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Am Fam Physician. 1999;59(9):2559-2560

See related article on sleep problems.

How much sleep do older people need?

Most of us need about eight hours of sleep at night to feel fully alert when we're awake. Many things can get in the way of sleeping well or sleeping long enough. As we get older, we might have more trouble sleeping.

What sleep changes are common in elderly people?

People 65 and older may have trouble falling asleep when they go to bed at night. They might not stay asleep all night. They might wake up very early in the morning and not be able to go back to sleep. These problems can make older people very sleepy in the daytime. The sleep-wake cycle changes as we get older, so we might get sleepy earlier in the evening and wake up earlier in the morning.

What causes sleep problems?

Several things cause sleep problems. By the time we're in our 60s and 70s, our sleep-wake cycle doesn't seem to work as well. Some lifestyle habits (like drinking alcohol or caffeinated drinks, or smoking) can give us sleep problems. Sleep problems may even be caused by illness, when pain keeps us from sleeping, or by medicines that keep us awake. People of all ages might have these sleep disorders: sleep apnea, restless legs syndrome and periodic limb movement disorder.

What is sleep apnea?

Sleep apnea causes breathing to stop during sleep for several seconds. This can happen hundreds of times in a night. Every time, it causes the person to wake up a little bit. Sleep apnea can cause daytime sleepiness. It can also make high blood pressure and heart disease worse. People with sleep apnea usually snore very loudly. Then they stop breathing for 10 to 30 seconds. Then they start breathing again with a gasp.

If you have sleep apnea, it might help if you lose weight. Many people need treatment with a nasal mask. You wear a mask during the night to keep your airways open. The mask treatment is called “continuous positive airway pressure,” or CPAP. It helps you breathe normally during sleep. Surgery can help some people with this problem.

What is restless legs syndrome?

This is a “creepy-crawly” feeling, mostly in the legs. It makes you want to move your legs or even walk around. It may be worse in the evenings when your legs are at rest. It usually happens every night and may start after you get in bed. The crawly feeling may keep you from falling asleep. Elderly people are more likely to have this problem.

What is periodic limb movement disorder?

A person with this disorder kicks one or both legs many times during sleep. Often the person doesn't even know about the kicking, unless a bed partner talks about it. It can get in the way of good sleep and cause daytime sleepiness. Some people with restless legs syndrome also have periodic limb movements during sleep. Medicine may help both of these problems.

What can I do to sleep better?

  • Try to go to bed and get up at the same time every day.

  • Try not to take naps longer than about 20 minutes.

  • Don't have caffeinated drinks after lunch.

  • Don't drink alcohol in the evening. It might help you fall asleep, but it will probably make you wake up in the middle of the night.

  • Don't lie in bed for a long time trying to go to sleep. After 30 minutes of trying to sleep, get up and do something quiet for a while, like reading or listening to quiet music. Then try again to fall asleep in bed.

  • Ask your doctor if any of your medicines could be keeping you awake at night.

  • Ask your doctor for help if pain or other health problems keep you awake.

  • Try a little exercise every day; that helps many older people sleep better.

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