As people age, they tend to sleep more lightly than when they were younger. Waking up during the night due to achy joints or the need to use the restroom becomes commonplace. Many seniors compensate for this lost sleep by catching a restorative nap during the day. That’s normal.
Daytime sleepiness in the elderly becomes problematic when a loved one spends most of their time dozing in bed or in their favorite chair instead of engaging in life. If you want an older adult to stay awake more during the day and sleep better at night, you'll need to discover the underlying reason(s) for their excessive napping. In some cases, you may need a doctor’s help to narrow down the cause and recommend solutions. Knowing what to look for can give you a jumpstart on improving a senior’s sleep schedule.
What Causes an Elderly Person to Sleep All the Time?
Boredom and Lack of Engagement
As people age, they may develop chronic health conditions and experience age-related changes that prevent them from doing the things they enjoy. When options for outings, activities, and entertainment are limited, it can deal a serious blow to an elder’s quality of life. They aren’t working anymore, they may struggle with reading or puzzles, and watching TV eventually gets old. In these cases, elders may not be clinically depressed or even all that tired. Instead, their fatigue stems from the fact that they are incredibly bored. With no schedule to keep and not much to look forward to in their lives, they slide into the habit of napping throughout most of the day.
Medication Problems
Polypharmacy is a serious concern for older adults. A recent Kaiser Family Foundation poll found that 89 percent of Americans age 65 and older report taking prescription medicine, including more than half (54 percent) who report taking four or more prescriptions.
All medications have side effects, so it should come as no surprise that taking multiple drugs can produce interactions that magnify these effects. In addition, older individuals metabolize medications differently than their younger counterparts, meaning they are even more susceptible to adverse effects like drowsiness and dizziness.
Prescription drugs and over-the-counter medications for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson’s disease, nausea, and allergies can all cause excessive sleepiness. Atypical (second generation) antipsychotics are notoriously hard on elderly patients as well, especially those living with dementia. If your loved one is using one or more of these drugs, discuss the side effects and alternative treatment options with their physician. You may even find that there are some medications in their regimen that could be reduced to smaller dosages or discontinued completely. Sometimes altering the timing of a senior’s doses can improve their alertness during the day.
Depression and Low Energy
Some elders become sad and lose interest in life, but depression is not a normal part of aging. Unfortunately, research estimates that major depressive disorder occurs in five percent of community-dwelling elders, while up to 16 percent of older adults have clinically relevant depressive symptoms. Most people are familiar with the basic signs of depression, but the red flags can be a little different for seniors. Sleep issues and fatigue may indicate changes in a loved one's mental health. If you notice these symptoms, do your best to talk with them about how they're feeling and make an appointment with their physician.
Read: How to Spot the Warning Signs of Elderly Depression
If a senior is already taking antidepressant medication or begins antidepressant therapy, keep in mind that finding the correct medication usually takes some trial and error. Again, sleepiness can be a common side effect of these prescription drugs. Be sure to communicate with the doctor about any adverse effects to ensure your loved one finds the right medication.
Advancing Dementia
Seniors with Alzheimer’s disease or other forms of dementia often experience a wide array of sleep problems, especially in the later stages of the disease. As the brain changes, issues arise with circadian rhythms and temporal awareness, making it difficult for dementia patients to sleep through the night and keep a normal schedule. In some cases, sleeping during the day is the only way that patients can make up for the shuteye they lose at night.
Sleep deprivation can exacerbate symptoms of dementia like sundowning and agitation, and the resulting odd schedules are often frustrating for caregivers. Unfortunately, there aren’t many foolproof methods for helping a dementia patient sleep through the night and stay awake during the day. Neither over-the-counter nor prescription sleeping pills are typically advisable.
The Alzheimer’s Association recommends planning engaging activities during the daytime, scheduling brief naps as needed, and sticking to a set sleep schedule as the best nonpharmaceutical methods for encouraging good sleep habits. A solid routine can be very effective in helping a loved one stay oriented and managing dementia behaviors.
Read: The Importance of Creating a Daily Routine for Dementia Patients
Changes in Health
In some instances, excessive sleeping in individuals with one or more serious medical conditions can indicate that their health has taken a turn. This may not necessarily mean that death is near, but it is a reason to contact their doctor to see if a specific treatment should be altered, added, or removed. If a loved one is spending a great deal of time asleep, it's important to devise ways of ensuring they still get the nutrition, personal care, and medications they need. Otherwise, complications like dehydration, malnutrition, and pressure ulcers can arise. In the most severe cases, a doctor may recommend an assessment for an increased level of care, such as skilled nursing or hospice.
Seniors who are terminally ill will experience marked changes in consciousness and decreased activity as they approach the end of life. In some cases, a dying person will experience periods of unresponsiveness and eventually lapse into a coma before passing. A hospice care provider can guide family members through these and other symptoms and ensure a dying loved one is calm and comfortable in their final days.
Read: End-of-Life Care: Signs That Death Is Near
The Importance of Staying Active
In addition to being vigilant about an aging loved one’s medications and health, it's also important to encourage participation in life. Providing plenty of opportunities for social interaction, mental stimulation, and physical activity helps to foster a high quality of life. But, for many family caregivers, seeing to these needs on top of their hands-on responsibilities and personal schedules is nearly impossible. A common solution is arranging respite care that doubles as a source of stimulation for a loved one.
In-home care and adult day care are two such options. Both professional in-home caregivers and adult day care staff can help set and maintain daily routines, provide engaging activities and outings, and broaden a senior’s social circle. Independent living, assisted living, memory care and nursing home care can also offer these benefits in a residential setting. When elders spend more time engaged in life during the day, it reduces boredom, minimizes depressive symptoms, and typically leads to better quality sleep at night.
As a concerned caregiver, your goal is to determine why your loved one is so fatigued and how you can boost their mood and energy level. The problems and solutions above may not apply to every senior, so don’t feel you must try to solve sleep issues on your own. Communicate with your loved one as best as you can and ask for help and ideas from physicians, elder care experts, and fellow caregivers. By doing so, you’ll get the support and reassurance you need to find a workable solution.