What is Normal and Abnormal Sleep in the Elderly? 

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Normal and abnormal sleep in the elderly can be distinguished by contributing reasons for seniors’ excessive sleepiness. This blog will discuss a few causes for abnormal sleep patterns of the elderly. Firstly, let’s delve into the basic sleep patterns that are commonly recognized in the elderly. 

Regular Sleep Patterns of The Elderly  

Sleep patterns can change as people age, and this often includes alterations in the quality and quantity of sleep. While individual differences exist, here are some general characteristics of sleep patterns in the elderly: 

Decreased Total Sleep Time: 

Elderly individuals often experience a reduction in the total amount of sleep they get. They may spend less time in deep, restorative sleep stages such as slow-wave sleep (SWS) and rapid eye movement (REM) sleep. 

Fragmented Sleep: 

Older adults may experience more fragmented sleep, meaning they wake up more frequently throughout the night. These awakenings might be due to various factors, including medical conditions, medications, or discomfort. 

Advanced Sleep Phase Syndrome: 

Some elderly individuals may experience a shift in their sleep-wake cycle, leading to earlier bedtimes and wake times. This condition, known as advanced sleep phase syndrome, can result in early evening sleep onset and early morning awakenings. 

Increased Daytime Napping:  

Older adults may take more frequent naps during the day, often due to decreased nighttime sleep efficiency. While napping can provide some relief from sleep deficits, excessive daytime napping can disrupt the ability to fall asleep at night. 

Changes in Circadian Rhythms: 

Aging can affect the body’s internal clock, leading to alterations in circadian rhythms. This can contribute to disturbances in sleep-wake patterns, such as difficulty falling asleep at night or waking up earlier than desired in the morning. 

Sleep Disorders:  

Elderly individuals are more prone to certain sleep disorders, such as insomnia, sleep apnea, restless legs syndrome, and periodic limb movement disorder. These conditions can further disrupt sleep and affect overall sleep quality. 

Medication Effects: 

Many elderly individuals take medications for various health conditions, some of which can affect sleep. Certain medications may cause drowsiness or insomnia, disrupt sleep architecture, or exacerbate sleep disorders. 

Impact of Health Conditions:  

Chronic medical conditions commonly associated with aging, such as arthritis, chronic pain, heart disease, and neurodegenerative disorders, can interfere with sleep quality and duration. 

It’s important to note that while changes in sleep patterns are common with aging, not all elderly individuals will experience the same sleep disturbances. Lifestyle factors, overall health, and individual differences can influence sleep patterns in older adults. If sleep disturbances significantly impact daily functioning or quality of life, it’s advisable to consult a healthcare professional for evaluation and management. 

Also Read: Neck Circumference and Sleep Apnea

Reasons For Excessive Sleepiness in Seniors 

Excessive sleepiness in seniors can be caused by various factors, including physiological changes associated with aging, medical conditions, medications, and lifestyle factors. Here are some contributing reasons for seniors’ excessive sleepiness: 

Changes in Sleep Architecture: 

Aging often leads to alterations in sleep architecture, including decreased time spent in deep, restorative sleep stages. This can result in poorer sleep quality and increased daytime sleepiness. 

Sleep Disorders:  

Seniors are more susceptible to sleep disorders such as insomnia, obstructive sleep apnea, restless legs syndrome, and periodic limb movement disorder. These conditions can disrupt sleep continuity and lead to excessive daytime sleepiness. 

Medication Side Effects: 

Many elderly individuals take medications for various health conditions, and some medications can cause drowsiness or sedation as side effects. Drugs such as certain antidepressants, antihistamines, benzodiazepines, and opioids can contribute to daytime sleepiness. 

Chronic Medical Conditions: 

Seniors often have chronic medical conditions such as diabetes, heart disease, arthritis, and neurodegenerative disorders, thus impacting sleep quality and quantity. Pain, discomfort, nocturia (frequent urination at night), and other symptoms associated with these conditions can disrupt sleep and contribute to daytime sleepiness. 

Mental Health Disorders: 

Conditions such as depression and anxiety are common among older adults and can affect sleep patterns. Depression is associated with insomnia and disrupted sleep, leading to daytime fatigue and sleepiness. 

Neurological Disorders: 

Neurological conditions such as Alzheimer’s disease, Parkinson’s disease, and stroke can disrupt sleep-wake cycles and contribute to excessive daytime sleepiness. These disorders may lead to fragmented sleep, frequent awakenings during the night, and difficulty maintaining alertness during the day. 

Sleep-Wake Cycle Disturbances: 

Aging can cause changes in circadian rhythms, leading to alterations in the sleep-wake cycle. Seniors may experience advanced sleep phase syndrome, where they feel sleepy earlier in the evening and wake up earlier in the morning. This in turn contributes to daytime sleepiness. 

Poor Sleep Hygiene: 

Seniors may have habits or environmental factors that negatively impact sleep quality, such as irregular sleep schedules, excessive napping during the day. Additional factors may include inadequate exposure to natural light, and engaging in stimulating activities close to bedtime. 

Nutritional Deficiencies: 

Deficiencies in certain nutrients such as vitamin D and magnesium, which are important for regulating sleep. Besides, they may contribute to sleep disturbances and daytime sleepiness in older adults. 

Social Isolation and Loneliness: 

Seniors who are socially isolated or lonely may experience increased stress, anxiety, and depression. As a result, it can disrupt sleep and contribute to daytime sleepiness. 

Treatment Options for Abnormal Sleep Cycles  

Treatment options usually depend on the underlying cause of the sleep disturbance. Here are some common approaches: 

Sleep Hygiene Practices:  

Encouraging healthy sleep habits can often improve sleep quality. This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, avoiding caffeine and electronics before bedtime. 

Cognitive Behavioral Therapy for Insomnia (CBT-I): 

CBT-I is a structured program that helps individuals identify and change thoughts and behaviors that contribute to sleep problems. It typically involves techniques such as stimulus control, sleep restriction, relaxation training, and cognitive therapy. 


In some cases, medications may be prescribed to help manage sleep disturbances. These may include over-the-counter sleep aids or prescription medications such as benzodiazepines, non-benzodiazepine hypnotics, or antidepressants.  

Light Therapy: 

 Light therapy involves exposure to bright light, particularly in the morning, to regulate the body’s circadian rhythms. It can be helpful for individuals with conditions such as delayed sleep phase disorder or seasonal affective disorder. 

Melatonin Supplements: 

Melatonin is a hormone that helps regulate the sleep-wake cycle. Supplemental melatonin may be recommended for individuals with circadian rhythm disorders or jet lag. 

Addressing Underlying Medical Conditions: 

 Sleep disturbances can be a symptom of underlying medical conditions like sleep apnea, restless legs syndrome, depression, anxiety, or chronic pain. Treating these underlying conditions may improve sleep quality. 

Behavioral Therapies:  

Additionally, behavioral therapies, such as relaxation techniques, biofeedback, or acupuncture, may also be helpful in improving sleep quality for some individuals. 

Consultation with a Sleep Specialist:  

In cases of persistent or severe sleep disturbances, consultation with a sleep specialist may be warranted. A sleep specialist can conduct a thorough evaluation, including sleep studies if necessary, to determine the underlying cause of the sleep problem and recommend appropriate treatment options. 

Wrapping It Up 

Addressing excessive sleepiness in seniors often requires a comprehensive approach that includes identifying and managing underlying medical conditions, optimizing medication regimens. Therefore, it is important to  promote healthy sleep patterns, and addressing any psychosocial factors that may be contributing to sleep disturbances.  

Consulting with healthcare professionals, including primary care physicians, geriatricians, and sleep specialists, can help seniors receive appropriate evaluation. Thus, enhancing management for their sleep-related issues through remote sleep clinic consultations