The purpose of this chapter is to discuss changes in sleep quality and architecture that occur as one ages. Normal age related changes in sleep architecture will be discussed fi rst, followed by sleep and circadian rhythm disorders that increase in prevalence as we age. Finally, a short section at the end of this chapter discusses neurological disorders more frequently seen in older adults, and their impact on sleep.There is a general perception that degradation of sleep quality is a normal part of aging. In fact, practitioners who see geriatric patients on a regular basis often hear complaints of sleep difficulties in their patients. As we age, a number of age-related health problems are associated with difficulty sleeping. It is often difficult to differentiate sleep problems secondary to underlying health problems or medication effects from primary sleep disorders. This chapter will review the changes that occur in sleep quality as one ages and will address sleep disorders often seen in the older adults. The data discussed within this chapter is almost exclusively based on defining age chronologically. Some have argued that subjective or physiological age and time from death are more accurate ways of defining age; however, chronological age is the most consistent definition for aging. Therefore, it is the one used within this chapter.
Changes in Sleep Architecture as We AgeA number of studies have been conducted to look at changes in sleep architecture over the life span. One of the most consistent age-related changes in sleep architecture is a decline in delta or slow-wave sleep (SWS). SWS is de fi ned electrographically by low-frequency (0.5-2 Hz), high-amplitude (>75 m V) waveforms [ 1 ] and is primarily con fi ned to the fi rst half of the sleep