Sleep Disorders in Older People (Part II)

One of common complains among older people is sleep disturbance. They frequently complain that they find it difficult to fall asleep or only can sleep for a few hours and wake more frequently during the night. It is still a big question for them and their families that need to be answered, whether these conditions are normal or abnormal in older people. Part I of five reviews on Sleep Disorder in Older People will highlight the changes in sleep pattern associated with aging

Sleep is a vital physiologic process with important restorative functions. Normal sleep progresses through several stages.

Aging is associated with several changes in pattern of sleep. Typically, there is a phase advance in the normal circadian sleep cycle: older people tend to go to sleep earlier in the evening but also to wake earlier; wake more frequently during the night and experience fragmented sleep. With aging, the total amount of time asleep shortens: infants and young children sleep an average of 16-20 hours per day; adults, 7-8; and people over 60 years of age, 6½ hours daily. Delta sleep (stage 3 and 4), the deepest and most refreshing form of sleep, diminishes with age.

In short, typical sleep changes with aging are as follows:decreased total nocturnal sleep time; delayed onset of sleep; advanced circadian phase: early to bed, early to rise; reduced slow-wave sleep; reduced REM-sleep; reduced threshold for arousal from sleep; fragmented sleep with multiple arousals; daytime napping.