As we age, the architecture of our sleep changes dramatically. The deep, delectable sleep in which we're oblivious to the outside world and its sounds, called slow wave sleep, becomes shorter and more elusive. Our total sleep time also declines. Infants sleep an average of 11.6 hours per night, but by the time we hit 70, our nighttime sleep has shrunk by nearly half, to an average of 6.6 hours.
Just because older people sleep less doesn't necessarily mean they have sleep problems. But if someone you're caring for complains of not sleeping well, having to get up frequently at night, or not waking up feeling refreshed, consider taking him or her to visit to the doctor. A thorough exam can unearth problems that can interfere with sleep, including pain from arthritis or other chronic conditions.
Medications can also interfere with sleep. Diuretics, typically used to reduce fluid retention in people with congestive heart failure, can cause a need to urinate frequently in the middle of the night if taken too late. Beta blockers, a class of heart medications, can cause insomnia, as can medications used to treat high blood pressure and thyroid problems. See our checklist for more about sleep problems.
Some sleep strategies that can help:
Get them moving
If the seniors you're caring for are able to exercise, one of the best things you can do is to get them moving. A study that compared 53 physically active older women to 48 wo men who didn't exercise showed that the exercisers slept an average of 50 minutes more each night than the sedentary group. What's more, the physically active women rated their sleep quality at 8.3 out of 10 compared to the nonexercisers who rated their sleep satisfaction at only 5.8.
Taking a brisk walk each day or finding an exercise class that's geared toward older adults can make a big difference. Remind them not to exercise vigorously too close to bedtime, though, because it might give them too much energy to relax and fall asleep. Some light stretching before bedtime is fine.
Help them change their daily routine
There are a number of changes seniors can make in their daily routine that can make going to sleep and staying asleep easier. If they nap during the day, encourage them to limit naps to no more than 30 minutes and to nap only in the early afternoon. If they didn't sleep well, it's better not to sleep in.
Advise them to eat a light evening meal. Choosing a salad or fish and vegetables instead of a big bowl of spaghetti and meatballs can result in more restful sleep. Similarly, cutting down on liquids during and after dinner can help reduce middle-of-the-night trips to the bathroom.
Also, help them develop an evening routine that doesn't demand too much thought or worry. Filling out health insurance forms, making potentially upsetting phone calls, and similarly unpleasant tasks should be avoided before bedtime. Such activities can frustrate anyone and make it hard to sleep.
If they enjoy playing cards or board games, you may want to join them for a hand before bedtime to help them unwind. If they're avid readers, encourage them to crack open a book. (Sleep experts say it's best to read somewhere other than in bed. The bed, they say, should be used only for sleeping and sex.)
Try mind games -- and block out the noise
If all else fails and they still worry about being able to get to sleep, try a tactic researchers call paradoxical intention. Instead of worrying about whether they can get to sleep, have them think about trying to stay up as late as they think they can -- and then go to bed. It's a slight shift in thinking that often works.
If they're open to the idea, biofeedback can help her learn how to reduce her
blood pressure and relax her muscles, which can contribute to more restful sleep. A trained biofeedback practitioner can teach her how to relax through visualization of a calming scene, using what's known as guided imagery.
Also, if they're sensitive to noise and aren't bothered by wearing ear plugs, suggest they give them a try. There are many varieties, at a wide range of prices, available at drugstores.
Make sleep medication a last -- and temporary -- resort
Experts agree that older adults should not take sleep medication on a long-term basis and should be monitored closely, since it can be habit forming.
Be aware that th e dosage for sleep medication should generally be lower in the elderly than in younger adults, since older people metabolize medication differently. Ask the doctor what the appropriate geriatric dose should be.