Sleep rhythm disturbances after 50, or why does our sleep quality decline with age?

We sleep worse and worse with age. Meanwhile, lack of sleep is not only frequent yawning during the day. Sleep problems can lead to a decline in immunity and an increased risk of many diseases, including depression. Melatonin can help.

Sleep disturbance is one of the most common health problems in developed countries. Unfortunately, after the age of 55, they can get worse. One reason may be that it reduces the production of melatonin, the body’s time to sleep.

Sleep deprivation and health

Prolonged disturbances in sleep rhythm can cause many ailments, including cardiovascular, respiratory and digestive system diseases, as well as a decrease in immunity. Sleeping too little can lead to obesity and high blood pressure, and increases the risk of depression, anxiety and psychotic disorders. When we sleep, our brain restores the proper functioning of the nerve cells that interfere with the processes taking place in them during the day.

It rebuilds them so that they can communicate with each other, thanks to which we can see, hear, feel, understand. Therefore, after a sleepless night, we often have problems with concentration, memory, choosing the right words, we can be distracted and irritable.

Choosing a drug for the treatment of sleep rhythm disorders

In order for the treatment to be effective and safe for the patient, drugs used in the treatment of sleep rhythm disorders must meet a number of conditions. This is especially important in the case of the elderly, in whom comorbidities and medications used to treat them significantly increase the risk of side effects and drug interactions. The presence of at least two somatic diseases is found in nearly 70% of people over the age of 65, and therefore these people often take five or more different medications. In addition to the low risk of interactions with other drugs, drugs used in the treatment of sleep rhythm disorders must also meet the following conditions:

1. fast action,
2. effective induction and maintenance of sleep,
3. restoring the natural sleep profile,
4. no effect on fitness during the day,
5. lack of tolerance development,
6. no risk of addiction,
7. no withdrawal symptoms after the end of treatment,
8. application regardless of age

In the case of the elderly, it is particularly important that the drug used to treat sleep rhythm disorders does not have an antihypertensive effect (i.e. lowering blood pressure), which increases the risk of dizziness and falls, and a cholinolytic effect, which limits the possibility of using the drug in patients with glaucoma, hyperplasia. prostate and urination disorders, and cardiac conduction disorders.

These diseases are present in many people over 65 years of age. The hypnotic drug should also not have a strong and prolonged sedative effect, which may lead to a deterioration of cognitive functions and psychomotor performance the next morning.

Declining melatonin resources

Everyone produces melatonin to regulate their circadian rhythm of sleep and wakefulness. Thanks to this, we sleep at night and we are active during the day. Melatonin is produced in the central nervous system by processes that depend on the light-dark cycle. The beginning of its secretion is initiated around 21.00 p.m. to 22.00 p.m., it increases at night, so that the highest concentration is reached between 2.00 a.m. and 4.00 a.m. The gradual reduction of its production takes place between 7.00-9.00.

The average daily melatonin secretion decreases with age. The maximum falls between the ages of 4 and 10. Then it decreases and until the age of 45 it is relatively constant. As the body ages, especially after the age of 55, the amount of melatonin synthesized in the body may be too low to properly regulate sleep. Sometimes the circadian rhythm of its secretion is completely lost. It affects not only sleep rhythm disturbances, but the body’s resistance, metabolism, heart function, neurological and mental state.

Daily melatonin rhythm depending on age (dark belt – dark period):

Melatonin deficiencies in people over 50

Correct circadian rhythm determines the fact that we want to sleep at night. The melatonin secreted by the body regulates the circadian rhythm of sleep. Meanwhile, its bad ones make us struggle with sleep problems in old age. Older people often suffer from an accelerated sleep phase, i.e. they go to bed earlier than in middle age, often before 21.00 p.m. and wake up in the early morning hours, often around 4.00 a.m.

There is also an increase in the frequency of arousal, which negatively affects the circadian rhythm of hormone secretion. Melatonin plays an important role in regulating the circadian rhythms. Too low its level in people over 55 years of age. may cause difficulty falling asleep, as well as poor sleep quality, which is manifested by frequent waking up and shallow sleep.

Melatonin in the treatment of sleep rhythm disturbances

Exogenous melatonin is a drug recommended primarily for the treatment of disorders of the circadian rhythm of sleep and wakefulness, especially disorders with delayed sleep and wake phase, sleep disorders associated with changing time zones or shift work, disorders with irregular sleep and wake rhythm and non-24-hour rhythms. rhythm of sleep and wakefulness. It is considered to be the first-line treatment in these indications. Melatonin can also be used to treat sleep rhythm disturbances in people over 55 years of age.

Melatonin is not a sedative like sleeping pills. After taking it, we do not feel suppressed. It also does not disturb cognitive functions and does not delay reaction. The main physiological task of melatonin is to indicate to the body the night hours for sleep. It is safe and, unlike some sleeping pills, it is not addictive – even with long-term use.

In order to restore the normal circadian rhythm and improve the quality of his sleep, take 5 mg immediate-release melatonin. In the case of disturbances in sleep rhythm with falling asleep disorders, it is best to use 5 mg of melatonin an hour before going to bed, while in the case of disturbances in sleep maintenance and night awakenings, 5 mg can be taken just before going to bed. The recommended treatment period is 6-12 weeks. In order for such therapy to bring even better results, it is worth changing the lifestyle so that it also strengthens the circadian rhythm of sleep and wakefulness – Tab. 1.