Sleep Changes as We Age

Before you read on

This article is general information, not medical advice. Sleep can be affected by many health conditions and medicines, so it is worth speaking with a doctor or other qualified professional about persistent sleep problems, daytime exhaustion, anxiety or low mood. Please consult a professional before adding sleep aids, supplements or changing medications.

What commonly changes

Researchers and clinicians describe several patterns that many older adults notice. They do not apply to everyone, and plenty of older people sleep well.

• Lighter sleep. Sleep often becomes lighter, so noise, light or discomfort wake you more easily.
• More awakenings. Waking once or more during the night is common, and falling back asleep may take longer.
• Earlier timing. Some people become sleepy earlier in the evening and wake earlier in the morning, a pattern sometimes called an advanced sleep schedule.
• More daytime napping. Short naps may become more frequent, particularly if nights are broken.

Needing a bit less deep sleep with age is often described as a normal change. However, feeling consistently unrefreshed, struggling through the day, or sleeping poorly most nights is not something you must accept as “just age.” Many causes are manageable.

Possible contributors

Sleep difficulties in later life often have several causes at once.

• Medical conditions, including pain, arthritis, heart or lung conditions, reflux, and conditions that cause frequent urination at night.
• Medications. Some prescription and over-the-counter products can disturb sleep or cause drowsiness. Do not stop or adjust any medicine without speaking to your prescriber or pharmacist.
• Sleep disorders. Sleep apnea, where breathing repeatedly pauses, and restless legs are more common in older adults. Loud snoring, gasping, or an urge to move your legs at night are worth mentioning.
• Mood and worry. Anxiety, depression and grief frequently affect sleep, and poor sleep in turn can affect mood.
• Lifestyle and environment. Less daylight exposure, less activity, irregular routines, caffeine, alcohol and an uncomfortable bedroom can all play a part.
• Life changes. Retirement, bereavement, caregiving or moving can disrupt routines that once kept sleep steady.

Habits many people find helpful

None of these is guaranteed, but they are commonly suggested:

1. Keep a regular schedule. Going to bed and waking at similar times, including weekends, supports a steady body clock. A good sleep routine is built mostly on consistency.
2. Get daylight. Morning or daytime outdoor light, such as a walk or time sitting by a window, helps many people feel more awake by day and sleepier at night.
3. Move during the day. Gentle activity may help, though vigorous exercise close to bedtime bothers some people.
4. Watch caffeine and alcohol. Coffee, tea and cola can linger for hours, so many people limit caffeine to earlier in the day. Alcohol may make you drowsy at first but often fragments sleep later.
5. Be thoughtful about naps. A short nap earlier in the afternoon works for some. Long or late naps can make nights harder.
6. Create a calm wind-down. A calming evening routine, such as dim lights, quiet reading, a warm bath or soft music, signals the day is ending. Limiting evening screens helps some people.
7. Make the bedroom comfortable. A cool, dark, quiet room and a comfortable mattress and pillow matter. Sleeping positions and bedding can influence aches.
8. Plan for night trips. Reduce evening fluids a little if nighttime bathroom trips bother you, but do not cut back on drinking overall without asking a clinician. Use night-lights to make walking safer.
9. If you cannot sleep, many sleep experts suggest getting up and doing something calm in low light rather than lying awake frustrated, then returning when sleepy.

Be careful with sleep aids

Over-the-counter sleep products and some prescribed sleeping medications can cause next-day drowsiness, confusion or falls, and older adults are often more sensitive to them. Herbal remedies and supplements are not risk-free and can interact with other medicines. Please discuss any of these with a doctor or pharmacist first. For long-term insomnia, structured approaches such as cognitive behavioral therapy for insomnia are sometimes recommended by clinicians, and a doctor can advise whether it suits you.

When to ask about it

Consider speaking with a doctor if:

• You regularly take more than 30 minutes to fall asleep or lie awake for long periods in the night, and it continues for several weeks.
• You snore loudly, gasp or have pauses in breathing noticed by a partner.
• You feel sleepy during activities such as driving or conversation.
• You act out dreams, have uncomfortable leg sensations, or wake confused.
• You feel low, anxious or hopeless along with poor sleep.

If you ever feel unsafe or in crisis, contact emergency services or a crisis line immediately.

Keeping perspective

Sleep that is somewhat different from your younger years is common and not necessarily a problem. Worrying about sleep can itself keep you awake, so a calm approach often helps. Start with one or two adjustments, give them a few weeks, and bring your observations, perhaps from a simple sleep diary, to your next appointment.