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Sleep and Aging. Meredith Broderick, MD April 2, 2008. Sleep and Aging. How does sleep change as we age? Do we need less sleep as we get older? Can a person expect to experience more sleep problems or have a sleep disorder as they advance in age?
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Sleep and Aging Meredith Broderick, MD April 2, 2008
Sleep and Aging • How does sleep change as we age? • Do we need less sleep as we get older? • Can a person expect to experience more sleep problems or have a sleep disorder as they advance in age? • As we age, how does sleep affect our overall health, medical conditions and general well being? • What can we do to get good sleep?
What is aging? What is sleep? • multidimensional process of physical, psychological, and social change
Myths about sleep and aging • Poor sleep is an inevitable consequence of getting older • Being sleepy is part of the aging process
Health and Environment Affect Our Sleep With age, we become more sensitive to: • Hormonal Changes • Physiological Conditions • Environmental Conditions • Light • Noise • Temperature
Normal Sleep and Normal Aging:Sleep Efficiency Sleep Efficiency (% Time in Bed Sleeping) Men Women Age Changes with age
Changes in sleep with Aging • Increased napping through out the day • Increased sleep latency • Increase in awakenings and arousals • Decreased stage 3 and 4 sleep (slow wave sleep) • Increased stage 1 sleep. Stage 2 sleep is variable. • Decreased REM sleep. REM sleep appears to be equally distributed through sleep cycles. I.e. there is no increase in REM at the end of the sleep period. • Reduced sleep efficiency • Increased stage shifts • Fewer cycles • Phase advancement • Decreased melatonin levels
Sleep changes and aging • Aging is associated with malfunction or decrease in sensitivity of the SCN to environmental cues to adjust circadian rhythm to a natural 24-hour day/night cycle • More fragmented sleep • Increased in stage 1 and 2 sleep with more fragmented REM sleep indicating more dreaming • Slow wave sleep is reduced
Sleep and Aging • In the 2003 Sleep in America poll, NSF profiled the sleep patterns of older Americans. About two-thirds of older adults reported experiencing one or more symptoms of a sleep problem at least a few nights a week
Age related changes in the Brain • Decrease brain to cranium volume • Loss of neurons • Loss of mass • Increasing gray to white ratio
Sleep and Aging • NSF 2003 Sleep in America poll • The first NSF poll to look at the sleep habits of older Americans -- those between the ages of 55 and 84 -- and the association between their sleep behavior, their medical and physical conditions, their outlook and their lifestyles.
Sleep and Aging • More older adults are sleeping 7-9 hours on both weeknights and weekends (56% vs. 51% for weeknights and 60% vs. 55% for weekends). Additionally, the 32% of older adults who nap 1–3 days a week or more get an average of 41-51 minutes of supplemental sleep time.
Sleep and Aging • NSF poll found that the better the health of older adults, the more likely they are to sleep well • The greater the number of diagnosed medical conditions, the more likely they are to report sleep problems. • Positive moods and outlooks as well as having more active and "engaged" lifestyles (having someone to speak with about a problem, exercise, volunteer activity, etc.) are associated with sleeping 7–9 hours and fewer sleep complaints.
Sleep and Aging • Rather than a consequence of aging, poor sleep among older Americans appears to be an indicator of health status
Summary:Sleep Changes • Sleep during the night changes with increasing age: • Less deep sleep and more lighter sleep • More difficulty maintaining sleep due to arousals and awakenings • Sleep is less efficient and more fragmented • The internal biological clock shifts to earlier bed and wake times • Older persons experience a higher prevalence of medical conditions and take meds that interrupt sleep and are associated with sleep • problems/disorders • Older persons experience a higher prevalence of sleep disorders
Summary:Consequences of Sleep Changes • Tendency to stay in bed longer to get a sufficientamount of sleep results in worse sleep • More likely to take more naps to meetsleep need—may result in worse sleep • Inadequate or poor sleep results in daytimesleepiness and fatigue • Ability to function well, enjoy life andoverall quality of life is affected
Summary:What you can do • Learn about sleep • Understand how your sleep changes and observe your habits and experiences • Apply healthy sleep practices to your sleep style so that you get sufficient quality sleep • Talk to your doctor about your sleep and see a sleep specialist if you experience chronic difficulty sleeping and/or have symptoms of sleep disorders