Aging affects all of the functions of the body, including sleep, although not all them are affected with the same intensity or at the same time.
In addition, the chronological age of the elderly does not always coincide with the physiological, so changes in sleep patterns may appear in some subjects sooner and later in others.
In comparison to young adults, several prominent changes affecting both the architecture of nocturnal sleep and the sleep-wake circadian rhythm have been observed. All these changes contribute to making the sleep of the elderly characterized as being more “fragile” than when they were younger.
There is controversy over whether the need for sleep decreases with age. However, healthy elderly persons tend to need and get the same amount of sleep as they did when they were young, though they may have different sleep architecture and a different distribution during the 24 hours.
Objectively, we can say that the elderly spend more time in bed and less time sleeping, since they take longer to get to sleep, have more awakenings during sleep with extended night waking periods, have lower efficiency of sleep with a lower proportion of deep sleep of slow waves and REM, as well as changes in the alternation between wakefulness and sleep.
Sleep Disorders in the Elderly
Sleep problems are common in the elderly, and are probably more related to a lower “ability’”to sleep than a decline in the “need” to sleep.
The factors that contribute to the deterioration of sleep in senility are:
Physiological changes of aging.
Pathology of sleep itself most frequent in these ages: Insomnia, sleep apnea-hypopnea syndrome, periodic leg movements.
Other situations often associated with age: Existence of medical diseases, psychosocial conditions, sleep habits, concomitant treatments.
Insomnia: This is the most frequent complaint. Its frequency increases with age, especially the chronic form, and is often secondary. Risk factors for the emergence of insomnia in older age are depression, respiratory symptoms, disability, and subjective feeling of ill health.
Circadian rhythm changes: Advanced sleep phase is a disorder of the sleep-wake circadian rhythm that is common in the elderly. It is observed in subjects who are sleepy in the afternoon to evening so they go to sleep early and wake up, with difficulty returning to sleep.
Sleep apnea-hypopnea syndrome: Its prevalence increases with age, although the severity of the disorder may decrease in the elderly. This disorder is more common in women after menopause. In the elderly, the appearance of a sleep apnea-hypopnea syndrome would be a secondary condition to processes dependent on aging (increase in the collapse of the airway, decrease of the pharyngeal muscles response to negative pressure, narrowing of the diameter of the airway (by fatty deposits), decrease in the capacity for the diffusion of oxygen, weight gain, and the existence of other pathologies (e.g., hypothyroidism). In addition there is not an appropriate response to oxygen and CO2 concentrations in the blood.