Sleep through life
Sleep in Older Adults
Sleep changes with age: it becomes lighter, more broken and earlier. But persistent insomnia and daytime sleepiness are not a normal part of ageing, and most causes can be treated.
What changes with age
Older adults tend to spend less time in deep sleep, wake more often during the night and feel sleepy earlier in the evening, waking earlier in the morning. The National Institute on Aging notes that older adults need about the same amount of sleep as younger adults, around 7 to 9 hours a night, even though getting it can be harder.
Common causes of poor sleep
- Needing to urinate at night
- Pain from arthritis or other conditions
- Medications, including some for blood pressure, depression and breathing
- Sleep apnea, which becomes more common with age
- Restless legs syndrome
- Less daytime light and activity, especially after retirement
- Depression, anxiety, grief and loneliness
- Long or late daytime naps
Habits that help
- Keep a regular wake time and get outside in the morning; daylight strengthens the body clock.
- Stay physically and socially active during the day.
- Keep naps short (about 20 minutes) and before mid-afternoon.
- Limit caffeine after noon and alcohol in the evening.
- Reduce fluids in the 2 hours before bed and empty your bladder before sleep.
- Make the path to the bathroom safe with dim night lights.
Be cautious with sleep aids
Over-the-counter sleep aids containing diphenhydramine or doxylamine are anticholinergic medicines that can cause confusion, constipation, urinary retention and falls in older adults. The American Geriatrics Society's Beers Criteria advise older adults to generally avoid them. Some prescription sleeping pills also raise the risk of falls and next-day impairment. Always discuss sleep medicines with your doctor or pharmacist, and never stop a prescribed medication suddenly without advice.
CBT-I works at any age
Cognitive behavioral therapy for insomnia is effective in older adults and avoids medication side effects. If you try sleep restriction, do it with professional guidance, especially if you are at risk of falls or have other health conditions.
When to see a doctor
Talk to your doctor if you snore loudly or have breathing pauses, feel sleepy during the day, act out dreams (which can be an early sign of some neurological conditions), have restless legs, get up to urinate multiple times every night, or have new confusion or memory changes. Sleep problems in people living with dementia are common, and caregivers can ask for specific support.
Frequently asked questions
Do older people need less sleep?
Not much less. The NIA says older adults need about the same amount as younger adults, around 7 to 9 hours, although sleep often becomes lighter and more broken.
Is it normal to wake up at 4 or 5am as you get older?
The body clock often shifts earlier with age. Getting bright light in the late afternoon or early evening and avoiding early evening dozing can help shift it later.
Are sleeping pills safe for older adults?
Many carry risks such as falls and confusion. Over-the-counter antihistamine sleep aids are generally advised against. Talk to your doctor about safer options, including CBT-I.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.