Naturally, of course, being the interpretive word here.
The study, out of Brigham and Women’s Hospital in Boston, analyzed the sleep patterns of elderly subjects aged 60 to 75, and compared the results with a group aged 18 to 32. All the subjects were healthy and not on any medications that could disturb sleep. The subjects were instructed to stay in bed in a darkened room for 16 hours daily, including day and night to adjust for circadian rhythms. It turned out that the younger subjects easily slept for an average of nine hours (considerably less than their usual nighttime sleep), while the older subjects on average couldn’t sleep beyond 7.5 hours.
According to study director Elizabeth Klerman, “The most parsimonious explanation for our results is that older people need less sleep.” The results don’t necessarily mean that older people thrive on less sleep, or even that they have experienced changes in their sleep “set point.” Although Klerman admits, “It’s also possible that [older people] sleep less even when given the opportunity for more sleep because of age-related changes in the ability to fall asleep and remain asleep,” she asserts that these age-related changes are normal and not cause for alarm, nor cause for taking sleeping pills.
“If older people believe that they need more sleep than they can achieve even when they spend extra time in bed, then they may complain of insomnia: being awake when wanting to be asleep,” she says. “They may start using medications needlessly. If they are tired during the day, they should consider evaluation for a sleep disorder that may be interfering with their ability to obtain good sleep at night.”
In fact, another study indicates that snagging extra sleep (at least too much of it) may work to the detriment of older adults. The March 2009 study published in the Journal of the American Geriatrics Society found that elderly women who napped more than three hours weekly had a 44 percent greater risk of dying from any cause and a 58 percent increased risk of dying from cardiovascular causes. The study also found that subjects who slept between nine and ten hours a night had a higher rate of mortality compared to women who slept eight to nine hours.
The researchers determined that napping and sleeping long weren’t causing death, but rather that those who took naps and slept 10 hours daily probably had underlying health problems that kept them from sleeping well at night, and so they craved more mattress time.
“Since excessive sleep suggests that night time sleep is disrupted, interventions to treat sleep disorders and improve sleep quality in older women may reduce mortality risk,” said Katie L. Stone, co-author of that study. Sounds like the beginnings of a case for dishing out medications designed to improve sleep, which is exactly what Dr. Klerman’s study recommends against.
By the way, naps amounting to less than three hours weekly had no detrimental effect in the study. It should also be noted that other studies have found that afternoon naps boost mental performance in the elderly and have no correlation to increased mortality, while the case for longer sleep at night linking to increased risk of death is nearly unanimous.
For instance, one huge study published in The Archives of General Psychiatry in 2002 looked at sleep patterns of over a million adults aged 30 to 102. Those who slept more than eight hours a night had a 12-percent increased mortality rate, and that risk escalated with each additional hour of sleep. The risk also applied to those getting four or fewer hours nightly, with six to seven hours proving optimal.
Another study in 2007 out of the University of Warwick and University College in London confirmed those findings, determining that both too little and too much sleep led to higher mortality. Those subjects who reduced sleep from seven to five hours nearly doubled their mortality risk, while those who increased sleep from seven to eight hours also had twice the risk of death. Again, seven hours of sleep per night emerged as the magic number.
But the one thing all of these studies avoid talking about is the quality of sleep. Yes, quantity matters, but quality matters more — particularly as we age. Older people don’t just sleep less; the quality of their sleep is diminished too. The problem is that the average percentage of time spent in deep, slow-wave sleep decreases dramatically as we age. By the time most people are 60, they spend most of their time in stage 1 and 2 sleep and almost none in delta. This has a profound effect on both on how alert you feel during the day and on your overall health. The bottom line is that 7.5 hours of surface sleep and 7.5 hours of deep delta sleep are not the same thing.
For a more detailed discussion of sleep and how to get better at it, check out my newsletter — To Sleep, Perchance to Dream.
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