How to Sleep Well as You Age
Tips for Overcoming Insomnia and Improving Sleep
As we age we often experience normal changes in our sleeping patterns, such as becoming sleepy earlier, waking up earlier, or enjoying less deep sleep. However, disturbed sleep, waking up tired every day, and other symptoms of insomnia are not a normal part of aging. Sleep is just as important to our physical and emotional health as it was when we were younger. These tips can help you overcome age-related sleep problems and get a good night’s rest.
The importance of sleep for older adults
A good night’s sleep is especially important to older adults because it helps improve concentration and memory formation, allows your body to repair any cell damage that occurred during the day, and refreshes your immune system, which in turn helps to prevent disease.
Older adults who don’t sleep well are more likely to suffer from depression, attention and memory problems, and excessive daytime sleepiness. Insufficient sleep can also lead to serious health problems, including an increased risk of cardiovascular disease, diabetes, weight problems, and breast cancer in women.
How many hours of sleep do older adults need?
While sleep requirements vary from person to person, most healthy adults require 7.5 to 9 hours of sleep per night. However, how you feel in the morning is more important than a specific number of hours. Frequently waking up not feeling rested or feeling tired during the day are the best indications that you’re not getting enough sleep.
Insomnia & Aging tip 1: Understand how sleep changes as you age
As you age your body produces lower levels of growth hormone, so you'll likely experience a decrease in slow wave or deep sleep. When this happens you produce less melatonin, meaning you'll often experience more fragmented sleep and wake up more often during the night. You may also:
- Want to go to sleep earlier in the evening and wake up earlier in the morning.
- Have to spend longer in bed at night to get the hours of sleep you need, or make up the shortfall by taking a nap during the day.
In most cases, such sleep changes are normal and don't indicate a sleep problem.
Sleep problems not related to age
At any age, it’s common to experience occasional sleep problems. However, if you experience any of the following symptoms on a regular basis, you may be dealing with a sleep disorder:
- Have trouble falling asleep even though you feel tired
- Have trouble getting back to sleep when awakened
- Don’t feel refreshed after a night’s sleep
- Feel irritable or sleepy during the day
- Have difficulty staying awake when sitting still, watching television, or driving
- Have difficulty concentrating during the day
- Rely on sleeping pills or alcohol to fall asleep
- Have trouble controlling your emotions
Insomnia & Aging tip 2: Identify underlying problems
Many cases of insomnia are caused by underlying but very treatable causes. By identifying all possible causes, you can tailor treatment accordingly.
- Are you under a lot of stress?
- Are you depressed? Do you feel emotionally flat or hopeless?
- Do you struggle with chronic anxiety or worry?
- Have you recently gone through a traumatic experience?
- Are you taking any medications that might be affecting your sleep?
- Do you have any health problems that may be interfering with sleep?
Common causes of insomnia and sleep problems in older adults
The most common causes of insomnia and sleep problems in older adults include:
- Poor sleep habits and sleep environment. These include irregular sleep hours, consumption of alcohol before bedtime, and falling asleep with the TV on. Make sure your room is comfortable, dark and quiet, and your bedtime rituals conducive to sleep.
- Pain or medical conditions. Health conditions such as a frequent need to urinate, pain, arthritis, asthma, diabetes, osteoporosis, nighttime heartburn, and Alzheimer's can interfere with sleep. Talk to your doctor to address underlying issues.
- Menopause and post menopause. During menopause, many women find that hot flashes and night sweats can interrupt sleep. Even post menopause, sleep problems can continue. Improving your daytime habits, especially diet and exercise, can help.
- Medications. Older adults tend to take more medications than younger people and the combinations of drugs, as well as their side-effects, can impair sleep. Your doctor may be able to make changes to your medications to improve sleep.
- Lack of exercise. If you are too sedentary, you may never feel sleepy or feel sleepy all of the time. Regular aerobic exercise during the day can promote good sleep.
- Stress. Significant life changes like the death of a loved one or moving from a family home can cause stress. Nothing improves your mood better than finding someone you can talk to face-to-face.
- Lack of social engagement. Social activities, family, and work can keep your activity level up and prepare your body for a good night’s sleep. If you’re retired, try volunteering, joining a seniors’ group, or taking an adult education class.
- Sleep disorders. Restless Legs Syndrome (RLS) and sleep-disordered breathing—such as snoring and sleep apnea—occur more frequently in older adults.
- Lack of sunlight. Bright sunlight helps regulate melatonin and your sleep-wake cycles. Try to get at least two hours of sunlight a day. Keep shades open during the day or use a light therapy box.
Insomnia & Aging tip 3: Improve sleep habits
In many cases, you can improve your sleep by addressing emotional issues, improving your sleep environment, and choosing healthier daytime habits. Since everyone is different, though, it may take some experimentation to find the specific changes that work best to improve your sleep.
Encourage better sleep at night
- Naturally boost your melatonin levels. Artificial lights at night can suppress your body’s production of melatonin, the hormone that makes you sleepy. Use low-wattage bulbs where safe to do so, and turn off the TV and computer at least one hour before bed.
- Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source.
- Make sure your bedroom is quiet, dark, and cool, and your bed is comfortable. Noise, light, and heat can cause sleep problems. Try using a sleep mask to help block out light.
- Use your bedroom only for sleep and sex. By not working, watching TV, or using your computer in bed, your brain will associate the bedroom with just sleep and sex.
- Move bedroom clocks out of view. The light can disrupt your sleep and anxiously watching the minutes tick by is a surefire recipe for insomnia.
Keep a regular bedtime routine for better sleep
- Maintain a consistent sleep schedule. Go to bed and wake up at the same times every day, even on weekends.
- Block out snoring. If snoring is keeping you up, try earplugs, a white-noise machine, or separate bedrooms.
- Go to bed earlier. Adjust your bedtime to match when you feel like going to bed, even if that’s earlier than it used to be.
- Develop soothing bedtime rituals. Taking a bath, playing music, or practicing a relaxation technique such as meditation or deep breathing can help you wind down.
- Limit sleep aids and sleeping pills. Many sleep aids have side effects and are not meant for long-term use. Sleeping pills don’t address the causes of insomnia and can even make it worse in the long run.
- Combine sex and sleep. Sex and physical intimacy, such as hugging, can lead to restful sleep.
Can napping help with sleep problems?
If you don’t feel fully alert during the day, a nap may provide the energy your need to perform fully for the rest of the day. Experiment to see if it helps you.
Some tips for napping:
- Short – Naps as short as five minutes can improve alertness and certain memory processes. Most people benefit from limiting naps to 15-45 minutes. You may feel groggy and unable to concentrate after a longer nap.
- Early – Nap early in the afternoon. Napping too late in the day may disrupt your nighttime sleep.
- Comfortable – Try to nap in a comfortable environment preferably with limited light and noise.
Insomnia & Aging tip 4: Use diet and exercise to improve sleep
Two of the daytime habits that most affect sleep are diet and exercise. As well as eating a healthy diet during the day, it’s particularly important to watch what you put in your body in the hours before bedtime.
|Bedtime Diet Tips to Improve Sleep|
Limit caffeine late in the day
Avoid caffeine (from coffee, tea, soda and chocolate) late in the day.
Avoid alcohol before bedtime
It might seem that alcohol makes you sleepy, but it will actually disrupt your sleep.
Satisfy your hunger prior to bed
Have a light snack such as crackers, cereal and milk, yogurt, or warm milk.
Avoid big meals or spicy foods just before bedtime
Large or spicy meals may lead to indigestion or discomfort. Try to eat a modest-size dinner at least three hours before bedtime.
Minimize liquid intake before sleep
Limit what you drink within the hour and a half before bedtime.
Regular exercise for overcoming sleep problems
Exercise releases chemicals in your body that promote more restful sleep, especially aerobic activity.
Aerobic exercise helps older adults sleep better
A study at Northwestern University found that aerobic exercise resulted in the most dramatic improvement in quality of sleep, including sleep duration, for middle-aged and older adults with a diagnosis of insomnia.
- The participants exercised for two 20-minute sessions or one 30-to-40-minute session four times per week.
- They worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill.
- Their sleep quality improved from a diagnosis of poor sleeper to good sleeper.
- They reported fewer depressive symptoms, more vitality, and less daytime sleepiness.
Source: National Sleep Foundation
There are countless activities you can do to prepare yourself for a good night’s sleep at the end of the day. But always consult your doctor before embarking on any new fitness program.
- Swim/Water exercises – Swimming laps is a gentle way to build up fitness and is great for sore joints or weak muscles. Many community and YMCA pools have swim programs just for older adults, as well as water-based exercise classes.
- Dance – If you love to move to music, go dancing or take a dance class. Dance classes are also a great way to extend your social network.
- Take up lawn bowling, bocce, or pétanque – These ball games are gentle ways to exercise. The more you walk, and the brisker the pace, the more aerobic benefit you’ll experience.
- Golf – Golf is another exercise that doesn’t require vigorous movement. Walking adds an aerobic bonus and spending time on the course with friends can improve your mood.
- Cycle or run – If you are in good shape, you can run and cycle until late in life. Both can be done outdoors or on a stationary bike or treadmill.
If you have mobility issues, you can exercise from one position, either standing, sitting, or lying down.
Insomnia & Aging tip 5: Reduce mental stress
Stress and anxiety built up during the day can also interfere with sleep at night. It’s important to learn how to let go of thoughts and worries when it’s time to sleep.
- Keep a journal to record worries before you retire
- On your to-do list, check off tasks completed, list your goals for tomorrow, and then let go
- Listen to calming music
- Read a book that makes you feel relaxed
- Get a massage from a friend or partner
- Use a relaxation technique to prepare your body for sleep
- Seek opportunities to talk face to face with a friend about what is troubling you
Getting back to sleep at night
It’s normal to wake briefly during the night but if you’re having trouble falling back asleep, the following tips may help:
- Don’t stress. Stressing over the fact that you can’t get back to sleep only encourages your body to stay awake. Focus on the feelings and sensations in your body instead.
- Make relaxation your goal, not sleep. Try a relaxation technique such as deep breathing or meditation, without getting out of bed. Although not a replacement for sleep, relaxation can still help rejuvenate your body.
- Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a non-stimulating activity, such as reading a book.
- Postpone worrying. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve.
Insomnia & Aging tip 6: Talk to your doctor about sleep problems
If your own attempts to solve your sleep problems are unsuccessful, talk to your doctor.
Bring a sleep diary with you. Write down when you use alcohol, caffeine, and nicotine, and keep track of your medications, exercise, lifestyle changes, and recent stresses. Your doctor may then refer you to a sleep specialist or cognitive behavioral therapist for further treatment.
If stress, worry or relationship issues are making it harder for you to sleep, read FEELING LOVED.
More help for sleep
- Can't Sleep? Causes, Cures, and Treatments for Insomnia
- How Much Sleep Do You Need? Signs that You’re Not Getting Enough and What to Do About It
- How to Sleep Better: Tips for Getting a Good Night’s Sleep
Resources and references
General information about aging and better sleep
Sleep and Aging – An easy-to-understand guide to sleep for seniors. Includes illustrations and video clips. Displays information in easy-to-read chunks, and then offers optional quizzes on each section. (NIH Senior Health)
Aging and Sleep – Comprehensive series of articles covering sleep and aging topics including specific medical problems affecting sleep; dementia-related sleep problems; menopause and sleep; snoring; and sleep apnea. (National Sleep Foundation)
A Good Night’s Sleep (PDF) – An overview of sleep changes in older adults, common problems, and things you can do to alleviate sleep problems. (National Institute on Aging)
Sleep Problems in the Elderly – Journal article that provides a wealth of information on seniors and sleep problems. (American Family Physician)
Age-related Reduction in Maximal Capacity for Sleep – Study that suggests healthy older people may require less sleep than younger adults. (National Institutes of Health)
Diet, exercise, and better sleep for older adults
Foods that Help you Sleep – Foods recommended to help you sleep, and others that keep you awake. (AskDrSears.com – commercial site)
Diet, Exercise, and Sleep – Information about the interrelationships between sleep, nutrition, and exercise. (SleepFoundation.org)
Aerobic Exercise Relieves Insomnia – How a study by Feinberg School of Medicine at Northwestern University found that aerobic exercise resulted in improvement in seniors’ quality of sleep. (Northwestern University)
How to nap for better sleep as an older adult
New Respect for the Nap, a Pause That Refreshes – Encouraging words for taking a nap in the middle of the day to improve performance for the rest of the day. (Jane E. Brody, Science Times)
How to Nap – Tips on the best ways to take a nap during the day. (Boston Globe)
Cognitive behavioral therapy (CBT) for insomnia in older adults
Insomnia Treatment: Cognitive Behavioral Therapy Instead of Sleeping Pills – Your attitudes about sleep and certain behaviors are often the root cause of insomnia. (The Mayo Clinic)
Cognitive Behavioral Therapy for Insomnia – Describes how cognitive behavioral therapy works treating insomnia, and provides a case study as an example. (National Sleep Foundation)
Online Treatment May Help Insomniacs – Article about the success of online CBT applications to treat insomnia. (New York Times)
CBT for Insomnia Program – Online, interactive treatment program for insomnia from sleep doctor Gregg Jacobs. A Harvard Medical School study found this program to be more effective than Ambien. (cbtforinsomnia.com)
What other readers are saying
“As a woman in her 70's, I have been having difficulties with sleep. I have spoken with my doctor and then read your article. It is very helpful! [It] offers concrete suggestions of steps to take. A thousand thanks.” ~ Connecticut
“I am very glad I found your page… your advice is really helpful.” ~ Australia