It’s normal for our sleeping patterns to change with age because lifestyle habits and medical conditions can affect the production of sleep hormones.
As a result, many adults report having trouble falling asleep, staying asleep, feeling tired earlier in the evening, or waking up early in the morning. However, while changes to sleeping patterns can be a normal part of ageing, sometimes they can be the result of an underlying condition.
In this article, we’ll cover various age-related sleep conditions and the medical conditions that can sometimes cause them.
Common age-related sleep conditions
Insomnia
Insomnia is a common condition that causes disrupted or irregular sleeping patterns. It’s categorised by consistent difficulty falling or staying asleep, even when you feel physically and/or emotionally exhausted.
We all suffer from short-term insomnia from time to time – for example, when we’re nervous about something. But, when symptoms appear at least three times a week for longer than a month, this is classed as chronic insomnia.
In many cases, lifestyle changes can help treat insomnia. For example, reducing screen time before bed, exercising, sticking to a bedtime routine, and creating a relaxing sleeping environment. Though, in some cases, professional help may be required.
You can find tips on how to treat insomnia in our article; What is insomnia and how can you improve it?
Sleep apnea
Sleep apnea is a condition where breathing stops and starts during sleep. It can cause people to snore heavily, make gasping and snorting noises, and wake a lot throughout the night. This often results in disrupted sleep and daytime tiredness.
The most common type is obstructive sleep apnea, which is caused by blocked airways. Another less common type is central sleep apnea, which is caused by a failed connection between the brain and muscles responsible for breathing.
It’s important to speak to your doctor if you think you may have sleep apnea as it can sometimes be a predictor of an underlying health condition. If necessary, they may refer you to a specialist sleep clinic for further tests.
However, in mild cases, sleep apnea doesn’t require treatment. Many people use a CPAP machine, which is placed over the mouth and nose to help you breathe during the night. These are provided for free on the NHS where required.
You can find out more about treatments for sleep apnea on the NHS website.
Restless leg syndrome and periodic limb movements
Both restless leg syndrome (RLS) and periodic limb movements (PLMS) are distressing and can be disruptive to sleep. RLS is a neurological condition that causes an overwhelming urge to move your legs. PLMS are involuntary, repetitive movements of the arms and legs during sleep that occur more than 15 times per hour.
The exact cause of these conditions is unknown, however studies show that the risk of RLS and PLMS almost doubles with age. According to the Sleep Health Foundation, PLMS affects up to 40% of people over the age of 65.
Mild cases of RLS and PLMS can usually be treated with lifestyle changes such as quitting smoking, exercising regularly, and practising healthy sleep habits. However, if symptoms are more severe, medication may be required. If you think you have RLS or PLMS, it’s best to book an appointment with your GP.
Circadian rhythm sleep disorders
The circadian rhythm is the body’s internal clock that helps to regulate our sleep cycle. When disrupted, it’s considered a circadian rhythm sleep disorder – and these tend to be more common with age.
This is because the internal mechanisms and hormones (like melatonin) that are responsible for regulating the sleep-wake cycle weaken as we get older. Certain medical conditions and medications can also make people more susceptible to developing a circadian rhythm disorder.
Advanced sleep-wake phase disorder (ASWPD) – which causes people to routinely go to bed between 6pm and 9pm and wake up between 2am and 5am – is particularly common in older adults.
Similarly, irregular sleep-wake rhythm disorder (ISWRD), where sleeping patterns don’t follow a 24-hour day-night cycle, is common in adults with neurological conditions like Parkinson’s or Alzheimer’s disease. These conditions can lead to disrupted sleep patterns, excessive tiredness, trouble concentrating, and an increased likelihood of depression.
If you think you might have one of these conditions, it’s important to speak to your doctor. In many cases, lifestyle adjustments are enough to re-regulate the circadian rhythm. However, sometimes other treatments – such as melatonin supplements – may be required.
You can learn more about the sleep-wake cycle in our article; Everything you need to know about melatonin and the circadian rhythm.
REM sleep behaviour disorder
Rapid eye movement (REM) sleep is the stage of the sleep cycle where dreaming occurs. Our muscles are usually paralysed during this stage of sleep, but REM sleep behaviour disorder (RBD) causes people to physically act out their dreams.
For example, people may talk, shout, punch, kick, or jump. Unlike sleepwalking or night terrors, people with RBD can also recall their dreams after waking up. Studies show that RBD is most common in elderly men.
Experts are unsure of the exact cause of RBD, but it’s been linked to certain neural pathways in the brain. As a result, research suggests that RBD can be an early sign of Parkinson’s and dementia.
If you suspect you may have RBD, it’s best to book an appointment with your GP. In many cases, medication will be prescribed. Some people also find it useful to identify triggers that make their RBD behaviour worse – for example, alcohol or drugs. Precautions (such as locking windows, removing objects from the bedroom that could cause injury, and placing the mattress on the floor) can also be taken to improve safety.
What medical conditions can cause sleep problems?
In many cases, underlying medical conditions can cause sleep problems. For example, this study found that people who had trouble sleeping were more likely to have an existing condition and be less physically active. Some of the most common underlying conditions include…
Parkinson’s disease
Parkinson’s disease causes parts of the brain to become progressively damaged over time. Symptoms include involuntary shaking, slow movement, and stiff, inflexible muscles.
Unfortunately, both the disease itself and the medications used to treat it can lead to various sleep problems that can kickstart a cycle of insomnia and excessive daytime tiredness.
This is because people with motor (movement) symptoms often struggle to find comfortable sleeping positions, or may experience nocturnal hallucinations. People with Parkinson’s are also more susceptible to sleep conditions such as REM sleep behaviour disorder, restless legs syndrome, and obstructive sleep apnea.
To learn more, you might find it useful to read our article; Parkinson’s disease – symptoms, causes, and ways to cope.
Gastrointestinal conditions
Gastrointestinal conditions like irritable bowel syndrome (IBS), ulcerative colitis, and Crohn’s disease have been linked with poor sleep and insomnia.
This study found that almost eight in 10 people with Crohn’s or Colitis experience sleep problems during flare ups. And in another study, 39% of people with IBS suffered from insomnia at least once a month, with 15% reporting that stomach pain woke them up.
Equally, insomnia can trigger symptoms by causing stress and anxiety.
Chronic pain
Chronic pain is defined as pain that lasts for at least 12 weeks. Some of the most common types of chronic pain include arthritis pain, postsurgical pain, cancer-related pain, lower back pain, and headaches.
Chronic pain is closely linked with insomnia. While the pain makes it difficult to get comfortable, fall asleep, or stay asleep, a lack of sleep can also make symptoms worse.
If you’re suffering from chronic pain, your GP will be best placed to advise you. Methods to get your pain under control include medication, physical therapy, acupuncture, surgery, and cognitive behavioural therapy (CBT).
There are also lifestyle changes that can help alleviate pain and break the cycle of insomnia. These include creating a healthy sleep environment, eating foods that promote sleep, practicing yoga, taking short walks in the evening, and using breathing techniques.
Dementia
Alzheimer’s disease is the most common cause of dementia in the UK. It can cause shifts in the sleep-wake cycle such as trouble falling asleep and needing to nap during the day. You can read more about these changes on the Alzheimer’s Association website.
To help with this, experts recommend lifestyle changes. For example, maintaining a regular sleep schedule, getting enough sunlight, avoiding alcohol and caffeine, and exercising regularly.
If these don’t help, it’s important to speak to your GP.
Mental health conditions
According to UK charity MIND, sleep and mental health are closely related.
A lack of sleep can exacerbate existing mental health conditions. Equally, stress, anxiety, and depression can disrupt sleep. This can lead to an unhealthy cycle of struggling to get to sleep and waking up feeling unrefreshed, which can take a toll on mental health.
If you’ve been struggling with your mental health recently and are experiencing disrupted sleep, below are some articles that you may find useful…
What support is available?
There are places that you can reach out to if you’d like some extra support.
Firstly, it’s best to speak to your GP as they’ll be able to talk you through options available and offer guidance based on your individual circumstances.
Alternatively, The Sleep Charity aims to help everyone get a better night’s sleep. They also offer a confidential helpline if you need to talk to someone about your sleep.
You can find a longer list of useful resources on the MIND website.
Final thoughts…
It’s normal for sleeping patterns to change with age and we may find it more difficult to fall asleep, stay asleep, and feel refreshed in the morning.
Sometimes, these changes can be down to sleep conditions such as sleep apnea, REM behaviour disorder, and circadian rhythm disorders. While, in other cases, underlying medical conditions like Parkinson’s, chronic pain, and gastrointestinal conditions may be the cause.
The good news is that the majority of sleep conditions can be improved with lifestyle changes and, in cases where symptoms are more persistent, other treatment options are available too.
What are your experiences with sleep conditions? Have you noticed changes to your sleeping patterns as you’ve aged? We’d be interested to hear from you in the comments below.
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