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The Sleep Whisperer is a series of columns offering insights and advice about sleep health. It is not a substitute for seeking professional medical care.
Have you noticed your sleep changing as the years go by? For many, the shift begins as early as our 40s.
Research from sleep laboratories confirms that as we age, sleep becomes shorter, lighter and more fragmented. By the time we reach our mid-60s, it’s not unusual – even in otherwise healthy people – to have very little deep sleep, or in some cases, none at all.
Why does this happen? Scientists are still piecing together the puzzle, but we already have a few clues.
Struggling with insomnia? ‘Sleep hygiene’ rules could be making it worse
There are two main forces that regulate sleep: our “sleep drive” (the pressure to sleep, which builds the longer we stay awake) and our internal biological clock, which tells our body when it’s time to be awake and active and when it’s time to rest.
With aging, both systems lose strength. Sleep drive becomes sluggish, which cuts down deep sleep. Also, the biological clock tends to shift earlier and generate weaker sleep and wake signals, making us more prone to getting up early, daytime drowsiness and nighttime awakenings. What’s more, sleep gets more susceptible to external challenges as we age. For instance, sleep becomes more sensitive to stress hormones, noises in our sleeping environment, jet lag and shift work.
On top of these natural changes, age also increases the risk of several sleep disorders. For instance, there is a strong relationship between older age and sleep apnea – when breathing repeatedly stops during sleep. Sleep apnea not only fragments sleep but also raises the risk of high blood pressure, heart disease and stroke. Because it alters sleep quality and deprives the brain of oxygen, it can worsen irritability and accelerate memory decline.
Canadian researchers are uncovering how age-related sleep changes connect to brain health. At Concordia University, clinical epidemiologist and sleep neuroscientist Dr. Arsenio Páez found that declines in specific brain waves during sleep – spindles and slow waves – are linked to the buildup of harmful proteins at the core of Alzheimer’s disease. As he notes, because sleep is something that we can actively improve, it may be a helpful target to slow Alzheimer’s progression and protect brain health.
Also, recent work led by Dr. Andrée-Ann Baril, from the Quebec-based Centre for Advanced Research in Sleep Medicine, points to inflammation as a key link between sleep and Alzheimer’s disease. Inflammation acts like the body’s alarm system, summoning the immune response to heal and protect when we face a health threat. Short-term inflammation helps healing, but when it lingers too long it can affect brain health and cognitive function. Sleep problems can fuel this process. In a 13-year study, Baril showed that older adults who had a combination of poor sleep and high inflammation were more likely to develop dementia. The good news is that sleep in and of itself has natural anti-inflammatory effects.
So, what can you do? While it’s important to keep expectations realistic –sleep will naturally change with age – it doesn’t mean poor sleep is inevitable. Protecting sleep is one of the best investments in healthy aging.
Here are some steps you can take to help:
- Work with your body clock. If you’re getting sleepy earlier in the evening, embrace it instead of forcing yourself to stay up. Going with your natural rhythm helps preserve total sleep time since you may have a tendency to wake up earlier in the morning.
- Keep a stable sleep schedule. A regular bedtime and wake up time may not be on your radar if you’re retired and freed from external constraints. However, regularity is a critical part of sleep health. It may also have protective effects for brain health as we age, according to a Canadian study.
- Keep your naps short and early. Current guidelines recommend a similar total amount of sleep for adults aged 18-64 (7-9 hours) and those aged 65 and up (7-8 hours). Yet, since sleep may be more broken up at night as we age, boosting your total sleep time with daytime naps is a valid strategy as long as you do not have insomnia. Short naps (10–30 minutes) before 3 p.m. can be restorative without interfering with your nighttime sleep.
- Treat insomnia properly. If you have difficulties falling asleep or staying asleep at least 3 nights per week for over three months, you may have crossed the line between normal age-related changes and insomnia disorder. Cognitive- behavioural therapy for insomnia (CBT-I) is the No. 1 treatment – and it works well for older adults too.
- Address sleep apnea. If you snore heavily or feel excessively sleepy during the day, ask your doctor about a referral to a sleep specialist. A sleep test is the only way to diagnose apnea, and treatment can be life-changing.
Sleep will evolve as you age, but it’s not something you should simply surrender. Nurturing your sleep can keep both your body and mind healthier for longer.
Dr. Rébecca Robillard, PhD, is a clinical neuropsychologist and associate professor at the School of Psychology at the University of Ottawa. She also leads clinical sleep research at The Royal. Robillard’s main area of work focuses on interactions between mental health, the sleeping brain and the sleeping heart. She co-chairs the Canadian Sleep Research Consortium, a national hub of sleep scientists and clinicians.