The need for sleep continues to exist as we age and it is essential for proper functioning on a physical and cognitive level. In fact, the National Sleep Foundation of the United States recommends between seven and eight hours of sleep daily for older adults, just one less than for young adults (recommendation of between 7 and 9 hours). However, it is not unusual to hear older adults complain about their sleep, how little they sleep.
It is not a trivial complaint. According to Dr. Ana Fernández, coordinator of the Sleep and Wakefulness Disorders Study Group of the Spanish Society of Neurology (SEN), several studies have estimated that total sleep time is reduced between 10 and 12 minutes per decade. of adult life until stabilizing around age 60. At this age there is also a decrease in the proportion of time that we are actually asleep while lying resting in bed. If in adolescents this proportion is 90%-95%, in a 70-year-old person it is already reduced to approximately 80%.
“There are several factors for this, among them the changes produced in sleep due to aging itself, the increase in the prevalence of sleep disorders (especially insomnia, obstructive apneas or abnormal movements during sleep) and the increase of the incidence of other diseases that can affect rest, such as mood disorders, chronic pain or respiratory diseases,” explains the neurologist, who also adds the importance of other changes that occur with age, including an imbalance in circadian rhythms, modifications in sleep homeostasis, as well as hormonal changes at the level of cortisol, melatonin or sex hormones.
The latter especially affect women, who after menopause “have an overall worse quality of sleep”, with higher rates of insomnia and a notable increase in suffering from disorders with obstructive sleep apnea: “The reason is the decrease in sex hormones (estrogen and progesterone), which have brain receptors in areas related to the cycle, sleep and wakefulness, as well as comorbidity with other medical problems such as mood disorders or chronic pain.
To these more physiological changes are added others of a more social nature, among them fundamentally retirement which, as the researcher at the BarcelonaBeta Brain Research Center of the Pasqual Maragall Foundation points out, can lead to changes in lifestyle (schedules, routines , daily stimuli and activities, lack of physical exercise, etc.): “In cases where there is a sedentary lifestyle and little occupation, this can give way to prolonged naps that make it difficult to sleep at night. And, on the other hand, at this stage it is more common for mental health disorders such as depression or anxiety to occur that affect sleep bidirectionally.”
All of these changes ultimately translate into shallower sleep. “We have different phases of sleep, and with age, especially after the age of 50, the amount of slow wave sleep, deep sleep, decreases, so sleep becomes more sensitive to any interference” , says Dr. Sandra Giménez Badia, coordinator of the Cognition and Sleep working group of the Spanish Sleep Society (SES).
And less deep sleep, in turn, implies more nocturnal awakenings, which is why, as the clinical neurophysiologist at the Hospital de la Santa Creu and Sant Pau in Barcelona adds, the architecture of sleep becomes fragmented: “At a younger age We sleep at night and are awake during the day, but with age this weakens and the sleep we lack at night is recovered to a certain extent during the day, through more fragmented naps. It is the compensation we make, but the sleep lost at night is not compensated because the sleep from the naps does not have the same quality.”
Although the physiological changes that occur during aging can cause worse sleep, Giménez Badia highlights the importance of not normalizing the idea that turning older necessarily means sleeping worse. “It would be like saying that if you get older you lose your memory and develop dementia. It is one thing for your dream to change, but it does not affect your daily life; and the other is that you sleep badly. Is not the same. You can get older and your dream may change; That, for example, you have to get up more times to go to the bathroom because you have prostate problems. But if you sleep poorly, have apneas or insomnia and wake up exhausted, that is not normal and should be studied,” she reflects.
Continuing to maintain healthy rest and achieving those seven or eight hours of daily rest that the National Sleep Foundation recommends, in fact, is essential for health at all levels. And, as Ana Fernández recalls, a short sleep duration (less than 7 or 5 hours, according to studies) is associated in the short term with worse cognitive performance, daytime sleepiness, and less likelihood of engaging in physical activity and have social interactions; while in the medium and long term this lack of rest is related to greater fragility and an increased risk of developing a multitude of diseases, including dementia, mental health disorders, some types of cancer and cardiovascular diseases.
In order to maintain the best possible rest despite the changes inherent to age, the experts consulted agree on pointing out a series of basic sleep hygiene guidelines that could be extended to any adult:
