You open your eyes as the daylight grows outside, half an hour before your alarm clock rings. Sighing, you close your eyes. If only you could go back to sleep. After a few minutes, you give up, tired but not wanting to sleep. As you get out of bed, you think, "But why am I so tired all the time? I thought we needed fewer hours of sleep as we got older ..."

This is totally wrong. Older adults need the same amount of sleep as younger adults, usually about 8 hours per night. They simply have more obstacles to overcome in order to get the sleep they need.

The mutations of sleep

About half of older Americans suffer from insomnia or lack of restful sleep. 70% of French people complain of insomnia. An increasingly common problem. In older adults, insomnia most often manifests itself as frequent awakenings throughout the night or very early morning awakenings.

One important reason for these changes in sleep "behaviors" is a series of age-related physiological changes. For example, older adults spend less time in deep or REM sleep, making it more likely that they will wake up during the night. Older women, who are 50% more likely than men to experience sleep difficulties, often suffer from hot flashes due to menopause, which causes an interruption in their sleep. Moreover, our biological clocks or our circadian rhythms (as a reminder, these rhythms are characterized by a period close to 24 hours) change with age, so that with age, we are more tired earlier in the evening, and we wake up earlier in the morning.

Scientists have not yet determined the reasons for these changes in sleep behaviors, but they are closely studying the issue. That said, while age-related changes in sleep behavior are real, they are often minor. Dr. Saul Rothenberg, a psychologist at the Sleep Disorders Center in North Shore Long Island, USA, emphasizes that these altered sleep behaviors are not as important as total sleep time, which should always be the same as what was needed when younger.

Sleep and health problems

These changes in sleep behavior are, in fact, underlying real health problems also related to age. Many pathologies can indeed cause sleep disorders and lead to more or less frequent episodes of insomnia.

 The majority of sleep problems in older adults are related to medical conditions 

Dr. Phyllis Zee, Director of the Sleep Disorders Center at Northwestern University, Memorial Hospital, USA.

Several large-scale studies have shown that when mental and physical disorders are controlled, the level of sleep disturbance in the elderly decreases by 50 to 10%. The most common age-related diseases that disturb sleep are:

• The pains of arthritis, which can affect falling asleep or cause nighttime awakenings;
• The diabetic or bladder problems, which result in frequent trips to the bathroom at night ;
• Obesity and cardiovascular problems, which can lead to breathing difficulties.

Ironically, sleep deprivation itself is a risk factor for many age-related diseases, particularly cardiovascular disease, diabetes and obesity.

Studies conducted by eminent American diabetologists have revealed that insomniacs are more likely to develop diabetes or to suffer from obesity, as lack of sleep affects the metabolism of sugars and the body's possible resistance to insulin action. This creates a vicious cycle in which sleep disorders and medical problems gradually affect an older person's health.

Hoping to break this cycle, Dr. Zee began testing to see if planned exercise or light exposure could improve sleep and thus the health of older people.

Physical sleep disorders

In addition to sleep disorders per se, various physical sleep disorders become more prevalent with age. One of the most common is apnea, a disorder characterized by brief interruptions in breathing during sleep. It is caused by partial obstruction of the upper airway. The symptoms are a very loud snoring and pauses with a noisy ventilatory recovery. Older adults with obesity are particularly at risk.

There is still not enough awareness of the danger of sleep disorders and it is believed that about 90% of individuals with obstructive sleep apnea go undiagnosed and untreated, as the functional signs are often tolerated for a long time. However, it is a syndrome that must be recognized and treated in time. Because apnea, in turn, is a risk factor for a number of medical conditions, such as high blood pressure and cardiovascular disease. It can also contribute to daytime sleepiness and disrupt a partner's sleep.

Apnea can be treated by using a nasal mask that prevents pharyngeal collapse and allows apnea and snoring to disappear completely. This very effective treatment is now widely used. It restores normal ventilation during sleep and, as a result, eliminates nocturnal micro-awakenings and excessive daytime sleepiness. Surgery can also be a very effective solution. Losing weight or sleeping on your side can also reduce the severity of apnea.

Another very common sleep disorder is Nocturnal Periodic Limb Movement Syndrome. An estimated 40% of older people suffer from this problem, which "forces" a person to suddenly move one or more limbs, usually the leg, at 5-90 second intervals while sleeping - these are small jerks that repeat throughout the night.

Although in most cases it does not have a significant effect on the quality of sleep, this syndrome, when severe, can reduce deep sleep time and therefore cause excessive daytime sleepiness. Just like apnea, this disorder can disturb the sleep of a partner and it is often this one who, by observation, will make the diagnosis.

Another limb-related disorder is Restless Legs Syndrome, also known as "Lower Limb Impatience Syndrome on Awakening." This problem always occurs, at least at the beginning, when the person is awake or at rest.

He or she has an unpleasant (or painful) sensation in one or both legs. This sensation disappears only if the subject moves his or her legs, usually while walking. This discomfort syndrome occurs mainly in the evening or at the beginning of the night, and prevents the person from falling asleep. Discomfort can be reduced by applying cold or warm compresses to the legs or by massaging the legs and feet before going to sleep.

Both syndromes - periodic limb movement and restless legs - can also be treated medically.

Treating sleep disorders

Older adults who suffer from insomnia really do have several options for treating their problem. Most importantly, it is imperative to treat the underlying problems which are the actual health problems or physical disorders such as apnea.

Often, simple lifestyle changes can restore good sleep. Reduce your alcohol intake, caffeine intake or reduce the dosage of certain medical prescriptions. Foods such as valerian or almonds help to improve your sleep.

Even if insomnia persists after taking these steps, never lose hope. Older adults with chronic insomnia can be treated just like younger people. Cognitive behavioral counseling is also a very effective treatment.

Although many medications are available to restore good sleep, they have side effects and are addictive, so they can lose their effectiveness over time. Research has shown that these solutions are not as effective in the long term as behavioral and cognitive therapies. Some herbal food supplements will help you help to find sleep.

In summary, what should an older person with chronic insomnia do? See their therapist, naturopath or contact a sleep center - but in any case, don't resolve.

Don't suffer with this problem, but do something about it! An older person can solve these sleep problems just like a younger person.