Senior Sleep Guide

Everything to Know About How Sleep Changes As You Age

This article was originally published in mattressclarity.com.

It’s super common to discover that your sleep habits change with age. One minute you can party until dawn and pull an all-nighter without thinking twice; the next you’re yawning as soon as you get home from work and find yourself waking up before sunrise. People who previously never napped might find themselves exhausted at midday, or night owls may discover their bedtime getting earlier and earlier over time.

So what exactly changes in our bodies throughout adulthood that causes these shifts in our sleep habits? And what’s the relationship between sleep deprivation and aging? Experts agree that older adults (age 65 and up) need around 7 hours of sleep each night. However, due to changes in circadian rhythms and time spent in each sleep stage, elderly adults might find themselves experiencing excessive daytime sleepiness because they are constantly short on sleep.

Meanwhile, sleep deprivation can actually speed up the aging process. One 2013 study by researchers at University Hospitals Case Medical Center found a lack of sleep ages your skin. The National Institutes of Health says sleep deprivation can also exacerbate forgetfulness and memory problems.

This creates a bit of a Catch-22: Older adults need sufficient sleep in order to stay as healthy as possible, but it can be harder to obtain sufficient sleep as we age. Luckily, the right information can empower you to develop healthier sleep habits no matter you’re age. Here’s what you need to know about how your sleep needs change as you get older.

How Much Sleep Do I Need For My Age?

The recommended amount of sleep for each age group varies widely. Babies, children, and teens need a lot of sleep each night. The American Academy of Sleep Medicine (AASM) recommends:

• Infants ages four to 12 months should sleep 12 to 16 hours a day (including naps)

• Toddlers ages one to two years old should get 11 to 14 hours (including naps)

• Kids ages three to five should get 10 to 13 hours (including naps)

• Kids who are six to 12 years old need 9 to 12 hours

• Teens aged 13 to 18 need eight to 10 hours

When it comes to adults, the Centers for Disease Control and Prevention (CDC) suggest that:

• Adults ages 18 and over get at least 7 hours of sleep every night

• Adults ages 61 to 64 get 7 to 9 hours

• Adults ages 65 or over get 7 to 8 hours per night

“Normal” Sleep At 65+

What is “normal” for someone aged 65 and over depends on a few things. It’s important to remember that people are different and thus generally need different sleep requirements. Generally, experts agree that older adults sleep for less time than younger adults, even though both groups generally need around 7 hours of sleep each night.

“Older adults need about the same amount of sleep as younger adults,” the Mayo Clinic explains. “As you get older, however, your sleeping patterns might change. Older adults tend to sleep more lightly and for shorter time spans than do younger adults.”

The AASM’s Sleep Education website explains that “older people often sleep less deeply and wake up more often throughout the night,” which can make them more likely to nap during the day. Plus, the site says, “many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning.”

It’s not totally clear what causes these changes, but the AASM says older adults might produce less melatonin, a hormone involved in sleep. It’s also possible that older adults are more sensitive to environmental factors. For example, they might wake up more easily due to noise or temperature changes at night.

James Cobb, a registered nurse and member of Mattress Clarity’s Expert Network, says that the increased frequency of urinary interruptions in both men and women with age may play a factor in sleep quality at night. “When we’re talking about a broad group of people, not every older woman is going to have stress incontinence or bladder or pelvic organ prolapse, but a good many do,” he says. Likewise, Cobb says many older men contend with issues relating to prostate trouble.

Sleep Stages Evolve With Age

While you are asleep, your body goes through various sleep stages: Stages 1 through 4 and then REM sleep.

Typically, stage 1 is the lightest phase of sleep, and each stage gets increasingly deeper (meaning it’s harder to wake you up). REM sleep is where most of your dreaming occurs. Usually, one full sleep cycle from stage 1 to REM takes approximately 90 to 110 minutes, so you will repeat the whole thing a few times during the course of a single night’s sleep.

A long-term study of 9,000 people aged 65+, which was published in the journal American Family Physician, found that elderly adults have more fragmented sleep, and spend much less time in stage 3 and stage 4 sleep than young adults do. The study concluded: “The deepest stages of non-REM sleep are frequently reduced or nonexistent in elderly persons; however, REM sleep tends to be preserved”⁽¹⁾.

Why The Elderly Are Considered “Early Birds”

The term “early bird” often refers to the fact that seniors typically eat dinner early, but it can also be used to refer to an early bedtime and waking up early in the morning.

According to one study, shifts in circadian rhythm can make elderly people feel tired much earlier in the evening, around 7 p.m. This causes them to go to bed early and wake up extremely early — think 3 a.m. or 5 a.m ⁽²⁾.

Again, we don’t know exactly what causes this, but the study posits a couple of theories:

One is that elderly people spend less time in daylight, which is very important for regulating your circadian rhythms. This particularly applies to elderly people who are in nursing facilities or who have less mobility than they used to and find it a little trickier to get outside. The National Institute of General Medical Sciences explains: “The body’s master clock, or SCN, controls the production of melatonin, a hormone that makes you sleepy. It receives information about incoming light from the optic nerves, which relay information from the eyes to the brain. When there is less light—like at night—the SCN tells the brain to make more melatonin so you get drowsy.”

Another is that changes in your brain’s hypothalamus as you age can shift those rhythms. One 2001 study, which was published in JCEM, suggests elderly people produce and secrete less melatonin, which affects their sleep/wake cycles ⁽³⁾.

Sleep Issues Are Tied To Age

Multiple factors can affect your sleep as you age. Changes in health, daily routines, sleep schedules, and brain function can all affect your sleep as time goes on. Some people aged 65+ may find they don’t get enough sleep, while others will discover they are sleeping far too much.

RELATED: Best Mattress For Seniors

Perhaps because of these changes, a number of sleep issues are common among elderly adults. Here’s an overview of some of the most common sleep conditions affecting adults ages 65+.

Insomnia

According to the National Institute on Aging (NIA), insomnia is the most common sleep problem affecting people age 60 and up.

“Insomnia is more common for seniors, partly because of health issues, partly because of the anxiety and the concerns of aging, and sometimes because of medication,” Dr. Jack Gardner told WebMD. The NIA defines insomnia as trouble falling asleep and staying asleep, and says that symptoms of insomnia can include:

• Taking a long time to fall asleep at night

• Waking up several times throughout the night

• Waking up early and not being able to fall asleep again

• Waking up feeling tired

• Feeling very sleepy throughout the day

One 2006 study published in the American Journal of Medicine suggests older people might experience these symptoms but consider them a normal part of aging, thus preventing them from seeking help⁽⁴⁾. If you are experiencing symptoms of insomnia, speak to your physician about potential treatments )such as tweaking your daily schedule and strengthening your sleep hygiene habits).

Medications

As one study explains, different types of medications can sometimes act as stimulants, thereby causing sleep problems (1). These categories of medication include:

• Antidepressants, which are used to treat depression and anxiety, can sometimes disturb sleep

• Decongestants, which are taken to relieve nasal congestion, can sometimes make you excessively sleepy

• Bronchodilators, which treat breathing issues, have been linked to occasional insomnia

• Antihypertensives, which are taken for high blood pressure, can sometimes cause insomnia

• Corticosteroids, which are taken for inflammation, can also cause insomnia

“If a person takes the medication furosemide, or another diuretic, too late in the day, they can be kept up all night with urination,” Cobb says. “Having coffee too late in the day can affect someone by their stimulant and diuretic effects.” Taking too long of a nap can affect someone’s ability to sleep at night too, Cobb says. He suggests paying attention to your experiences and make adjustments accordingly.

Sleep Apnea

As the Mayo Clinic explains, sleep apnea is a condition where your breathing is obstructed or starts and stops during sleep. Men, older adults, and overweight or obese adults are at an increased risk for developing sleep apnea. There are three main types of sleep apnea:

• Obstructive sleep apnea, which is caused by muscles in your throat relaxing so that it’s harder for air to pass through your airway

• Central sleep apnea, which happens when your brain does not send the right signals to the muscles in your body that control breathing

• Complex sleep apnea (also sometimes called treatment-emergent central sleep apnea), which is when you have both obstructive sleep apnea and central sleep apnea

A 2008 study, which was published in Clinics in Geriatric Medicine, found that elderly people might be less likely to seek treatment for sleep apnea because they might attribute common symptoms — including “snoring, sleepiness, fatigue, nocturia, unintentional napping, and cognitive dysfunction” — to the aging process ⁽⁵⁾.

According to the Mayo Clinic, the most common treatment option for sleep apnea is a continuous positive airway pressure (CPAP), which involves wearing a mask during sleep to help keep your airway open so you can breathe. Other options include oral appliances that open your throat by bringing your jaw forward, or even surgery to remove obstructive tissue or reposition your jaw. Surgery is typically a last resort for treatment.

Restless Legs Syndrome

The Mayo Clinic says that Restless Legs Syndrome (RLS), which is also called Willis-Ekbom Disease, “is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation.” The condition is significantly more common in elderly people: One 2002 study from the journal Drugs & Aging estimates that up to 35 percent of individuals over 65 years of age have it ⁽⁶⁾.

According to the Mayo Clinic, people experience RLS in a variety of different ways, but symptoms can look like any of the following:

• Sensations that occur after the body is at rest.

• Feeling relief through movement.

• Symptoms increase at the end of the day.

• Twitching legs overnight.

The sensation is often described in the following ways, according to the clinic:

• Crawling

• Creeping

• Pulling

• Throbbing

• Aching

• Itching

• Electric

When symptoms are bad enough to disrupt sleep and generate daytime drowsiness it’s time to call the healthcare provider to talk about treatment options. The Mayo Clinic says that sometimes treating an underlying condition, like iron deficiency, can lessen the symptoms of RLS. If this doesn’t work, a doctor may prescribe lifestyle changes like baths, massages, exercising, and avoiding caffeine. In some instances, a doctor will prescribe medication when other more natural options have been exhausted.

Hypersomnia

Hypersomnia can mean either excessive daytime sleepiness or excessive time spent sleeping. WebMD says the amount of sleep you need “depends on your age and activity level as well as your general health and lifestyle habits” — which also means there’s no single amount that is “too much” sleep.

One 2012 study from the journal SLEEP found that excessive sleepiness could help predict cognitive decline in elderly people (7). A few medical conditions can cause you to sleep a lot, Heathline explains, including:

• Depression

• Diabetes

• Thyroid problems

• Heart disease

Underlying Medical Conditions

Certain medical conditions can affect how well you sleep, as well as how tired you feel and how much sleep you need. For example:

• Depression can cause people to feel more tired than usual.

• Pain from arthritis might make it harder to fall asleep.

• Medical conditions that cause you to urinate more frequently and may mean you wake up more often at night to go to the bathroom, disrupting your sleep.

“Insomnia and disrupted sleep in elderly people are a common side effect caused by many chronic medical conditions such as arthritis, congestive heart failure, depression, and gastroesophageal reflux disorder,” Harvard’s Healthy Sleep website explains. “Unfortunately, sleep problems in older adults often go undiagnosed and untreated simply because many people believe sleep problems are a normal part of aging or that nothing can be done to help them sleep better. Thankfully, treating any underlying medical disorders can dramatically improve sleep.”

Poor Sleep Hygiene

It’s possible that less-than-ideal sleep hygiene habits are affecting your sleep more than you think. Learn more about how to adopt effective sleep hygiene below!

The Importance Of Sleep As You Age

Sleep is important for everyone, as it’s crucial for your memory, cognitive function, and ability to learn. Getting adequate sleep also puts you at a lesser risk for health issues.

“Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke,” the National Institute of Health explains. This can be especially relevant for older adults who are more likely to have chronic health issues than younger people. Plus, according to the National Institute on Aging, sleep deprivation in older adults can contribute to:

• Feeling irritable

• Experiencing memory problems or being forgetful

• Feeling depressed

• Falling more often, or having more accidents

Sleep Aids

If you are struggling to fall asleep or stay asleep, there are many potential remedies and treatment options based on what is bothering you. If an underlying medical condition is causing your sleep problems, treating that condition may resolve the sleep issues. Lifestyle changes can also be helpful. Here are a few other ways to treat sleep issues.

Sleeping Pills

People with serious sleep issues may be prescribed pills to help them sleep. According to the Cleveland Clinic, the most common type of sleeping pills come from a class of drugs called benzodiazepines

“The American College of Physicians has acknowledged that sleeping pills should not be the first-line, knee-jerk response to sleep problems,” sleep researcher Matthew Walker said. “Sleeping pills sedate the brain, rather than help it sleep naturally. We must find better treatments for restoring healthy sleep in older adults.”

According to the Cleveland Clinic, sleeping pills can have serious side effects including daytime drowsiness, oversleeping, allergic reactions, and sleepwalking or doing activities in your sleep such as driving, eating, and even having sex while you are not awake.

Therapy

According to the Mayo Clinic, some forms of therapy — especially cognitive behavioral therapy (CBT) — can help with sleep disorders such as insomnia.

“Cognitive-behavioral therapy for insomnia is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep,” the Mayo Clinic explains. “Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.” There are multiple techniques involved in CBT-I, such as restricting yourself from naps and making yourself stay up until a much later hour than usual, following sleep hygiene rules, improving your sleep environment, and teaching yourself how to relax. If you’re curious about CBT-I, it’s important to consult a licensed therapist.

Natural Remedies

There are numerous natural remedies you can try to help you fall asleep, stay asleep, and wake up more easily. Some common natural sleep remedies include:

• Melatonin supplements. Your body naturally produces melatonin to help you sleep – and the idea is that taking supplemental melatonin will make it easier to fall asleep. WebMD notes that dietary supplements are generally not regulated and haven’t undergone testing the way medications have, but says that melatonin “has been used successfully for sleep enhancement in healthy individuals, as well as to reduce feelings of jet lag during global travels.”

• Chamomile tea. As the McGill Office for Science and Society explains, “this herb is made up of over 120 different compounds, including apigenin which has an affinity for the same cellular receptors used by minor tranquilizers.” The scientific evidence is sparse, but many people swear by chamomile tea to help them sleep.

• Magnesium supplements. In an article for Psychology Today, sleep expert Dr. Michael Breus explained: “Insomnia is a common symptom of magnesium deficiency. People with low magnesium often experience restless sleep, waking frequently during the night. Maintaining healthy magnesium levels often leads to deeper, more sound sleep. Magnesium plays a role in supporting deep, restorative sleep by maintaining healthy levels of GABA, a neurotransmitter that promotes sleep. Research indicates supplemental magnesium can improve sleep quality, especially in people with poor sleep.”

• Meditation. Research suggests that following a mindfulness meditation program can help combat insomnia and lead to better sleep. If you don’t know where to start, there are many free guided meditations available online that are specifically designed to help you sleep.

Tips For Good Sleep Health

The Cleveland Clinic recommends trying various lifestyle changes and practicing good sleep hygiene before speaking with your doctor about medication to help you sleep. Some of their tips for good sleep hygiene include:

• Avoiding caffeine and nicotine in the evening, as these substances can stimulate you and keep you awake. Caffeine affects everyone differently, but it’s a good rule of thumb to avoid caffeine after 2 or 3 p.m. If you regularly enjoy hot drinks in the evening, switch to decaf coffee or herbal tea

• Following a regular sleep schedule where you wake up and go to sleep at the same time every day, even on weekends

• Avoiding naps whenever possible, especially in the late afternoon

•  Staying away from alcohol and heavy meals right before bed

• Exercising earlier in the day, rather than in the evening or before bed

• Keeping your bedroom dark, cool, and quiet, which helps create a calm and comfortable place for you to sleep and makes it less likely that you will wake up due to a noise or feeling too hot or cold

• Staying away from digital screens before bed. These screens emit a blue light that can interfere with melatonin production, thus making it harder to fall asleep

• Winding down before bed by reading, meditating, or doing yoga to calm your body and mind

• Choosing an excellent mattress is never a bad decision. Seniors may want to consider shopping for a bed-in-a-box mattress that conveniently ships to your front door.

Additional resources

To learn more about sleep and aging, check out the following sites and webpages:

A Good Night’s Sleep (The National Institute on Aging)

Tips For Sleeping Better As You Get Older (WebMD)

References

Neubauer, David N., “Sleep Problems in the Elderly.” Am Fam Physician, 1999 May 1, pp. 2,551-2,558.

Cooke, Jana R., and Sonia Ancoli-Israel. “Normal and Abnormal Sleep in the Elderly.” Handbook of Clinical Neurology Sleep Disorders, 2011, pp. 653–665., doi:10.1016/b978-0-444-52006-7.00041-1.

Mishima, K., et al. “Diminished Melatonin Secretion in the Elderly Caused by Insufficient Environmental Illumination1.” The Journal of Clinical Endocrinology & Metabolism, vol. 86, no. 1, 2001, pp. 129–134., doi:10.1210/jcem.86.1.7097.

Kamel, Nabil S. et al. “Insomnia in the Elderly: Cause, Approach, and Treatment.” The American Journal of Medicine , Volume 119 , Issue 6 , 463 – 469

Norman, Daniel, and José S. Loredo. “Obstructive Sleep Apnea in Older Adults.” Clinics in Geriatric Medicine, vol. 24, no. 1, 2008, pp. 151–165., doi:10.1016/j.cger.2007.08.006.

Milligan, Shawn A., and Andrew L. Chesson. “Restless Legs Syndrome in the Older Adult.” Drugs & Aging, vol. 19, no. 10, 2002, pp. 741–751., doi:10.2165/00002512-200219100-00003.

Jaussent, Isabelle, et al. “Excessive Sleepiness Is Predictive of Cognitive Decline in the Elderly.” Sleep, vol. 35, no. 9, 2012, pp. 1201–1207., doi:10.5665/sleep.2070.

Written by Katie Golde

Katie manages the day to day operations of the Mattress Clarity news site and reviews sleep products in addition to writing and editing sleep news.She hails from Austin, where she lives with her growing family. She is a Certified Sleep Science Coach and has a master’s degree in Journalism from Northwestern University and has a background in health and science content. Her work can be found in print and online publications like Discover Magazine, USA Today and The Huffington Post.

Expert verified by James Cobb, RN, MSN

[Editor’s Note: The content provided on this site is for general informational purposes only. Any information provided is not a substitute for professional medical advice. We encourage you to consult with the appropriate health expert if you have concerns.]