HOW TO PREVENT CANCERS

Our expert: Professor David Hillman

Most of us have heard that we need less sleep as we age. So when older people spend hours awake in the middle of night or wake before the sun comes up, they tend to accept it as a normal part of ageing.

But do you actually need less sleep as you get older?

No, says Professor David Hillman, chair of the Sleep Health Foundation, older adults need the same amount of sleep as young people.

"Adult sleep requirements are pretty stable from about the age of 20 on. Sleep does change as you get older, but the sleep requirements remain pretty constant once you've established that in your early 20s," he says.

Hillman says it is remarkable how many older people endure feeling sleepy without seeking help, because they think it is a natural part of ageing. But in many cases there is a reason for this poor sleep, and once a sleep disorder is identified and treated, older adults can feel years younger.

"If people notice a change in their sleep requirements as they get older, such as spending longer in bed for less benefit, and waking up unrefreshed despite getting the same amount of sleep that used to refresh them, then that implies there's something wrong with sleep itself," he says.

"It's really a gratifying area to work in because there are actually easy wins in those areas and people just feel younger again," Hillman says.

Your "body clock", which is actually the circadian centres in your brain, dictates your propensity to sleepiness and wakefulness across day and night. These centres are generally influenced by light and darkness, but can also be affected by other aspects of your daily routine, such when you eat and when you exercise.

While some people have quite robust sleep patterns and still get the rest they need despite changing their daily routines, many people's body clocks rely on fairly constant habits.

Your body clock also controls the production of a hormone called melatonin, which promotes sleep. As you grow older you produce less of this hormone, which may make it more difficult for you to sleep.

Older adults are also more likely to experience advanced sleep phase syndrome, which means you get sleepier earlier in the evening so while you may still be sleeping for eight hours, you might find yourself awake before the birds.

Also, while your body is programmed to sleep at night, some of us find ourselves feeling sleepy in the afternoon. Given that older adults are less likely to be at work, they sometimes have an afternoon nap. But napping in the afternoon, especially later in the afternoon, will affect how well you sleep at night.

There are also specific health issues related to ageing that can have a significant impact on sleep, especially your ability to fall asleep, these include:

aches and pains, especially conditions such as arthritis and osteoporosis,anxiety and depression, Alzheimer's disease and dementia,reflux, which many older adults experience after a meal, especially if it's exacerbated by lying down,men with prostate problems may need to get up during the night to urinate,sleep apnoea is also common among older adults, and can cause significant sleep disturbances, some medications such as antidepressants, blood pressure tablets, and diuretics, can also hinder the ability to fall asleep. While they might not be the cause of sleep problems, it's best to review your medications with your doctor if you have concerns.

If any of these factors are affecting your sleep then it's important to talk to your doctor about them, as treating an underlying condition that is causing poor sleep often leads to better sleep.

And if you don't have an underlying issue, but still have constant difficulty dropping off to sleep, or going back to sleep after waking during the night – then you may have insomnia. Insomnia is not necessarily linked to ageing, so it's best to speak with your doctor about your options for treating insomnia.

Although older people do face many challenges in achieving a good night's sleep, following a few simple rules can help.

Allow an adequate amount of time for sleep on a daily or near daily basis.Go to sleep at the same time each night.Supplement a lack of sleep with short afternoon naps between 30 minutes and one hour.Eat at regular times and don't eat a big meal late at night.Avoid caffeine after mid-afternoon – if you want a warm drink before bed have weak tea or a decaffeinated coffee.Ensure your bedroom environment is conducive to sleep – dark, a comfortable bed, the right temperature and no television.Try not to bring your worries to bed – if needed spend some time just before bed writing down your worries and a plan for the coming day.Speak with your doctor if your sleep changes after starting new medications.

Professor David Hillman is an anesthesiologist and sleep physician and chair of the Sleep Health Foundation. He spoke to Jenny Pogson.

Published 14/11/2013