Aging and Sleep

Sleep Through the Ages

We slept warmly in our mother’s womb. Then as neonates, we spent most of our days asleep because our brain and body demanded it as we grew so rapidly. Our sleep continued to change as we became teenagers, adults and elderly. It is an unavoidable fact that we humans change as we age; so does our sleep, sometimes not to our liking. People are aware of changes in their body when they look in the mirror. The less visible changes show up as join pains, decreased acuity of vision and a poorer quality of sleep.  Let’s take a look at how sleep changes throughout our lives.

Neonate

They spend most of their lives asleep. Their sleep oscillates between REM and non-REM sleep. REM sleep refers to rapid eye movement sleep, a state known for dreaming and muscle paralysis. Non-REM sleep is the quieter sleep. Whereas adults sleep in 90-minutes cycles of REM/non-REM, neonates have 60 minute cycles. Neonates’ biological clock which sits in the brain is not mature, so their sleep and wake times tend to be random. Over time, they will establish a pattern to the joy of their sleep deprived parents.

Children

After one year of age, the child sleeps for almost 14 hours plus a couple of naps during the day. Their rhythm becomes more in tune with adults’ rhythm: they sleep at night and wake during the day. By age 5, their total sleep drops to about 10 hours. They also stop taking two naps.

Teens

During puberty, the brain goes through incredible changes with rewiring of the nervous system. Hormones such as testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) are released in large amounts during puberty in girls and boys. These hormones influence the brain’s development. A good night sleep is important for a teenager’s development.

Many teens turn into night owls. That is because their biological clock is shifter later. The medical term is “delayed sleep phase syndrome”. They become alert in late evenings and nights. They go to bed later. In the meantime, their biological need for sleep actually increased compared to a grown child, so instead of getting the 9 hours of sleep they typically need, they get much less. Let’s not forget the social changes that affect staying up late (texting, talking to friends, computers) and the not-so strict parenting are setting for staying up late.

Unfortunately schools have not caught up on this biological change in teens. Early school hours lead to sleep deprivation in many teens. This increases irritability and mood problems and affects their school performance. Few states have adopted a delay in starting school and the results have been an improvement in students being awake and engaged. Minnesota, which delayed the school start time by a little more than an hour in the morning, found that students were more alert in class, their behavior improved, were more likely to eat breakfast and complete their homework.

Adults

Studies done by well known sleep researchers such as Sonia Ancoli-Israel tell us that an average adult who is between the ages of 40 and 65 requires about 7 hours of sleep. Other studies point to 7.5 to 8.5 hours of sleep. Certainly, as we move from childhood and puberty, we require less sleep. Unfortunately, adulthood emerges with sleep problems which are typically the result of busy lives, responsibilities, stress, and physiological changes such as aging, weight gain, sleep apnea, medications, pain, menopause etc. Many adults experience insomnia, fatigue, sleep apnea, restless legs, daytime sleepiness and unrefreshed sleep.

Adults function better if they make their sleep a priority by adopting good sleep habits, stress management and get the adequate amount of sleep. If you suspect an unrelenting sleep issue, seek medical help from your physician or a sleep medicine specialist.

Elderly 

Many elderly folks are not satisfied with their sleep. Their sleep becomes lighter and disrupted. They take naps during the day. Aches and pain, the effect of medications, sleep apnea, restless legs, depression, retirement and sedentary lifestyles are some of the causes for a restless sleep and daytime fatigue.

It is still important to keep good sleep habits and pay attention to the medications you take. Talk to your doctor about the side effects of your medications. If a medication causes insomnia for example, ask your doctor if you can take it in the morning. Vice versa, if the medication causes drowsiness, see if you can it in the evening or nighttime.

Don’t resort to a sleeping pill as your first option if you have insomnia. First, try to figure out why you are not sleeping well at night. Maybe it is too many naps and too little physical and mental activities during the day. Do you snore and wake up with gasping episodes at night? This is concerning for sleep apnea, which needs to be treated because of the harms it imposes on your body. Do you have lots of stress and worries at night? Try counseling and talk therapy to learn to cope with stress.  Avoid too much caffeine and alcohol.