Many aspects of our life change as we get older and sleep is no exception. Over time, our sleep patterns change. When we are still infants, we need about 14 to 17 hours of sleep per day. This amount of sleep is usually divided into 10 to 12 hours of nocturnal sleep and 3 to 5 hours of napping in the day. When we enter our teenage years, the amount of sleep we need goes down to about 9 hours per night. Once we enter our adult years, the amount of sleep we need per night for the rest of our lives is 7 to 9 hours. However, although the amount of sleep we need in our elderly years don’t change, our sleep patterns do. Unfortunately, senior sleep statistics show that these changes in sleep patterns can cause sleep troubles in the elderly.

(What to Expect), (Nationwide Children’s Hospital), (Sleep Education)

The Most Surprising Senior Sleep Statistics

• About 40 to 50% of those over the age of 60 report insomnia symptoms.
• Insomnia has a 5% incidence rate among people over the age of 65.5.
• Only 7% of the incident cases of insomnia in the elderly occur without psychiatric risk factors, lik depression.
• Senior sleep statistics show that older adults wake up an average of 3 or 4 times each night.
• About 7 to 15% of older adults don’t feel rested after waking up in the morning.
• Less than 20% of older adults rarely or never have any sleep complaints.
• Around 13 to 32% of people over the age of 65 have some sleep apnea.
• Periodic limb movement syndrome can occur in over 30% of people aged 65 and older.

(Oxford Academic Sleep), (U.S. National Library of Medicine), (Medline Plus), (Cleveland Clinic)

General Senior Sleep Statistics and Facts

1. About 50% of older adults complain about difficulty initiating or maintaining sleep.

The prevalence of insomnia is higher in the older population than in the younger, where insomnia prevalence is around 12 to 20%.

(Kate Crowley, PhD), (Dhaval Patel, MD)

2.Total sleep time decreases by 10 minutes per decade of age.

Another study found that total sleep time decreased by 27 minutes per decade from mid-life until the 80s. Compared with younger adults, the elderly spend more time in bed but have deterioration in both the quality and quantity of sleep.

(Maurice M. Ohayon, MD, PhD), (Eve Van Cauter, PhD)

3. Just like with total sleep time, slow-wave sleep also decreases by about 2% per decade of age.

Slow-wave sleep (SWS) refers to phase 3 sleep. This sleep phase is the deepest phase of non-rapid eye movement (NREM) sleep. SWS is characterized by delta waves. Dreaming and sleepwalking can occur during SWS. SWS is thought to be important for memory consolidation. Thus, lower SWS can result in memory problems, a trait that is common among the elderly.

(Maurice M. Ohayon, MD, PhD), (Nature)

4. A study of adults over the age of 65 found that 13% of men and 36% of women take more than 30 minutes to fall asleep.

Sleep latency is the time it takes for people to fall asleep. Sleep latency has also been observed to increase with age. An analysis of different studies found that sleep latency increases by 5% between 20 and 70 years of age.

(Sleep Education), (Maurice M. Ohayon, MD, PhD)

5. Sleep efficiency decreases by 18.6% between the ages of 40 and 100 years.

Sleep efficiency is the time spent asleep in a night divided by the time spent in bed. The amount of melatonin the body produces decreases as we get older. This trait may be a reason for lower sleep efficiency over time. Moreover, light is an environmental cue that keeps our body’s circadian rhythm on schedule. However, elderly people spend too little time in daylight.

(Altug Didkoglu), (Jana R. Cook, MD and Sonia Ancoli-Israel, PhD)

6. Senior sleep statistics show that REM sleep decreases by 2 to 3% in the elderly.

Dreaming occurs most often during REM sleep. The reasons behind the decreases in sleep quality are still unclear. However, some factors may contribute to poorer sleep in the elderly. These factors include poor sleep habits and health conditions whose negative effects may accumulate or worsen with age.

(Maurice M. Ohayon, MD, PhD), (Cleveland Clinic)

7. In contrast, 65 sleep studies found that as we age, there is an increase in stages 1 and 2 of sleep.

Stage 1 is the lightest stage of NREM sleep. Muscle tone throughout the body relaxes and brain wave activity slows down. Stage 1 sleep allows the body to enter Stage 2. For most people, Stage 2 sleep takes about 40 to 60 % of sleep time. The increases in stages 1 and 2 are often attributed to higher sleep arousals and awakenings the elderly experience. As a consequence, their bodies rarely transition to Stage 3 and REM sleep.

(Maurice M. Ohayon, MD, PhD), (Bradley Edwards, PhD)

8. Adults around 80 years old who experience sleep fragmentation are more than 2 times as likely to nap during the day.

Naps have been suggested to help older adults function properly during the day. Moreover, older adults who report diabetes and bodily pain are likelier to have longer naps.

(Suzanne Goldman, PhD)

9. Having a 1-hour nap in the middle of the day may boost the mental ability of older adults.

A Chinese study found that adults aged 65 or older who take a 1-hour nap after lunch had better cognition. On the other hand, those who nap for less than 30 minutes and more than 90 minutes did not have the same benefits in cognition.

(Junxin Li, PhD)

10. Nearly 1/3 of adults aged 80 years or older experience excessive daytime sleepiness (EDS).

A study among Australian adults found that the prevalence of EDS increases with age. By 60 years old, it is expected that around 15% of adults will have EDS. EDS may be a result of other underlying sleep disorders, such as obstructive sleep apnea, or lifestyle, such as poor sleep hygiene.

(Amie Hayley, PhD)

11. Senior sleep statistics show that older adults with excessive daytime sleepiness have a 33% higher chance of dying from cardiovascular diseases.

A study in France recruited more than 8,000 subjects with an average age of 74 years. After 6 years, the study found that those with EDS had a 42% increased risk of mortality. Moreover, Moreover, those with EDS had poorer sleep quality, snored more frequently, had more insomnia and more frequently used medication for sleep or anxiety.

(Dr. Jean-Philippe Empana)

Senior Sleep Disorders

12. About 83% of people older than 65 years with insomnia have one or more comorbid conditions.

Chronic conditions such as depression, chronic pain, and cardiovascular diseases tend to be present in the later and elder years of life. These conditions can cause insomnia symptoms, which may explain the high prevalence of insomnia among the elderly.

(Daniel Foley, LMFT)

13. Adults aged 65 years or older may be more tolerant of sleep deprivation.

The American Insomnia Survey found that respondents older than 65 years complained less about insomnia. Another study found that sleep deprivation severely affected younger women more than older women. The sleep-deprived younger women fell asleep more and rated themselves more sleepy than the older women.

(Dhaval Patel, MD), (Patricia Stenuit, MSC and Myriam Kerkhofs, PhD)

14. Elderly people with low physical activity can have more than 5 times a higher risk for insomnia.

Researchers found that lower physical health, depressed mood, and lower physical (but not social) activity levels consistently appeared as significant risk factors for prevalent, persistent, and incident insomnia.

(Kevin Morgan, PhD)

15. A research found that the elderly have a 23% higher risk in developing depression symptoms.

Sleep disturbances are common in people with depression and are usually a consequence of it. However, this research found that insomnia can occur before depression. The researchers found that insomnia and excessive daytime disorder is a significant risk factor for people aged 65 years and older to develop depression. Insomnia and excessive daytime disorder can cause depression regardless of sociodemographic, behavioral, and clinical characteristics, and even history of major depression.

(Isabelle Jaussent, MSc)

16. Up to 44% of the elderly with persistent insomnia can continue to have depression after 6 months.

Persistent insomnia can cause the development of new-onset and recurrent major depressive disorder (MDD). However, researchers also found that persistent insomnia can perpetuate MDD. In particular, people aged 60 years or older are less likely to recover from MDD if they have insomnia.

(Wilfred Pigeon, PhD)

17. Older adults who sleep for 5 hours or less per night are 2.5 times more likely to have diabetes.

Similarly, sleeping for 9 hours or more per night also increases the chances of getting diabetes by around 1.8 times.

(Daniel Gottlieb, MD)

18. Sleep apnea is present in 13 and 4% of men and women, respectively, aged 65 years or older.

Sleep apnoea is a breathing disorder in sleep usually caused by repetitive upper airway obstruction. Its primary symptoms include snoring, daytime sleepiness and decreased cognitive functioning. The prevalence of sleep apnea appears to increase with age.

(Dr. Giora Pillar and Tamar Shochat)

19. Older adults with moderate to severe sleep apnea who report struggling with excessive daytime sleepiness are (EDS) 2 times as likely to die.

Researchers suspect that the reason sleep apnea and EDS increases the risk of mortality in older adults is inflammation. Interestingly, older adults who only have either sleep apnea or EDS are safe from the higher chances of mortality.

(Nalaka Gooneratne, Md, MSc)

19. Older adults with severe sleep apnea can have a nearly 3.5 times a higher risk of stroke.

Researchers now recommend that physicians ask all patients with cardiovascular disease about sleep symptoms, especially obstructive sleep apnea symptoms.

(Neurology Today)

20. Senior sleep statistics show that older adults with untreated obstructive sleep apnea can have a 2.25 times higher chance of dying from cardiovascular diseases.

Obstructive sleep apnea (OSA) is commonly treated with continuous positive airway pressure (CPAP) therapy. Researchers found that elder patients with OSA and treated with CPAP have a lower chance of dying from cardiovascular diseases.

(Martinez-Garcia MA, PhD)

21.As many as 86% of older people with periodic limb movement syndrome can have at least 5 limb movements per hour of sleep.

Many of the limb movements are flexions that last between 0.5 to 5 seconds, and they can occur every 10 to 90 seconds. These periodic movements can also last from minutes to hours.

(Dr. Magdolna Hornyak and Claudia Trenkwalder, MD), (Healthline), (Cleveland Clinic)

22. Restless legs syndrome can be present in 10 to 35% of people over the age of 65.

People with RLS commonly get an unpleasant and eve painful feeling in their legs. The feeling temporarily goes away by moving the legs. Patients with poorly controlled RLS may develop related problems like insomnia and depression.

(Dr. Shawn Milligan and Dr. Andrew Cheson)

23. Older adults with restless legs syndrome (RLS) have a 67% higher chance of having ischemic stroke.

Older men with RLS may also have a slightly increased risk for an ischemic heart disease event

(Professor Peter Elwood)

24. Older adults with restless legs syndrome have a a 66% higher chance of also being anemic.

A common cause of secondary RLS is. Iron is needed to make dopamine. Dopamine is an important neurochemical in the brain that is involved in sleep, movements, and the control of pleasurable emotions iron deficiency.

(Won-Hyoung Kim, MD), (Richard Allen, PhD)

25. Older adults with restless legs syndrome have a 2.5 times higher chance of having renal disease.

Nearly all patients with end stage renal disease have anemia, which why RLS can also occur in patients with renal disease.

(Won-Hyoung Kim, MD), (American Kidney Fund)

Conclusion

Sleep problems can palgue anyone, but they can be more problematic in the elderly population. Many older adults have trouble falling asleep and awaken after only a few hours. As a consequence they can be more fatigued during the day. Therefore, it is important to know what changes, whether big or small, can we make to improve their sleep so they can feel more at ease in their twilight years.

References

What to Expect:

https://www.whattoexpect.com/first-year/newborn-sleep.aspx

Nationwide Children’s Hospital:

https://www.nationwidechildrens.org/specialties/sleep-disorder-center/sleep-in-adolescents

Sleep Education:

http://sleepeducation.org/news/2013/08/07/sleep-and-growing-older

Foley et al., 1995:

https://academic.oup.com/sleep/article-abstract/18/6/425/2749669

Foley et al., 1999:

https://pubmed.ncbi.nlm.nih.gov/10394609/

Medline Plus:

https://medlineplus.gov/ency/article/004018.htm

Glasser et al., 2011:

https://breathe.ersjournals.com/content/7/3/248

Cleveland Clinic:

https://my.clevelandclinic.org/health/diseases/14177-periodic-limb-movement-disorder-plmd-in-adults

Crowley, 2011:

https://link.springer.com/article/10.1007%2Fs11065-010-9154-6

Patel et al., 2018:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991956/

Ohayon et al., 2004:

https://academic.oup.com/sleep/article/27/7/1255/2696819?login=false

Van Cauter et al., 2000:

https://pubmed.ncbi.nlm.nih.gov/10938176/

Nature:

nature.com/subjects/slow-wave-sleep

Didikoglu et al., 2019:

https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.12898

Cooke and Ancoli-Israel, 2012:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142094/

Edwards et al., 2010:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500384/

Cleveland Clinic:

https://my.clevelandclinic.org/health/articles/12227-sleep–aging

Goldman et al., 2008:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2398743/

Li et al., 2016:

https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.14368

Hayley et al., 2014:

https://www.sciencedirect.com/science/article/pii/S1389945714000203?via%3Dihub

Empana et al., 2009:

https://www.ahajournals.org/doi/full/10.1161/strokeaha.108.530824

Foley et al., 2004:

https://www.sciencedirect.com/science/article/pii/S0022399904000327?via%3Dihub

Patel et al., 2018:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991956/

Stenuit & Kerkhofs, 2005:

https://academic.oup.com/sleep/article-abstract/28/10/1283/2708118

Moran,2003:

https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2869.2003.00355.x?sid=nlm%3Apubmed

Jaussent et al., 2011:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138165/

Pigeon et al., 2008:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2279755/

Gottlieb et al., 2005:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486518

Shochat & Pillar, 2003:

https://link.springer.com/article/10.2165%2F00002512-200320080-00001

Gooneratne et al., 2011:

https://academic.oup.com/sleep/article-abstract/34/4/435/2433778

Neurology Today:

https://tinyurl.com/wd8u7oc

Martínez-García et al., 2012:

https://europepmc.org/article/med/22983957

Hornyaka & Trenkwalder, 2004:

https://www.sciencedirect.com/science/article/pii/S0022399904000200?via%3Dihub

HealthLine:

https://www.healthline.com/health/sleep-disorder-periodic-limb-movement#causes

Cleveland Clinic:

https://my.clevelandclinic.org/health/diseases/14177-periodic-limb-movement-disorder-plmd-in-adults

Milligan & Chesson Jr., 2012:

https://link.springer.com/article/10.2165%2F00002512-200219100-00003

Elwood et al., 2006:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465538/

Kim et al., 2012:

https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.2754

Allen et al., 2011:

https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.23397

American Kidney Fund:

https://www.kidneyfund.org/anemia/anemia-in-esrd/