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We all want to sleep better, but did you know that sleeps gets harder as we age?
Many mid-age and older clients come to me with the aim of sleeping better. When I ask what their best hopes are, they often 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 about what they hope to get out of therapy 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 3am” syndrome.
There is also 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 trialling avoiding 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.
Medical conditions can cause pain or other sleep-disruptive symptoms, or people can be on medications that could make them very sleepy during the day and make it hard for them to sleep at night.
And women often see a deterioration in sleep due to menopausal hormonal fluctuations, which are linked to anxiety and insomnia symptoms.
How therapy can help improve sleep as you get older
Figuring out what’s going on is always the first step in looking at how to improve your sleep, and you should see a GP first if there appears to be an underlying medical problem for why your sleep is poor, such as snoring or sleep apnea.
A recent survey shows that worry and stress are the number one thing that stops us getting a good night’s sleep. Hypnotherapy or other therapies help you change your negative thought patterns around sleep, which then can reduce you anxiety about what a bad night’s sleep will mean for you.
The disruption technique is a really useful tool to practise when you are trying to go to sleep. When you find yourself having a negative thought, you argue against it in your head. So rather than thinking “Oh no, I’m awake again at 3am, I will feel awful tomorrow”, you say ‘Great, four more hours of sleep for me”. The distraction technique is also another method: Think about your favourite holidays and visualise all the things you love about them. These thoughts will quickly calm your mind and ease you back to sleep.
Hypnosis and breathing techniques also help by reducing cortisol levels and so quieting 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 to discuss as part of therapy: 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 natural change
It is also normal to feel less refreshed in the morning - again, this is natural change
Falling back to sleep after going to the toilet in the 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 - it is 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
If sleep is a big problem in your life, the most important thing to do is acknowledge that you need help and to get support. It can improve.
I am a trained therapist in sleep problems, using hypnotherapy and CBTi to change your relationship to sleep. Find out more - https://www.tamsindenbightherapy.com/sleep-help
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