Many seniors have trouble with sleep.

A study of adults older than 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep. Other seniors complain about frequent waking during the night, sleeping too lightly, waking early without feeling rested, an urge to go to bed in the early evening, being tired in the daytime, and needing naps.

Not sleeping well can lead to problems. Older adults who have poor nighttime sleep are more likely to feel depressed; to have attention and memory problems, excessive daytime sleepiness, and nighttime falls; and to use over-the-counter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life.

Sleeping well is essential to seniors' physical health and emotional well-being. As we age, a good night's sleep is especially important because it allows our bodies to repair cell damage that occurred during the day and refreshes our immune system, which helps to prevent disease.

It's not just getting older

"The biggest myth is that sleeping poorly is just part of getting old," said Dr. Sonia Ancoli-Israel, director of the Sleep Disorders Clinic at the San Diego Veterans Affairs Medical Center. But if age isn't robbing seniors of restful sleep, what is?

According to Dr. Andrew Monjan, Chief of Neurobiology of Aging Programs at the National Institute on Aging, "It's not the aging process itself but ailments associated with aging—such as arthritis, physical disabilities, respiratory problems, and depression—that are likely to blame."

As we age, we're more likely to develop health problems that could cause our sleep patterns to change. Among those problems are arthritis, osteoporosis, heartburn, cancer, diabetes, high blood pressure, Parkinson's disease, Alzheimer's disease, incontinence, gastroesophageal reflux disease, stroke, chronic obstructive pulmonary disease, asthma, heart disease, and enlarged prostate. The likelihood of sleep apnea and restless leg syndrome also increases with age.

Seniors who have diabetes, leg edema, enlarged prostate, or incontinence might need to urinate more frequently. Add to that the fact that our bladder capacity shrinks as we age, and you might find yourself getting up at night to use the toilet more often. Getting up so often can make it hard to get back to sleep.

Do seniors need less sleep?

Contrary to popular opinion, older people don't need less sleep than the average person. In fact, adults require about the same amount of sleep from their 20s into old age—about seven to nine hours per night—although the number of hours per night varies from person to person. But many older adults get much less sleep than they need, for a variety of reasons. What are the culprits?

• Chemicals and the sleep cycle. Older adults sleep less deeply and awaken more often during the night because they may produce and secrete less melatonin, the hormone that promotes sleep, and because they are more sensitive to changes in their environment, such as noise.
  
• Body rhythms. Changes in the body's biological clock are a natural part of aging and are likely culprits in the reduced sleep quality of older people. As adults age, "advanced sleep phase syndrome" sets in, causing the body's internal clock to adjust to earlier bed and wakeup times. But some seniors continue to stay up late, as they did in their younger years. Sleep deprivation is often the result. To help yourself, start by developing daily routines. Performing basic activities such as eating, dressing, exercising, and bathing at the same time every day has been found to improve sleep quality. Wake up at the same hour every day.
• Common medications can make it difficult to fall asleep or stay asleep. These include antidepressants, beta blockers, bronchodilators, calcium channel blockers, corticosteroids, cardiovascular drugs, decongestants, and gastrointestinal drugs.

Home remedies for sleeping easier

Here are some better-sleep strategies from the experts:

• When you're awake, stay active. Sleep-and-aging experts agree that what people do during the day is critical to a good night's sleep. Staying active, tackling intellectual tasks, and exercising regularly are at the top of the list for combating sleeplessness. But don't exercise within about two hours of your bedtime, because exercise increases your core temperature, making it harder to fall asleep.
  
• Avoid long naps during the day, as they can disrupt your sleeping pattern. Limit naps to 30 minutes or cut them out completely if they interfere with regular nighttime sleep.
  
• Let the sun shine in. You might not spend enough time outdoors. Sunlight helps keep your body's circadian rhythm working appropriately. In general, you need about two hours of bright-light exposure each day to help your body gauge when to sleep and when to wake up. If you can't get outside, talk to your doctor about a light box or a full-spectrum lamp.
  
• Watch your intake. Older adults need to watch what they eat and drink. Evening consumption of foods and drinks that contain caffeine—such as coffee, tea, chocolate, and sodas—can interfere with nighttime sleep. Drinking alcohol before bed makes it harder to sleep, as well. So does nicotine. Avoid even non-caffeinated liquids close to bedtime.
  
• Stage your sleep environment. A good sleep environment is quiet, dark, and on the cool side. Check your mattresses, too. If a mattress is lumpy, sagging, or worn, it may be part of the problem. Use your bed for sleeping, not activities like reading or watching television. Don't sleep with a pet. Close your door and minimize light and noise.
  
• Scrutinize your partner. If the bedroom and the mattress check out, maybe the problem is your bed partner. People who share a bed with partners who are restless, snore, or have an illness are likely to be sleep-deprived. Talk with your partner about his nighttime sleep habits and be sure to consult with your physician. In the meantime, instead of staring at the ceiling, move to a separate room to get some shut-eye so both of you can rest easier at night.
  
• Finally, avoid trying to sleep. The harder you try to sleep, the more difficult it becomes.

Getting at an underlying problem

If your sleep doesn't improve with all those techniques, a bigger underlying problem may be at work. Anxiety, depression, and other emotional issues, for example, can make it hard to sleep at night. Don't hesitate to tell your doctor if you have feelings of sadness or anxiousness that keep you up at night. These feelings can be treated.

If you avoid caffeine and nicotine but still wake up often to use the bathroom, see your doctor to rule out prostate enlargement or incontinence. Besides being annoying, getting up at night to use the bathroom increases the risk of falling, which is a leading cause of injury and death among seniors.

Also talk to you doctor if:

• you have disruptive snoring or irregular breathing;
  
• you depend on pills to sleep;
  
• it's been a month or more since you've been able to sleep soundly or fall asleep when you wanted to;
  
• you generally feel anxious, and it's associated with lack of sleep; or you routinely feel sleepy at times when you need to be alert, such as when you're driving.

Bottom line: It's important to find the root cause of sleepless nights, especially if sleep issues are masking deeper medical problems. See your doctor if you're not getting restful sleep and are unable to wake up refreshed. Healthy sleep is something one should expect at all ages.

Sleeping pills: Not a long-term solution

Sleeping pills, whether over-the-counter or prescribed by your doctor, are generally not a long-term solution to sleeplessness. Medications can sometimes be used in the short term and only as directed by your doctor. Using prescription sleeping pills incorrectly can cause addiction or dependence. Sleeping pills can also put you at risk of falls and broken bones. If you're struggling with your sleep, ask your doctor whether sleeping pills might help. But don't turn to sleeping pills rather than remedying the underlying cause of your sleep problems.

Don't accept sleeplessness

The National Institutes of Health Web site includes a Sleep and Aging section that provides detailed information about the importance of sleep for seniors, some of the sleep difficulties people encounter as they age, and the symptoms and treatment of sleep disorders such as insomnia, sleep apnea, and movement disorders. Visit http://nihseniorhealth.gov.
Don't accept sleeplessness as part of the aging process. The sooner you talk to your doctor, the sooner you and your doctor can get to work on a solution. Then you can get back to a good night's rest.

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