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I am 85 years old, born and live in the UK, of Scottish and Anglo-Saxon ancestry. I get eight hours of untroubled sleep every night, yet still I am sleepy during the day and regularly doze for an hour or so in the afternoon. I am in good health, 5'6" tall, weigh 63 Kg, feel well, but successfully treated for heart failure. I exercise by walking briskly about two miles most mornings.

I've no mental problems, I still tutor science and maths and give well-received talks on science subjects.

Should I worry about that daytime sleepiness?

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Several studies, mainly based on polysomnography, conducted among elderly participants have shown that sleep efficiency and total sleep time are decreasing with age. Quality and quantity of sleep is affected by ageing. As a consequence, elderly individuals often show excessive daytime sleepiness.

The literature provides a very thorough list of possible cause of decreased quality and quantity of sleep with age, most common causes though seem to be related to chronic diseases such as joint diseases and chronic pains but also cardiac and pulmonary diseases. Concerning the latter, patients with pulmonary and cardiovascular diseases may suffer from sleep apnea (you can test this by answering the “Epworth Sleepiness Scale”, available on the internet). Your questions provides to few details to answer this, and maybe you should check with your family doctor. Also, some medications have been linked to sleep disturbances such as beta-blockers and diuretics (which are often prescribed in the case of heart problems).

However, sleep disturbances may also affect elderly individuals who are in good health. In the last decades, several hypotheses have been suggested to explain the alteration in circadian rhythm in the elderly. For example, one of the organ involved in circadian rhythm synchronisation, the suprachiasmatic nucleus, shows a decline in its function with age. Also, age is associated with a decrease in melatonin, a hormone essential in the regulation of circadian rhythm.

As you can see there are many reasons for day sleepiness in the elderly. If your daytime sleepiness impacts on your daily life (and on your social activities), you may wish to consider seeing your family doctor.

Sources:Cooke JR, Ancoli-Israel S. Normal and Abnormal Sleep in the Elderly. Handbook of clinical neurology / edited by PJ Vinken and GW Bruyn. 2011;98:653-665. doi:10.1016/B978-0-444-52006-7.00041-1.

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Lacking any obvious health related causes, it's not unusual to have a nap in the afternoon, especially when very young or as years advance. There's a general lack of recognition of the fact that we are not meant to sleep the night, the whole night and nothing but the night. Living by clocks and schedules is a general lie. On the other hand if you start napping many times during the day, maybe not enough oxygen in the blood. So as long as the blood test is ok, you're in pretty good shape. Try sleeping without a pillow, if you like. I just tried it and had really good sleep/rest last night. Low quality night sleep is common in the western world which sacrifices truth for money. I'm not a paleo nutter or anything but, just as in religion, the sheer mass of conviction one way or another, is a brute force to be reckoned with when searching for truth.

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