Coping with an Older Loved One’s Sleep Issues

It is the middle of the night. You worked all day, cooked dinner for your family and played cards with your aging parents before sinking into bed. You immediately fall asleep, only to be awoken by the sound of people pacing downstairs. You realize your parents are still up and about. They complained about being sleepy all day. Why are they still awake?

Yes, it is true: sleeping patterns morph with age. Changes in hormone levels affect “sleep architecture,” the cycle of progressing through different stages of sleep, which means that older adults often experience less deep sleep and wake up more frequently throughout the night (Insomnia and Seniors, Sleepfoundation.org, 9/28/20). Their internal timekeeping system, known as the circadian clock, also shifts, impacting how long and how well they sleep. Older adults may fall asleep earlier in the evening and wake up even earlier, which in turn creates the urge for naps, which then makes it even more difficult for them to sleep at night. Studies now show that up to 48 percent of older adults exhibit symptoms of insomnia (Dhavel Patel et al., Insomnia in the Elderly, Journal of Clinical Sleep Medicine, 6/15/18).

While chronic health conditions and medication interactions may also affect the sleep patterns of older adults, living under the constraints of the COVID-19 pandemic has further added to these challenges. Activities and finances have been disrupted, isolation has made people feel depressed, many are less physically and mentally active, fears around health and contact with others dominate public thinking and uncertainty has filled every aspect of daily living. According to research by Sleep Medicine, “Simple routines typically performed at fixed times, such as waking up in the morning, showing up at work, eating meals, and maintaining social and leisure activities have all been disrupted by the pandemic and social confinement.” All of these factors further upset the ability of older adults to sleep well.

These stressors not only impact the sleep habits of older adults; they can also directly affect us as their caregivers. Work from home may be possible – but productive work may often feel out of reach. The blurred lines between work and home further contribute to elevated stress levels, as do the often-conflicting demands of employers, caregiving and homeschooling. (Dr. Ellemarije Altena et al., Dealing with sleep problems during home confinement due to the COVID-19 outbreak, Beck Institute). Taken together, the stress related to coping with the virus negatively impacts restorative sleep, which further builds up feelings of stress and anxiety, making it even harder to sleep and therefore harder to cope. And so the cycle continues.

Tips to manage sleeping difficulties

Why is it important to focus on sleep? Sleep is key to physical and emotional health, regardless of age. According to HelpGuide, “A good night’s sleep helps improve concentration and memory formation, allows your body to repair any cell damage that occurred during the day, and refreshes your immune system, which in turn helps to prevent disease.” Thus, it is particularly vital now, during the pandemic, to manage good sleep habits.

While sleep medications may not be recommended, there are steps that we can take to improve the sleep routines of both ourselves and the older loved ones we care for. We can:

• Structure our days, establish a regular sleep schedule and try to go to bed and wake up at the same time each day.
• Discourage napping to promote better sleeping at night.
• Sleep in a dark, quiet, cool room.
• Intentionally practice relaxation or mindfulness before heading to bed.
• Avoid staying stationary by doing something physical every day. However, we should remember to consult with a loved one’s doctor before planning any kind of exercise routine.
• Minimize the use of computer/phone screens before bedtime. 
• Find ways to get at least two hours of sunlight each day. Sunlight has been shown to help regulate the sleep-wake cycle (Sleep tips for older adults, HelpGuide).