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For Many Seniors, Sleep is an Elusive Dream

But treatments can help those in search of a good night's rest

TUESDAY, April 1, 2003 (HealthDayNews) -- Two-thirds of older Americans say they have problems sleeping, but doctors have only diagnosed a tiny percentage of them, says a new survey.

In a bit of good news, the survey by the National Sleep Foundation also found that many seniors typically get about seven hours of sleep a night -- as much as their younger counterparts. And only 53 percent of healthy seniors report trouble sleeping. The findings were released April 1.

"Just because you age doesn't mean you're going to sleep poorly," says Michael V. Vitiello, a professor of psychiatry and behavioral sciences at the University of Washington at Seattle. He was not involved with the survey.

Doctors can often fix sleep problems in seniors through medications or changes in behavior, Vitiello says, adding, "if you get to the causes, you can have effective treatments."

The telephone survey of 1,506 Americans aged 55 to 84, completed in late 2002, found seniors with medical conditions were the most likely to report sleep problems. Such problems were reported by between 71 percent and 82 percent of seniors diagnosed with stroke, heart disease, lung disease, diabetes, arthritis or hypertension. Eighty-four percent of those with mobility difficulties reported sleep difficulties.

The findings show that factors related to age -- such as illness -- cause sleep problems in seniors, not age itself, Vitiello says. "Old people are going to experience more illness, both chronic and acute, and very often sleep is disrupted secondary to the illness."

While it's clear that chronic pain and other symptoms can disrupt sleep, researchers aren't sure if lack of sleep can contribute to illness itself, Vitiello says. "It makes sense, but it's far from proven."

Not surprisingly, the survey found that older people develop different sleep patterns as they age. Seniors rarely sleep in on weekends; younger people typically snooze for an hour longer on Saturday and Sunday mornings than during the week.

The survey also found that about 65 percent of seniors said they wake up at night several times a week to go to the bathroom.

Vitiello says he's skeptical of the survey finding that suggests seniors get as much sleep -- seven hours per night on average -- as younger people. People who respond to surveys are notoriously bad at guessing how much sleep they really get, he says, and seniors appear to get less-fulfilling sleep than younger people.

Seniors "spend more time in bed, less time asleep," Vitiello says. "The difference is made up with a lot of waking," partly due to a greater amount of light sleep.

Despite their potential for sleep problems, seniors can respond as well as younger people to treatments, Vitiello says. Common treatments include sleeping pills and cognitive behavior therapy, which teaches people how to alter their routines to help them sleep better.

Seniors shouldn't take naps of more than 15 to 20 minutes if they want to sleep well at night. And they shouldn't lie in bed for hours while trying to sleep, says James B. Maas, a professor of psychology at Cornell University and author of Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance.

Sleep experts often will reset the internal clocks of people by keeping them awake until they're exhausted, prompting sleep that's short but effective, Maas says. "It's as if we have to truncate the sleep to make it more efficient and effective before we extend it," he says.

Vitiello says the survey bolsters the value of diagnosing and treating sleep problems among older people.

"We make assumptions about the elderly, and sometimes the elderly make assumptions about themselves," Vitiello says. "Doctors have to pay more attention to their patients when they talk about sleep."

More information

Learn more about sleep disorders from the National Sleep Foundation or the National Center on Sleep Disorders Research.

SOURCES: Michael V. Vitiello, Ph.D., professor, psychiatry and behavioral sciences, University of Washington, Seattle; James B. Maas, Ph.D., professor, psychology, Cornell University, Ithaca, N.Y.; "2003 Sleep in America" poll, National Sleep Foundation, Washington, D.C.
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