SLEEP NEEDS FOR OLD PEOPLE

The Old Rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

I slept in this morning until 11 which is later getting out of bed than I can remember.  Attaining this sleep record got me wondering how much sleep should old people get each night and let’s include day time naps?  I think all information known to mankind is somewhere on the web so that is where I went in my quest to find the sleep needs for old people.

Being a scientist I understand somewhat the validity of research studies such as the topic of sleep which involves physiology because I have a doctorate in physiology.  Now, I am not putting myself here as an expert on the science of sleep as it pertains to old people.  I am just reporting what I found on the web.  And, I found quite a bit there on the subject of sleep but not so much on sleep needs of old people.  I am not surprised about the lack of information regarding us old people because not much research has been done with us in any field of science including medicine.

First I found at several sites this thing called ‘advanced sleep-phase syndrome’ where old people go to bed very early so they get up early.  This ‘problem’ apparently can be fixed by adjusting the circadian rhythm with ‘bright light therapy’.  I won’t get into the specifics here because this was not what I was searching for.

I found most information concerning other problems about old people sleeping. Interestingly these concerned primarily men for some reason and included simple insomnia, sleep apnea, circadian rhythm disturbances all of which gets worse with increasing age. Well that was not good news especially when I read about many treatments for these conditions which include breathing exercise, yoga, restful environment in the bedroom, and cognitive and behavior therapy.  Once again this was not what I was looking for.

Finally I came across the fact that sleep needs vary with age.  Aha, now I am getting someplace then I read that sleep needs also vary with individuals.  Of course the question now is can these be separated?

As expected, I found lots of bad news about too little sleep which included daytime drowsiness, getting fat, diabetes, heart problems, a decrease in the ability to reason, and memory loss with an increased chance to develop Alzheimer’s .  On the other hand the effects of too much sleep, which was my quest with all of this research, are pretty much unknown.  Then I read that the average mortality increases in people with sleeping less than 7 hrs. but also in people sleeping more than 8 hrs. Now, this got my attention but as I thought about a window of just a single hour at 8 hrs. of sleep affects mortality rate I immediately questioned the validity of such a finding.

Another age-related sleep study showed that people in bed for 8 hours got less sleep with age.  That is ages 20-30 slept an average of 7.2 hrs.; 40-55 slept 6.8 hrs.; and 66-83 (hey that includes me) 6.5 hrs.  And, with age there is less Rapid Eye Movement (REM) which occurs with slow wave sleep which is the good sleep where you dream, is less in older people.

Then I came across a considerable amount of information on us old people but not our needs but more information regarding sleep habits which included: (1) it is not normal to sleep during the day even in older people; (2) role of sleep is not well understood and it is not known how much sleep people need; (3) old people do not need more sleep than younger adults; (4) old people have more difficultly falling asleep; and (5) older people sleep less.  I knew most of those things but what got my attention was (2) which made me begin to think I was on an impossible quest.

Yet in another study published in the Dec 2014 issue of AARP I read that 30 min catnaps provide an important midday pick-me-up.  On the other hand daily naps of one hour plus each day are 32% more likely to die of any cause. This information is opposite to item (1) in the above paragraph.

Finally, a breakthrough as to why old people sleep less: (1) we produce less melatonin (a hormone which puts a person to sleep); (2) we are more sensitive to the sleeping environment changes such as noise; and (3) sleep neurons in the brains of old people die off with age.  Interesting information but it did not tell me about how much sleep old people need. 

In the fall 2014 issue of AARP I did come across an article by Dr. Cohen entitled ‘Stay Well Forever’.  A rather misleading title as ‘forever’ cannot be measured in time and our lives are limited by time. One of his subtitles ‘Turn in Early’ caught my eye for it related to the sleep needs of mature people.  I write ‘mature’ because he mentions that people 50 years of age and older need 6 to 8 hours sleep each night.  Of course to get this much sleep when people are old in their 80's and generally retired does not require us to turn in early.

I am always dubious about articles like this which includes old people with middle-aged people and 50 years of age is middle age.  He does offer some sound reasons for the proper amount of sleep: (1) think better; (2) strengthen the connection between brain cells (you know think well); and (3) repair our bodies from that day’s stresses. Now this last reason makes sense and provides me clues as to the number I am looking for.  And, that number depends on several factors one of which involves our activities the day before we sleep. So, there is no magic number for it depends.

The word ‘repair’ Dr. Cohen used caught my eye.  Well, old people require more time to recover/repair from diseases and surgery.  So as I understand the need for sleep it is to refurbish the physiologic functions of the body after using them all day.  These functions get tired and need sleep to recover and in old people that takes more time.

These thoughts have been re-enforced when I came across an article published more than a year later than when I wrote this article in December 2014 which has yet to be published on my blog.  This article appeared in the March 2016 Scientific American on the importance of having a ‘clean brain’.  Recent studies have found that the brain has a drainage system unique from all the other organs.  Yes, it is this the lymphatic system but quite different in structure and function called the lymphatic system.  This system removes proteins associated with Alzheimer’s, Parkinson’s and other neurological diseases. And, it is most efficient during REM sleep!

So, with this information does it not make sense that we old people need more sleep each night to recover the rigors of our day-time activities?  Of course if there is no physical activity during the day then less rest might be required.  Still sitting around all day watching TV requires some brain activity so even a sedentary person requires sleep just to clean out the brain.  Certainly, this holds for adults of all ages.

In my case as I have written before I do daily exercises at the gym including muscle strength and aerobics.  I take three mile walks three times each week at a leisurely pace.  (Now two and a half years later, I do not take those walks and I work out less at the gym). With this much activity each day, maybe sleeping in once in a while is not all bad!  When I read articles on the web there is frequently comments by readers their take on the information they had just read.  Sometimes they add information mostly their experiences but sometimes knowledge on the subject.  During my search on sleep I came across many comments from readers noting that their grandparents or older parents sleep some 20 hrs. each day! Obviously these people are suffering from depression and have lost the desire to live any longer. 

To summarize what I found on the web about sleep in regards to old people: (1) we get less REM sleep, (2) can suffer from advanced deep-phase syndrome, (3) have numerous problems with sleep patterns, (4) more medical problems with too little sleep, (5) we sleep less than younger adults, (6) have different sleeping habits, (7) produce less melatonin, (8) have fewer sleep neurons in the brain, (9) sleep needs vary with age and individuals, and finally (10) more sensitive to sleep environment interference.

Wow, with all of those negatives regarding sleep with old people it is a wonder that we can get any sleep. So, I guess me sleeping until 11 in the morning with good REM sleep is a feat worth bragging about. Still, I was expecting a simple number for my sleep needs as an old person.  Obviously because of its complexity there is no such number for how much sleep we require. In fact I believe age has very little to do with how much sleep us old people need.  Like all humans we need as much as our body requires and that depends!!!!!

I suppose I asked myself this question when I slept in very late because I had some guilt going back to what my mother cautioned me when I was a teenager.  You know, ‘don’t sleep your life away’.  Oh yes I learned from my research that babies and young people including teenagers require more sleep than adults.  Hey, I think maybe I am returning to life as a teenager then I see one jog past me during my walk in the park.  I shake my head realizing that my life as a teenager can only be accomplished in bed and to make that clear, in bed sleeping.

12/14 revised 3/16