Earlier times of poor sleep and their impact on sleep now
Whilst many older people talked of how poor their sleep is now, and often thought it was down to the fact that they were getting older, several of the older people we talked to also described how their sleep had been poor at other times in their lives, and still had an influence on their sleep now. They identified several factors that may have changed their sleep patterns, such as bereavement, stress from work and health problems.
One very common reason for having poor sleep now was having spent some time caring for or the death of someone close to them. People talked about how they found their sleep had deteriorated once their partner had died, and remained poor, even though it may have been several years since the death of their partner. Others found that both the physical caring and worrying for someone close to them who is terminally ill was very disruptive in terms of sleep. Judy looked after her brother for two years before he went to live in a home but her sleep still remained poor because she felt guilty and worried about him.
You see really. So I didn’t get a good night’s sleep. I did have some sleep but not a good night’s sleep. And I think this is what happens. If you go to bed and you are tired and like as I said, I can’t sleep during the day, I never have been able to sleep. I am not one that would lay and doze in a chair or anything. If I was really tired I would have to lay down and stretch out, but it is a thing I have never done and I have always tried to keep busy so that when I go to bed I am exhausted. But some nights, I might get six hours. And another night it might only be about three. It all depends how your mind works, but as I said before I do find that the television is a boon in the middle of the night. It saves you tossing about. You can put it on quietly and there is some quite interesting programmes on, especially the BBC news the world news. And I do find that interesting and I find before I know where I am I have dozed off and missed half of it you see, and then perhaps I might wake up about seven, come down and make a cup of tea and come back and usually my brother puts the paper in for me about quarter to eight and I go back with the paper. Sometimes I might doze off for another hour. But otherwise I get up and try and keep busy, but that is how I find, that since I lost my husband, that is how my sleep pattern is.
So was it different when your husband was alive?
Oh yes. I could always have a good night’s sleep. Never no bother, you know, always reckoned to have a good seven hours at least. Seven or eight.
What seven hours unbroken or…?
Yes usually yes.
Age at interview:
Widowed, but married again subsequently, one child, retired Secretary
Well we had just moved house and we had got a new doctor and she did very kindly come and see me one afternoon and he said if you need me for anything he said, you know, I am only on the end of the phone.
Oh that is good.
Just give me a bell, and if I am not there my wife will be there and she can relay a message, just ring me. He said do you need anything at the moment and I said no not really because although I was waking up a lot then, I thought oh this will pass, you know, this too shall pass, you know, and get through, you get through the funeral, you get through the everything else that you have got to get through and after a few months I thought oh well my sleep isn’t coming back like I hoped it would.
Did it improve a bit?
It improved a little bit yes, but then of course the things that wake you up are when you have been through that you are thinking could I have done anything else. What about if I had done this or said that. And you just get those sort of thoughts as well that wake you up. And constant dreams, dreams of being there.
Age at interview:
Widowed, 2 children, retired Engineering Development Manager
Well I knew, I thought she was dying, and nobody had said dying, but gradually the body language of the consultants and the nurses you know, you put all this together and my own common sense I did know. But this, it still couldn’t help the problem of being awake in the worst case about six times a night when she was diabetic. When we got that under control she kept wanting to go to the toilet. And other times when she couldn’t sleep and she would want to get out of bed and so on. And that set my physical condition and I think my sleep mode until the end of April when she went and I went away for a holiday and then sleeping in my little caravan I had some good night’s sleep. But after getting refreshed as it were, I think the body was telling me you have got to have some sleep. Once I was obviously physically better, I reverted, I have reverted now to this stop and start sleeping. Previously as I could go to bed at ten o’clock, eleven o’clock and wake up at half past six or seven o’clock or when I wanted to, and have a solid night’s sleep. It is still an interrupted sleep pattern.
Age at interview:
Judy is separated and is a retired retail assistant. She has five children and 15 grandchildren.
So he was wondering around in the night here?
Oh gosh yes, absolutely, and then sometimes he wouldn’t get up in the morning, and he wouldn’t get up and have anything to eat, and as I say in the end, it got so stressful that the doctor said he has got to go, and that is what we did. But he was quite happy where he was, but he lasted a lot longer than we thought he would.
Were you working at the time as well?
No I gave up work to look after him. But, even when he was well I didn’t sleep that well.
Really, so even before he was poorly?
Yes, before he was ill, I was 64 when that happened, and I was going for retirement anyway, but I just to give up the job straight away and there was an awful lot to do as far as his place was concerned. When I look back on it, I don’t know how I did it, but I did it, and then we brought him up here which was so much easier for me, but he got worse, and you never know if you are doing the right thing or not.
Sometimes older people realised their poor sleep was influenced by events earlier in their life. One person knew she wasn’t sleeping well because of needing to get up and go to the toilet, and put this down to old age, but then realised that there had been other times in her life when she didn’t sleep well.
Married, 2 children, Renal Social Worker (part-time)
Well… no, there wasn’t a strict routine at all but I had very bad asthma as a child. So probably I didn’t sleep very well. I have never thought about it actually until you mentioned it this moment but no I got a lot of asthma. I was off school a lot.
Because the treatment then wasn’t so good?
Oh Ephedrine they gave you. They boiled kettles and things. And my Father would spend a lot of time helping me. At night actually. I remember that now. I hadn’t thought. I may have never slept very well.
Although actually when I was about fifteen my asthma sort of stopped until it came back when I was about forty. So I did have some time. But then I had the children so may be there wasn’t, may be in my twenties I slept well.
People weren’t always clear about what caused the change in their sleep, but were aware of a general decline in sleep quality over several years. Christopher said that because he had worked shifts he had “never had a regular pattern of sleep all my life”. A few women thought that one of the possible reasons for their poor sleep was the onset of the menopause, and the symptoms that are associated with it. Other women mentioned that disturbance in their sleep had started when their children were young and it had never been the same since. A few people had worked in shifts in the past which they thought might have had an influence.
Married, 2 children, Renal Social Worker (part-time)
Can you think back to when this type of sleep you have got now…?
I think it started with the menopause. Although I think it might have started when I had children. I mean I think once you have children you are much more alert to waking up. I don’t remember before having children having any problems with sleep at all. And then I remember waking up with the children but mostly it is since the menopause.
You have had more disturbed sleep you are saying. And what about getting to sleep. The time it takes you to get to sleep. When did you notice that?
When did that start? Probably in the last ten years I think. I haven’t really sort of analysed it.
So it was like a gradual onset?
It was a gradual onset yes and it is not because I have been particularly worrying about anything although of course we all know that once we start thinking about things that keeps us awake more than anything else. So I try very hard to shut up, shut off and forget anything that might be worrying me.
Age at interview:
Married, two children, retired Ofsted School Lay Inspector
I think it is not always the pain, I get, I often get very hot at night and I try and keep… and then I get cold. So you tuck the bedclothes at bit, you know, a bit like, you know, the old hot flushes, you know, you toss the bedclothes off and then you are cold. It is quite often with diabetes as well having to go to the lavatory. So it is not always the pain, but it is a lot of the time. I am conscious of it. And I am conscious of having quite a low level of sleep before I actually wake up. It is almost as if I take a long time to come round, you know.
Many of the older people we talked to reflected on how their sleep had changed as they got older and they expected to sleep less and to have to get up in the night. However, some also talked about how worries and concerns affected their sleep. Some of these were more recent worries, but several older people also talked about how worries in earlier life were still affecting how they sleep. This varied from worries about family and work, to health and financial issues. Some older people often woke up in the night thinking about past events that had been distressing and how they might have handled things differently, whilst others felt that the stress and worry of jobs they'd had before retirement continued to affect their sleep. If worries about work had caused them to toss and turn, this is a habit which continued, even some years after retirement.
Married, two children, retired Managing Director, Care Facilities for Older People
What did you start waking up in the night or …just not being able to get to sleep or both?
Waking up. Being sick. I used to be sick. Every night.
Oh goodness. What wake up and feel sick and be sick. Is that the stress?
The stress. It was a very stressful situation and because of the responsibility. It is the responsibility isn’t it. You are responsible for so many vulnerable people and I took it personally. Where I might have got carers going out, but before I went to bed, I rang every one of them to make sure they are working, their car hasn’t broken down.
I think it started, obviously with children you have got to be up a bit… no I slept well. I always slept well.
So growing up you slept well and prior to having children you slept well?
It is the care company I think. That is when it started. And that was because the, as I said before I needed to know that everything was in place before I went to bed, and I am wondering if that… although I am not doing it now, I don’t have to do it now, I am wondering if it is a habit, but I don’t know.
For many others though, health problems that had started in earlier life were an additional reason for poor sleep in later life. Significant health issues, such as heart problems, diabetes, rheumatoid arthritis and prostate problems can disturb sleep at the time they are diagnosed, and can continue to disturb sleep after diagnosis. But some people who experienced a disturbance to their sleep at the time of diagnosis and treatment of a health problem, also found that this disturbance continued, even when the health problem has been resolved. Sometimes the legacy of an injury causes problems in terms of sleep, even years after the injury.
Married, 4 children, part-time Test Centre Administrator
You have talked about your sleep changing as you have got older. Can you think back to what point you noticed it to change to start to deteriorate?
I suppose about yes, I think after my heart surgery funnily enough. That was one of the points…
You were sleeping okay up until that point?
Strangely, yes. You would have thought with a heart problem I wouldn't, I think I was. Yes, I mean to the best of my knowledge and my memory, I think I was having a regular seven hours. And it is in the last fifteen years, twelve, fifteen years that things have deteriorated a bit. I say deteriorated. I don’t feel any particularly bad, you know, this is what, if I felt really wretched I would go to the doctors but I do know I get less sleep. My friends they seem to get a bit more sleep then I do. And they are all about my age.
Age at interview:
Married, 2 children, retired Systems Engineer
An average night’s sleep I will go to bed at about eleven. Hopefully get to sleep fairly soon, within ten minutes, quarter of an hour. Could be a problem if I don’t, if I don’t get to sleep fairly soon. A few years ago, well quite a few years ago, I injured my left shoulder. I fell in the shower after running a road race at the YMCA in [Town]. And broke the ball and socket joint on the left side. Well I have to lay on the left side, if I lay on the right side the hanging sort of arm aches badly, but sometimes laying on the left side starts to ache and if I don’t get to sleep, can keep me awake. Under which situation I need to get up and take a painkiller, stay up for anything from half an hour to an hour, watching night time television which is pretty dreadful even though we have got digital. But a normal night I will sleep through generally reasonably well until six something, six thirtyish. Stay in bed till ten past eight, turn on the radio at eight, just before eight for the news and get up at ten past eight. That is typical.