Why sleep gets worse with age (but it can improve)

Many mid to older-age clients come to me with the aim of sleeping better. When I ask what their best hopes are, I often get the reply “to have continuous sleep”.

This kind of sleep is the sleep they remember pre-children, pre-work or before reaching their middle ages. It’s almost magical in their memories - the ability to go straight to sleep and then wake up in the morning feeling refreshed.

Setting realistic expectations at this stage is important, as the truth is that as we get older, sleep gets more problematic and we may not sleep as long or as soundly as when we were younger. Why is this?

Sleep changes in mid to older adults 

• As we enter our 40s, we start seeing a reduction in our deep NREM sleep, which continues to reduce so that by our 70s we get only around 10 to 20% of the deep sleep we had as a teenager. NREM is the restorative stage of sleep, the sleep that makes you feel well-rested and energetic.
• We also wake up more frequently throughout the night, mainly due to conditions such as a weakened bladder, certain medications, anxiety or hot flushes. Routine visits to the bathroom in the middle of the night often lead to the 'I’m wide awake at 3 am' syndrome.
• The third is a change to our circadian timings. As we age we get an earlier evening release of melatonin, signalling us to go to sleep earlier. This explains why older people are often seen napping in the early evening whilst watching TV or reading. This early nap can then disrupt our sleep later as we don’t have enough sleep pressure to fall asleep or stay asleep. Dr Neil Stanley, sleep expert and author of How to Sleep Well, advises that it is worth trying to avoid an afternoon snooze if you suffer from chronic insomnia. Getting bright light exposure in the late afternoon to avoid early evening sleepiness is a further tip by Matthew Walker, author of Why We Sleep.
• The fourth change is that anxiety and insomnia may be synonymous with menopausal hormonal fluctuations for women in their 50s.

How therapy can help improve sleep as you get older

Figuring out what’s going on is always the first step in looking at why you have a sleep problem, and if there is any indication that there is an underlying medical problem, then you should talk first with your GP.

A new global sleep survey by Philips shows that worry and stress are the number one thing that stops us from getting a good night’s sleep. Hypnotherapy or other therapies can help you to change your negative thought patterns around sleep, which then can reduce your anxiety about what a bad night’s sleep will mean for you.

The disruption technique is a really useful tool used by hypnotherapists which you can practise when you are trying to go to sleep. If you find yourself having a negative thought, you strongly argue against it in your head. So rather than thinking “Oh no, I’m awake again at 3 am, I will feel awful tomorrow”, you say "Great, 4 more hours of sleep”.

The distraction technique is also another method: think about your favourite holidays and visualise all the things you love about them. These positive thoughts and images will quickly calm your mind and so ease you back to sleep.

Hypnosis and breathing techniques also help to reduce cortisol levels and so reduce anxiety and quieten a racing mind (cortisol is the stress hormone which overrides the relaxing hormones of melatonin and serotonin). Using hypnotherapy recordings daily as part of your healthy sleep routine can help you fall asleep and stay asleep in as little as a week. For some people, it can take longer, usually because there are some other things they have to work through first that are causing them stress.

Good sleep hygiene solutions are also important: from regular bedtime routines and reduced alcohol and screen time before bed, to increased exercise and deep relaxation practice.

A few sleep and age myth-busters

• It is normal to have disrupted sleep as you get older - this is a natural change.
• It is also normal to feel less refreshed in the morning - again, this is a natural change.
• Falling back to sleep after going to the toilet at night can take a while, but doesn’t mean you have a sleep problem. Changing your mindset is key.
• You don’t need less sleep as you get older - you need the same amount for a 70-year-old as a 25-year-old. So investing in your sleep at any stage of your life is important.

And so to sleep

I have experienced from time to time, difficulties going to sleep or staying asleep and know the impact of sleep deprivation. I have readjusted my thinking to accept that being awake is not the end of the world which then helps make me less anxious – and eventually, sleep does take over.

If sleep remains a constant problem in your life, it can get better. Reach out and get help - it will be one of the best investments you make to feel better and sleep better.