Assisted Living Education discusses the importance of sleep, especially as we age and for seniors in assisted living.

The Importance of Sleep

As most people know, sleep is incredibly important for maintaining good health and quality of life. Our brain forms new pathways to store information efficiently while we sleep. Without enough of it, our ability to make decisions, control our emotions, and deal with change declines. Sleep is so vital to our mental health that sleep deficiency is believed to be a factor in depression and suicide.

Sleep is also important for our physical health. Our bodies’ defenses against disease and injury depend on us having enough rest. Studies show that people who are sleep-deprived struggle to fight common infections as effectively as their well-rested counterparts. There’s also evidence that sleep is critical to repairing your heart and blood vessels and when we regularly miss out on sleep our risk for kidney disease, heart disease, high blood pressure, diabetes, and stroke all go up.

Considering that the above factors are based on research for healthy, middle-aged adults, you can imagine that the body becomes even more sensitive to sleep deficiencies as it ages.

Assisted Living Education discusses how sleep patterns change as we grow older and what remedies can be useful to our residents who experience sleep difficulties.

How Sleep Changes as We Age

Because of the critical importance to both our mental and physical well-being that sleep plays, it’s vital to understand how our sleep patterns change as we age in order to recognize when your senior residents are becoming sleep deprived and how to fix it. In general, people report that they have a harder time falling asleep the older they get. They also wake more in the middle of the night and earlier in the morning.

The amount of sleep your residents require likely won’t change. However, because of the challenges associated with falling asleep, it is likely they will spend more time in bed to get the minimum seven hours of sleep required.

Seniors also tend to report waking up easier, which can be very disruptive to a healthy sleep cycle. On average, people over the age of 60 report three or four awakenings each night. As we age, we don’t get as much “deep sleep” as we used to. It’s also common for residents to wake up more due to frequent urination or discomfort from chronic illnesses. One of the most important things you can do for your residents’ health is to make sure they have a peaceful and quiet environment to rest in at night.

Insomnia’s Effect on Dementia

Researchers at the Johns Hopkins Bloomberg School of Public Health found that older adults who reported poorer sleep quality had higher levels of beta-amyloid protein which is a biomarker for Alzheimer’s. There isn’t conclusive evidence that sleeplessness causes the disease, however it can exasperate symptoms in those who already have the condition.

One of the more common conditions associated with Alzheimer’s or any other form of dementia is a state called sundowning. Sundowning is a sharp decrease in cognitive function in the late afternoon and evening in adults with dementia. Factors that may contribute to sundowning include:

  • Physical and mental exhaustion at the end of the day
  • Poor lighting can cause individuals with dementia to misperceive information and become fearful.
  • Having an out of sync circadian rhythm (the internal clock that tells us when to go to sleep and when to wake up) throws off the body’s sense of night and day
  • An inability to separate what’s real from what’s a dream
  • Inconsistent sleep schedules

Sundowning can be a very stressful and scary experience for both residents and their caregivers. Residents that suffer from this condition become more agitated, paranoid, delirious and in some cases, physically aggressive. Ensuring your residents with dementia receive adequate, consistent and high-quality sleep is helpful in lessening the intensity of some symptoms:

  • A glass of warm milk increases sleepiness because it contains a natural, sedative-like amino acid. Camomile tea can also help if the resident is lactose-intolerant.
  • Avoid giving your residents stimulants such as caffeine after lunch.
  • Keep residents active or engaged throughout the day. Avoid letting your residents nap during the day, which can encourage an irregular sleep schedule and cause difficulty falling asleep at night.
  • Provide residents with opportunities to participate in activities or get moderate exercise in the afternoon.
  • Avoid electronic stimulation too close to bedtime, such as TV shows, or movies.
  • Encourage your residents to practice relaxation techniques at bedtime.
  • Try to have your residents go to bed at the same time every night and wake up at the same time each morning.
  • If possible, avoid letting residents spend extended periods of time in bed outside of sleep.

Sleep Aids

Sleep aids can be considered as a last resort if the resident continues experiencing difficulty falling or staying asleep. Because seniors respond differently to medicines than younger adults, it is important to consult the attending physician before implementing a new routine or discuss options with the family, if they are involved. Due to the common side effects of sleep remedies, experts recommend that seniors avoid them if possible and never use them for extended periods as these drugs often carry a risk of dependence.

Melatonin is a sleep supplement that has grown in popularity in recent years. This hormone plays an essential role in regulating the body’s circadian rhythm. Our bodies produce less melatonin as we age which is another reason older adults tend to suffer from insomnia. There are limited studies on the effectiveness of consuming melatonin supplements to treat chronic sleeplessness, but there are known risks when taken with other medications. Keep in mind, melatonin is produced and most effective in a room that is dark. Avoid leaving unnecessary lights on, which can negate its efficacy. Additionally, while a sleep aid can be effective throughout the night, a good match should not leave the resident overly groggy in the morning or throughout the day.

The attending physician will be able to review and weigh the benefits/risks for the individual resident.

The Takeaway

If a resident cannot fall asleep after 20 minutes, advise them to get out of bed, if ambulatory, and move to a chair to do a quiet activity, such as reading or listening to music until they feel tired, then try again. Extended periods of time spent in bed, while awake, can condition the brain to stop thinking of the bed as a place exclusively for rest. The most important thing to remember is that your residents benefit most from consistency. Going to bed at the same time every night and waking up at the same time every morning is the surest way to build healthy, long-term sleep habits.


Assisted Living Education’s Promise

Assisted Living Education is committed to providing the highest quality education for those considering careers in senior care. We offer RCFE courses & certification, as well as online courses and continuing education. To ensure our students receive training based in research and extensive practice, we carefully select instructors with years of real-world experience in the industry; teachers with a reputation for their passion and their ability to make the classwork engaging. Explore our website or contact us to learn more.

About Assisted Living Education
Assisted Living Education has been operating in and improving the growing senior care industry for over 15 years. Founded by certified RCFE administrators, Jane Van Dyke-Perez and Bill Perez, we have licensed more than 1,100 assisted living facilities and built close relationships with the California Department of Social Services, assisted living managers, owners and industry professionals. As senior living care educators ourselves, we strive to contribute our knowledge and skills to continually improve senior care and the satisfaction of those working in the industry.