Family members often notice changes in an elderly parent’s sleep patterns, including increased sleep. While some shifts are normal with aging, a significant increase in sleepiness or total sleep duration can signal underlying health concerns. Recognizing the difference between typical age-related changes and potential issues helps families know when to seek medical advice.
Typical Sleep Patterns in Older Adults
As people age, their sleep architecture naturally changes. Older adults spend less time in deeper, restorative sleep stages, including reduced REM sleep. This leads to lighter, more fragmented sleep with frequent nighttime awakenings.
The body’s circadian rhythm also shifts, often causing older adults to feel tired earlier and wake earlier, known as advanced sleep phase. Daytime napping may increase, with about 25% of older adults napping compared to 8% of younger adults. However, excessive daytime sleepiness that interferes with daily life is not a normal part of aging.
Underlying Health Conditions
Excessive sleepiness in older adults can stem from various health conditions. Sleep apnea, where breathing repeatedly stops during sleep, affects up to 56% of those aged 65 and older, causing fragmented sleep and daytime fatigue. Restless legs syndrome, with its uncomfortable sensations and urge to move legs, also disrupts sleep and contributes to daytime sleepiness.
Chronic medical conditions common in older populations can also increase sleep. Hypothyroidism, an underactive thyroid, causes fatigue. Anemia, with insufficient red blood cells, often results in weakness and fatigue. Heart failure and kidney disease can lead to tiredness from toxin and fluid buildup. Poorly controlled diabetes can cause fatigue due to blood sugar fluctuations.
Neurological conditions also manifest with increased sleepiness. Early dementia, including Alzheimer’s, can involve increased napping and prolonged sleep. Parkinson’s disease is linked to excessive daytime sleepiness, either as a symptom or medication side effect.
Mental health conditions like depression and anxiety are common and impact sleep. Depression often presents with increased sleep (hypersomnia) or sleep difficulties. Infections like UTIs or pneumonia can cause general malaise and increased sleepiness, especially in elderly individuals who may not show typical symptoms. Chronic pain, common among older adults, can lead to exhaustion and a desire for more sleep as the body copes with discomfort.
Medication Side Effects
Many medications prescribed to older adults can cause drowsiness or sedation. Sedatives and anxiolytics, like benzodiazepines, promote relaxation and sleep, with lingering daytime effects. Older antihistamines, found in cold and allergy medications, are known for their sedating properties.
Certain antidepressants, especially older types, can cause drowsiness, though some newer ones can also induce somnolence. Antipsychotic medications frequently cause sedation. Opioid pain medications are a known cause of drowsiness and confusion, with prolonged effects due to age-related metabolism changes.
Muscle relaxants, prescribed for musculoskeletal pain, affect the central nervous system and cause tiredness. Certain blood pressure medications, like beta-blockers, can slow heart rate and contribute to fatigue. A comprehensive review of all medications, including over-the-counter drugs and supplements, with a healthcare provider is important to identify potential drug-induced sleepiness.
Lifestyle and Environmental Factors
Beyond medical conditions and medications, lifestyle and environmental factors can increase sleep in older individuals. Poor sleep hygiene, including irregular schedules, an uncomfortable environment, or excessive noise/light, disrupts sleep quality and causes daytime fatigue. An inconsistent sleep-wake cycle interferes with circadian rhythms, making alertness difficult.
A sedentary lifestyle and lack of physical activity can lead to increased daytime sleepiness. Reduced daily energy expenditure lessens the need for consolidated nighttime sleep, resulting in more napping and low energy. Boredom and lack of engaging activities can also lead to more time spent sleeping.
Social isolation and loneliness link to sleep disturbances and fatigue. Individuals feeling lonely or having weak social networks may experience poorer sleep quality, exacerbating isolation and contributing to depression.
Poor nutrition or inadequate hydration affects energy levels, causing fatigue and a desire for more sleep. Dehydration can cause dizziness and weakness, while nutrient deficiencies hinder energy production.
Environmental changes, like moving or limited natural light exposure, disrupt sleep patterns. Natural light regulates circadian rhythm; its absence can cause disorientation and altered sleep-wake cycles. Significant life events, including grief or chronic stress, can cause emotional exhaustion and increased sleepiness, as the body and mind require more rest to cope.
When to Consult a Healthcare Professional
Seek medical advice if an elderly parent’s increased sleepiness is a sudden or significant change. Any new or worsening symptoms, such as confusion, weight changes, severe mood swings, or breathing difficulty, require immediate medical evaluation. If increased sleep interferes with daily activities, reduces quality of life, or hinders engagement, medical attention is needed.
Discuss potential medication side effects with a doctor. Healthcare providers can review prescriptions and over-the-counter medications for drowsiness and suggest alternatives. If the individual is unusually difficult to rouse or unresponsive, this is a medical emergency. Prepare a detailed list of observations, including when increased sleep started, its duration, and associated symptoms, to assist the healthcare professional in diagnosis and care planning.