Do you get less REM sleep as you get older? Unpacking age-related sleep changes

According to the National Institute on Aging, healthy older adults need about the same amount of sleep as younger adults, but many struggle to achieve it. As you get older, one question often arises: Do you get less REM sleep as you get older? The answer is yes, though the changes are complex.

Quick Summary

Yes, REM sleep often decreases with age, especially after 60, but the change can be less pronounced than the dramatic reduction in deep sleep. Understanding these changes is key to maintaining healthy sleep habits in later life.

Key Points

• REM Sleep Generally Decreases: Yes, the percentage of REM sleep tends to decline with age, but often less dramatically than the more significant reduction in deep, restorative sleep.

• More Fragmented Sleep: Older adults experience lighter, more interrupted sleep with more frequent awakenings throughout the night, which disrupts later, longer REM cycles.

• Impacts Cognitive & Emotional Health: Insufficient or delayed REM sleep can negatively affect memory consolidation, emotional regulation, and may increase the risk of cognitive decline and dementia.

• Linked to Increased Mortality: Studies have associated lower percentages of REM sleep with a higher risk of earlier death in middle-aged and older individuals, suggesting its importance for overall health.

• Sleep Needs Remain High: The myth that older adults need less sleep is false; they still require 7-9 hours, but age-related changes make it harder to achieve.

• Lifestyle Changes Can Help: Implementing good sleep hygiene—including a consistent schedule, regular exercise, and avoiding alcohol before bed—can improve sleep quality and quantity.

What Happens to REM Sleep as You Age?

Rapid Eye Movement (REM) sleep is the stage where most dreaming occurs. It is crucial for processes like memory consolidation, emotional processing, and cognitive function. While many aspects of sleep change with age, the trend for REM sleep is generally a gradual decrease. However, it is important to distinguish this from the much more significant decline in deep sleep (N3), which begins much earlier in adulthood.

Research on REM sleep changes with aging has shown mixed results, with some studies finding a small, linear decrease over time, while others observe no significant change in healthy older adults over 60. These variations highlight the complexity of the aging process and individual differences. The overall sleep architecture becomes lighter and more fragmented, with increased wakefulness throughout the night. This fragmentation can shorten the later, longer REM cycles, even if the total percentage of REM sleep isn't affected as dramatically as deep sleep.

The Science Behind Age-Related Sleep Shifts

Several biological factors contribute to the way sleep patterns evolve as we age:

• Weakening Circadian Rhythms: The body's internal clock, regulated by the suprachiasmatic nucleus, becomes less robust over time. This leads to an earlier onset of sleepiness in the evening (phase advance) and earlier waking in the morning. This shift can disrupt the normal sleep-wake cycle and contribute to poor sleep maintenance.
• Decreased Melatonin Production: The pineal gland produces the sleep-regulating hormone melatonin, but its production tends to decrease with age. Less melatonin can make it harder to fall and stay asleep, leading to lighter, more fragmented sleep.
• Altered Sleep Homeostasis: The homeostatic drive for sleep—the pressure to sleep that builds up the longer you are awake—also diminishes. This means older adults may feel less sleepy after a period of wakefulness, and daytime naps are more common as a result. However, excessive daytime napping can, in turn, reduce the sleep pressure needed for a consolidated night's sleep.
• Increased Nocturnal Awakenings: Older adults wake up more frequently during the night, often due to lighter sleep and other age-related factors like needing to urinate (nocturia). These interruptions can cut short the crucial later REM cycles.

The Consequences of Reduced REM Sleep

While total REM sleep might not decrease as severely as deep sleep, the associated changes still carry significant health implications:

• Cognitive Decline and Dementia Risk: Studies have linked lower REM sleep with a higher risk of cognitive decline and dementia. Reduced REM sleep may disrupt the brain's ability to consolidate memories, especially emotionally charged ones, and has been associated with higher levels of toxic proteins like amyloid and tau, which are biomarkers for Alzheimer's disease.
• Increased Mortality Risk: In a notable study published in JAMA Neurology, researchers found a link between insufficient REM sleep and an increased mortality rate in both older and middle-aged adults. For every 5% reduction in REM sleep, there was a 13-17% higher risk of death from any cause.
• Emotional and Mental Health Impact: REM sleep plays a vital role in emotional regulation and mood. Chronic disruption of REM sleep can increase stress and anxiety, potentially worsening conditions like depression, which is also more prevalent among older adults.

How to Improve REM Sleep as You Get Older

While age-related shifts are natural, certain lifestyle strategies can help maximize the quality of your sleep, including REM sleep:

1. Maintain a Consistent Sleep Schedule: Going to bed and waking up at the same time every day, even on weekends, helps regulate your circadian rhythm.
2. Optimize Your Sleep Environment: Ensure your bedroom is dark, quiet, and cool. Blackout curtains, earplugs, or white noise machines can help.
3. Avoid Alcohol and Caffeine Before Bed: Both substances can disrupt sleep cycles, with alcohol notably suppressing REM sleep. Cut off caffeine consumption in the late afternoon and limit alcohol, especially close to bedtime.
4. Exercise Regularly: Consistent physical activity during the day promotes better sleep at night. However, avoid strenuous workouts within three hours of bedtime.
5. Wind Down Effectively: Develop a relaxing pre-sleep routine. Reading a book (not on a bright screen), listening to calm music, or taking a warm bath signals to your body that it's time for rest.
6. Limit Daytime Naps: Keep naps short (under 30 minutes) and early in the day to avoid disrupting nighttime sleep pressure.
7. Manage Stress: Practices like meditation, deep breathing exercises, or journaling can reduce anxiety and stress that interfere with sleep.

Sleep Stage Changes with Age: A Comparison

To illustrate the typical changes in sleep architecture, here is a comparison between a younger adult and an older adult.

Feature	Young Adult (approx. 20-30)	Older Adult (approx. 65+)
Deep Sleep (N3)	High percentage of sleep time (~20%)	Dramatically decreased percentage (~10-15%)
REM Sleep	Consistent percentage (~25%)	Slightly decreased, more fragmented
Sleep Maintenance	Wake up infrequently and briefly	Wake up more frequently, more aware of being awake
Sleep Efficiency	High	Lower due to fragmented sleep
Circadian Rhythm	Strong and robust, later sleep-wake cycle	Weakens, leading to earlier bedtimes and wake times

The Importance of Seeking Professional Help

While adopting healthy habits can make a significant difference, sleep problems in older adults are not always a normal part of aging. Conditions like insomnia, sleep apnea, or REM sleep behavior disorder are more common with age and can have serious consequences. If you have persistent trouble falling or staying asleep, excessive daytime sleepiness, or if your partner notices breathing issues, it's crucial to consult a healthcare provider. The National Institute on Aging offers valuable resources on this topic and emphasizes that improving sleep quality is possible and important for overall health, quality of life, and safety.

In conclusion, understanding how REM sleep and overall sleep architecture shifts with age is the first step toward proactive sleep management. By focusing on good sleep hygiene, addressing underlying medical conditions, and seeking professional guidance when needed, older adults can improve their rest and, consequently, their overall well-being. Good quality sleep is a cornerstone of healthy aging, not a luxury to be sacrificed.

Frequently Asked Questions

Is less REM sleep a normal part of aging?

A gradual decrease in REM sleep is often considered a normal part of the aging process, but significant reductions and fragmented sleep are not always inevitable. Many factors beyond normal aging, such as health conditions and medications, can influence sleep patterns.

How much REM sleep do adults need?

For healthy adults, REM sleep typically accounts for about 20-25% of total sleep time. If you get the recommended 7-9 hours of total sleep per night, this translates to roughly 90-120 minutes of REM sleep.

What is the biggest change in sleep as people get older?

The most significant change is the reduction in deep sleep (slow-wave sleep), which decreases substantially starting in middle age. This makes sleep lighter and contributes to more frequent awakenings during the night.

Can I increase my REM sleep naturally?

Yes, you can improve your chances of getting more REM sleep by practicing good sleep hygiene. This includes maintaining a consistent sleep schedule, exercising regularly (but not too close to bedtime), and avoiding alcohol and caffeine in the hours before sleep, as both can interfere with the REM cycle.

Does medication affect REM sleep?

Yes, many medications commonly used by older adults can interfere with sleep architecture, including REM sleep. These include certain antidepressants, beta-blockers, and some over-the-counter sleep aids. It's important to discuss any sleep issues with your doctor.

What is the difference between deep sleep and REM sleep?

Deep sleep is a restorative stage crucial for physical repair and immune function, characterized by slow brainwave activity. REM sleep is vital for memory consolidation and emotional processing, featuring brain activity similar to wakefulness and vivid dreams.

Should I see a doctor about my sleep problems?

You should consider seeing a doctor if your sleep problems are persistent, affect your daily functioning, or are accompanied by symptoms like excessive daytime sleepiness or loud snoring. Sleep issues can be a sign of treatable conditions like sleep apnea or insomnia.