Is it true that the amount of sleep the elderly have is decreasing?

Sleep is an essential component of health and well-being at any age. However, older adults often experience changes in their sleep patterns, such as taking longer to fall asleep, reducing deep sleep duration, and waking up more frequently during the night. This raises the question, “Do older adults really need less sleep?”

The structure of sleep and changes with aging

Sleep can be divided into two main types: Non-Rapid Eye Movement (NREM) Sleep and Rapid Eye Movement (REM) Sleep, each with its own role in restoring the body and brain processes. In the elderly, all are affected and affect sleep as follows:

1. Sleep Latency

In young people, the body can fall asleep quickly due to balanced levels of the hormone melatonin. However, as we age, melatonin production decreases, causing older adults to take longer to fall asleep.

2. Deep sleep stage (Slow-Wave Sleep – SWS)

Deep sleep is when the body restores cells and repairs tissues. It plays a key role in the production of growth hormone, which helps build muscles and bones. Studies have shown that with age, the proportion of SWS decreases, resulting in reduced recovery and potentially associated with long-term memory loss.

3. Sleep stage (REM)

REM sleep is a stage that is involved in learning, memory, and emotions. Research suggests that older adults have shorter REM sleep periods and may be more likely to wake up during this time, which can affect the efficiency of the nervous system and the ability to manage stress.

4. Waking up pattern in the middle of the night and early in the morning

The circadian rhythm of older adults tends to be shifted, causing them to wake up earlier than usual. They also tend to wake up more frequently in the middle of the night because their sleep homeostasis is not as efficient as in younger adults.

Factors affecting sleep duration in the elderly

· Changes in the brain and nervous system: Brain structures such as the Thalamus and Cerebral Cortex, which play an important role in regulating sleep, deteriorate with age, resulting in changes in sleep patterns.

· Hormonal changes: In addition to reduced melatonin, other hormones such as cortisol and serotonin can become imbalanced, making older adults more likely to have sleep problems.

· Mental and emotional conditions, stress, anxiety and depression are factors that directly affect the quality of sleep in the elderly.

· Environmental and lifestyle factors: Noise, room temperature, and excessive light can disrupt sleep in older adults. Exercise and lifestyle habits also influence sleep patterns.

· Factors related to underlying diseases: Some underlying diseases directly affect sleep, reducing the quality of sleep. Also, taking certain types of medications affects the quality and continuity of sleep, which may cause you to wake up easily or have to go to the bathroom frequently.

The effects of insufficient sleep in the elderly

1. Chronic Disease Risk: Poor quality sleep has been linked to an increased risk of heart disease, diabetes, and dementia such as Alzheimer's.

2. Frailty in the elderly: Research has found that elderly people who sleep less than 5 hours per night or more than 9 hours per night may be at higher risk of frailty and loss of muscle mass.

3. Impact on mental health: Older adults with sleep problems are more likely to experience depression, anxiety, and mood swings.

The role of sex on sleep quality in the elderly

Decreasing sexual desire in the elderly, in addition to changing hormones, is also a result of reduced sleep quality, causing unpreparedness both physically and mentally. However, research from the English Longitudinal Study of Ageing (ELSA) found that having sex may play an important role in improving the quality of sleep in the elderly, especially in women who have sex regularly, tend to have fewer sleep problems, while men who have sex less are more likely to experience sleep problems.

Hormones involved in sexual activity, such as oxytocin and endorphins, can help reduce stress, relax the body, and help you sleep better. However, these results may vary depending on the health and mental state of each person.

summarize

The duration of sleep in the elderly is reduced due to biological factors, but focusing on the quality of sleep is equally important. Taking care of health through appropriate sleeping behaviors, such as controlling light and noise in the bedroom, exercising regularly, and taking care of mental health can help the elderly have better sleep quality.

Although it is natural for the body to adapt as we age, understanding the mechanics of sleep can help us adapt and take care of our own health and that of our loved ones more effectively.

Thanks for the reference information.

Lee, D.M., & Tetley, J. (2019). Sleep quality, sleep duration and sexual health among older people: Findings from the English Longitudinal Study of Aging. Archives of Gerontology and Geriatrics, 82, 147-154.

da Silva, AA, de Mello, RGB, Schaan, CW, Fuchs, FD, Redline, S., & Fuchs, S.C. (2016). Sleep duration and mortality in the elderly: a systematic review with meta-analysis. BMJ open, 6(2), e008119.

Edwards BA, O'Driscoll DM, Ali A, Jordan AS, Trinder J, Malhotra A. Aging and sleep: physiology and pathophysiology. Semin Respir Crit Care Med. 2010 Oct;31(5):618-33. doi: 10.1055/s-0030-1265902. Epub 2010 Oct 12. PMID: 20941662; PMCID: PMC3500384.

Chen, S., Wang, Y., Wang, Z., Zhang, X., Deng, C., Ma, B., ... & Zhao, Y. (2022). Sleep duration and frailty risk among older adults: evidence from a retrospective, population-based cohort study. The Journal of nutrition, health and aging, 26(4), 383-390.