Written By: Lana Adler
Reviewed by: Dr. Sherrie Neustein
Updated March 17, 2021
There is a misconception that older adults need less sleep, because they tend to sleep less.
Research on sleep and aging has found that 40% to 70% (2) of older adults suffer from some kind of sleep problem. In the 2003 National Sleep Foundation poll (3), 2 in 3 older adults said they experienced sleep problems at least a few nights a week.
Sleep problems are common in older adults (4), most commonly insomnia and sleep apnea (5). Sleeping less, however, does not need to be a natural part of the aging process if we pinpoint and treat the underlying sleep disorders.
Changes in Sleep Structure
Even perfectly healthy older adults experience changes to their sleep quality (6). They tend to sleep less overall. They may spend more time in bed but find it difficult to fall asleep and stay asleep.
Older adults tend to receive proportionally less deep sleep (7) and rapid eye movement (REM) sleep. Spending more time in light sleep leaves them more vulnerable to waking up (8) during sleep from noise or other external factors, which can lead to daytime drowsiness.
The circadian rhythm also shifts with age. Older adults who prefer staying up late may find that their body nudges them to wake up before they are ready. They may try to catch up on sleep by napping, which can make it even more difficult to fall asleep at night.
Nighttime Bathroom Trips
Waking up to go to the bathroom (9) is a common cause of sleep disruption for older women and men. This need to urinate at night might be a side effect of medications, or it could be due to prostate issues, female pelvic floor disorders, or reduced bladder capacity.
Another possible explanation is that older adults sleep less deeply than younger adults and are simply more likely to notice a full bladder while they are sleeping. This may be especially true for adults with obstructive sleep apnea or other disorders.
Certain sleep disorders are more common in older adulthood. These include obstructive sleep apnea, restless legs syndrome, and REM sleep behavior disorder.
Typically associated with snoring and gasping, obstructive sleep apnea is a condition that causes momentary lapses in breathing at night. These episodes interfere with sleep quality and may give rise to next-day sleepiness.
Restless legs syndrome causes an uncontrollable urge to move the legs when lying in bed. A similar disorder, periodic limb movement disorder, causes twitching and jerking while asleep. These conditions can disrupt sleep or make it difficult to fall asleep in the first place.
Older adults are also more likely to have REM sleep behavior disorder, in which they act out their dreams. People with REM sleep behavior disorder may experience vivid, frightening dreams and disturbed sleep.
Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders (10)
are known to cause fragmented sleep and irregular sleep schedules. Cancer, arthritis, heart disease, chronic pain, or other health conditions can also interfere with sleep.
Investing in a comfortable mattress may help alleviate some of the pain and discomfort associated with these conditions, so you can achieve better sleep.
Medications and Other Substances
Turning to alcohol, caffeine, or tobacco to cope with sleep problems is usually counterproductive. These substances may help you feel better in the short term, but they are known for causing lighter, more fragmented sleep.
Medications may be another culprit for insomnia, daytime sleepiness, or poor sleep quality. Side effects such as increased urination or coughing can further interfere with sleep quality, while certain medications can worsen the symptoms of already-existing sleep disorders.
Light is one of the principal cues for regulating the sleep-wake cycle. Older adults whose eyes don't let in as much light, or who spend most of their time indoors in dim lighting, may lack the stimulation required to feel fully alert during the day and sleepy at night.
Stressors and Lifestyle Factors
Older adults may feel anxious or depressed as they start to experience changes in their lifestyle. Retirement, losing a loved one, or reduced mobility and independence may be particularly difficult for those who live alone.
Feelings of loneliness, sadness, stress, and boredom may make it more difficult to muster up the energy to get outside, eat well, do exercise, and keep a regular schedule, all of which are important for sleep.
Aging and Sleep Problems: Finding a Solution
Sleep problems are not an unavoidable part of aging. If you are suffering from trouble sleeping, talk to your doctor. Many sleep problems in the elderly are actually the result of treatable conditions that can be managed using a combination of improved sleep hygiene and targeted therapy.
- https://pubmed.ncbi.nlm.nih.gov/29073412/ Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/28159095/ Accessed on February 17, 2021.
- https://www.sleepfoundation.org/professionals/sleep-americar-polls/2003-sleep-and-aging Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/25700593/ Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/19122865/ Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/26568120/ Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/28384471/ Accessed on February 17, 2021.
- https://medlineplus.gov/ency/article/004018.htm Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/26632430/ Accessed on February 17, 2021.
- https://pubmed.ncbi.nlm.nih.gov/26947521/ Accessed on February 17, 2021.