Belinda Setters, MD, MS, AGSF, FACP
Director, Mobile ACE & Transitional Care Programs
Associate Clinical Professor
Geriatric Medicine & Palliative Care
Robley Rex VA Medical Center
When most of us talk about sleep needs, we usually think about children. We know children need a certain amount of sleep to stay active and healthy and to grow into adulthood. Children have a bedtime and parents (and grandparents!) work hard to ensure they are in bed on time and get the sleep they need every night. But most of us don’t think about how much sleep we get or need as we grow older. And yet, sleep is just as critical to our health as we age.
As we age, our brains may tell us to go to sleep earlier. This is likely why so many folks fall asleep right after the evening news or dinner. Despite this, most older adults don’t always get a full 8 hours of sleep or awaken feeling refreshed. This may be because our brains don’t cycle through deep sleep as well or as much as they did when we were younger. Restless legs, arthritis, and breathing disorders can also keep us awake. And then there is the bladder. Older adults with prostate or bladder disorders often get up at night to use the bathroom. This disrupts sleep as well. Our bodies adapt as we age to adjust to these changes and as a result our sleep patterns adapt as well.
But do we really need 8 hours of sleep as we get older? Does napping make up for this lack of sleep at night? Is it possible to sleep too much?
The National Sleep Foundation says yes—to all of those questions. In an expert panel convened by the Foundation, sleep experts and other specialists reviewed extensive research on sleep needs by age groups, including older adults. Their February 2015 report reflects the most up-to-date recommendations on sleep needs. The panel found that while sleep patterns change with aging, adults 65-years-old and older still need between 7-8 hours of sleep nightly, and ideally over a continuous period of time.
The panel further determined that—while this range is ideal for older adults—some people may need slightly less or more sleep to meet their individual needs. Some people may have a sleep pattern that results in feeling fully refreshed with only 6 hours of sleep, for example. Meanwhile other people may need an extra hour or so, for a total of 9 hours nightly. To account for these variations, the panel noted a range just outside the recommended hours most folks need. This can be seen in the diagram released with the report below.
Understanding the range recommendations is important. While most people will fall into the primary sleep recommendations with some just on either end of the range, other people will get significantly less or more sleep nightly.
What does this mean? It means that some older adults will sleep less and some will sleep more than what’s recommended in general. Much like other health recommendations, this is not necessarily something to panic about. If you are a person who feels refreshed each morning without 7-8 hours of sleep and you are otherwise healthy, this is very likely normal for you. The concern is for those who get significantly more or less than the recommended hours and who do not feel rested or who have health problems related to sleep.
As I mentioned above, sleep is very important for overall health. Getting significantly more or less sleep than needed can be associated with health issues including high blood pressure, obesity, heart disease, and depression. But sleeping too little or too much may also be a sign of an undiagnosed problem such as a breathing disorder like sleep apnea, depression or anxiety, prostate disease, etc. If you have concerns about sleeping more than 9 hours nightly or not getting enough sleep (less than 6 hours), you should contact your healthcare provider to discuss your individual health needs.
How can you know if you should be concerned? Watch for these signs of too little or poor sleep quality:
- Daytime sleepiness
- Mood changes or irritability
- Excessive snoring
- Frequent awakenings at night
- A stop in breathing at night
The American Geriatrics Society (AGS) is proud to have participated in the National Sleep Foundation’s Expert Panel to help promote healthy sleep habits for older adults. You can view the Foundations recommendations and other information on sleep at www.sleepfoundation.org.
About the Author
Dr. Belinda Setters served as the AGS’ representative on the National Sleep Foundation’s Expert Panel for the development of these recommendations.