Common Sleep Disorders in Older Adults and How to Get a Better Night’s Sleep

AgingInPlace.org conducted a survey of 600 people in August 2022 to learn more about sleep health and habits. Our respondents’ ages ranged from 18 to over 55. The majority of people over 55 reported they only get 6–7 hours of sleep each night on average, slightly below the recommended 7–8 hours for their age group.

Average hours of sleep per night reported by each age group:

• 18–24 years old: 8–9 hours
• 25–34 years old: 7–8 hours
• 35–44 years old: 7–8 hours
• 45–54 years old: 6–7 hours
• 55 years and older: 6–7 hours

You may spend a good portion of your night tossing and turning and want a better night’s sleep. Or, perhaps you’re curious about the relationship between our sleep and health. This article explains how our sleep and health are intertwined, why poor sleep shouldn’t be a natural part of getting older, and what you can do tonight to create better sleeping habits.

How Does Sleep Affect Our Health?

Our body performs so many amazing, intricate functions throughout the day. Sleep is the opportunity for our body—especially our brain—to repair itself. Think of sleep as a chance for your body to recharge every night.

Our brain is busy processing memories, regulating emotions, restoring energy, and clearing toxins while we sleep. Healthy sleep helps our body regulate our metabolism and keeps major organs like the heart and lungs functioning properly.

Our immune system is also working hard at night. While you are sleeping, your body produces proteins that help your immune system fight inflammation. This is important because ongoing inflammation can eventually lead to chronic diseases, as reported by Harvard Health Publishing. We don’t want our bodies to skip out on this crucial process.

Sleep and our physical and mental health are so closely intertwined that even one night of poor sleep can lead to negative effects the next day, according to the Cleveland Clinic. These effects include:

• Poor focus and concentration
• Irritability
• Slower reaction times
• Increased anxiety and depression symptoms
• Lack of judgment

Some signs of poor sleep quality are taking more than 30 minutes to fall asleep, staying awake more than 20 minutes after waking up during the night, and waking up more than once at night, according to the Sleep Foundation. 

Because sleep is the chance for your body to regulate and repair itself, over time, poor sleep can lead to health issues like diabetes, stroke, heart disease, and heart attack. 

How Does Aging Affect Sleep?

Internal Clock Changes

To understand how aging affects our sleep, we first need to talk about our body’s internal clock, also known as a circadian rhythm. Circadian rhythms (there are multiple ones to regulate different aspects of our body) help our body carry out important functions at optimal times based on a 24-hour cycle.

The sleep-wake cycle is the circadian rhythm that helps regulate how long and how well we sleep. This internal clock shifts forward as we get older, causing us to become tired earlier in the evening and to wake up earlier in the morning.

Adjusting to a new internal clock may be difficult; you may even fight your body’s urge to go to sleep earlier. But trying to fight your biological clock is a losing battle. Instead, you can learn to work with these changes.

Natural light is one of the main regulators of our circadian rhythms. Po-Chang Hsu, MD and Medical Content Expert at SleepingOcean.com, suggests taking regular walks or sitting outside to get more exposure to natural light.

Hormonal Changes

Melatonin is a hormone that helps regulate your sleep cycle. Unfortunately, our bodies create less melatonin as we age. Lower levels of melatonin can make it more difficult to fall and stay asleep. The amount of daylight we’re exposed to also affects our melatonin levels. Getting only a small amount of sunlight during the day, on top of the natural aging process, can severely slow down our melatonin production.

While synthetic melatonin can be taken as a treatment option, direct sunlight can naturally increase your melatonin levels. Dr. Po-Chang Hsu recommends at least 30 minutes of direct sunlight each day for optimal melatonin production. He suggests timing your sun exposure for shortly after waking up or during the first half of the day. Remember to keep sun safety in mind: Wear a hat and protective clothing or sunscreen to help protect your skin from sun damage when outside.

As for supplements, always speak with your healthcare provider before adding a new one to your routine.

Medication Side Effects

Taking at least one prescription medication as part of your regular routine seems to go hand-in-hand with aging—at least, that’s the case for nearly 89% of adults age 65 and older, according to the Kaiser Family Foundation. While these medications may help you manage and treat symptoms for a better quality of life, they could also be disrupting your quality of sleep.

Common medications that may disrupt sleep, or even cause insomnia:

• Statins (treats high cholesterol)
• Angiotensin-converting enzyme (ACE) inhibitors (treats high blood pressure)
• Beta-blockers (treats high blood pressure)
• Antidepressants
• Thyroid hormone replacement
• Nicotine patch

Your healthcare provider may be able to modify your prescription(s) or prescribe an additional medication that will help you get a better night’s sleep.

Health Conditions

Chronic pain, arthritis, digestive problems, and other health conditions that come with aging may make it painful and uncomfortable to fall asleep at night. Unfortunately, pain was the top sleep disruptor for almost 68% of our survey respondents age 55 and older.

Managing your symptoms to help get a better night’s sleep could include medication, lifestyle changes, or both. Another option may be an adjustable bed. Adjustable beds have many supportive positions that can help chronic pain, improve poor circulation, and aid with digestive problems.

Alzheimer’s disease can also disrupt sleep, but the effects aren’t the same for everyone. You may oversleep, get less sleep, wander or wake up multiple times throughout the night.

Common Sleep Disorders in Older Adults

It’s normal to experience disruptive sleep and tiredness every once in a while. However, if you struggle to fall asleep multiple nights a week and are frequently tired, there may be a bigger issue.

The good (or bad) news is that you’re not alone. Nearly 40%–70% of older adults have chronic sleep issues, and almost half of these individuals haven’t been diagnosed, according to the study “Sleep in the Aging Population” that was originally published in Sleep Medicine Clinics.

Learning the signs and symptoms of common sleep disorders can help you be proactive about your sleep health, and can let you know what to ask when starting a conversation with your primary care physician.

Insomnia

Insomnia is one of the most common sleep disorders in adults. Older age and diabetes are two of the highest risk factors for chronic insomnia according to a study published in the National Library of Medicine.

Symptoms of insomnia:

• Trouble falling asleep and staying asleep
• Waking up in the middle of the night, or too early in the morning, and not being able to go back to sleep
• Severe sleepiness during the day

Health effects of insomnia:

• Memory loss
• Poor focus and concentration
• Heart disease
• Obesity
• Anxiety
• Depression

Treatment options: Insomnia may be a symptom of another health issue. If you’re not sure what’s causing your insomnia, your healthcare provider may recommend a sleep study, blood work, or a physical exam to help diagnose the potential root cause. From there, your healthcare provider will work with you to create an individualized treatment plan that may include medication or lifestyle changes.

Hypersomnia

If you have hypersomnia, you have trouble staying awake during the day, even if you’ve slept more than 8–10 hours the night before. Hypersomnia can be the result of a medical issue, alcohol and some medications, or just general poor sleeping habits.

Some cases of hypersomnia may not have a root cause. Some scientists believe hypersomnia may be genetic in those cases, but this hasn’t been confirmed. 

Symptoms of hypersomnia:

• Extreme sleepiness during the day, even if you’ve slept 8–10+ hours the night before
• Trouble waking up in the morning or after a nap
• Headaches
• Irritability

Health effects of hypersomnia:

• Memory loss
• Poor focus and concentration 
• Increased anxiety symptoms
• Low energy

Treatment options: Your treatment options could include medication or lifestyle changes, depending if the cause is known or unknown.

Parasomnia

Parasomnia is a sleep disorder that causes strange physical disruptions while sleeping. It has also been linked to untreated sleep apnea. Parasomnia can occur during the two different stages of sleep: non-rapid eye movement (non-REM) sleep and rapid eye movement (REM).

Non-REM sleep is the first stage of sleep. Parasomnia disruptions during this period include sleepwalking, sleep terrors, and eating or drinking unusual or unprepared food.

REM is the deep sleep stage when your breathing rate, heart rate, and blood pressure increase and your eyes move quickly under your eyelids. Parasomnia disruptions during REM sleep may include severe nightmares, verbally or physically acting out while sleeping, and sleep paralysis.

Symptoms of parasomnia:

• Sleepwalking
• Sleep talking
• Sleep terrors
• Unusual movement or behavior while sleeping
• Sleepiness during the day
• Waking up disoriented

Health effects of parasomnia:

• Unusual bruises or marks
• Poor focus and concentration
• Low energy

Treatment options: Treatment for parasomnia will alter depending on whether it occurs during non-REM or REM sleep. Treatment may include lifestyle changes or medication for non-REM parasomnia.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common disorder that affects up to 20% of older adults, according to the American Academy of Sleep Medicine. With OSA, the airway at the back of your throat closes, causing you to stop breathing for 10–30 seconds. This can happen hundreds of times during the night. OSA is a major sleep disruption—not only for the person with sleep apnea, but for their sleeping partner as well.

Symptoms of sleep apnea:

• Loud snoring
• Breathing stops during sleep
• Having a headache when you wake up
• Dry mouth
• Severe sleepiness during the day

Health effects of sleep apnea:

• High blood pressure
• Memory loss
• Increased chance of a heart attack and/or stroke

Treatment options: The most common treatment for OSA is a Continuous Positive Airway Pressure device (CPAP). This machine gently pushes air through a mask over your mouth and/or nose throughout the night.

Restless Leg Syndrome

Restless leg syndrome (RLS) is a medical issue that can lead to sleep problems. This nervous system disorder is linked to poor sleep because symptoms usually appear when you’re sitting or trying to rest. RLS may be genetic, but it can also be linked to certain chronic diseases, medications, or other sleep disorders.

Symptoms of restless leg syndrome:

• Itching, crawling, aching, or throbbing sensation in your legs
• Urge to move your legs to make the sensations go away
• Leg sensations are more severe in the evening and night

Health effects of restless leg syndrome:

• Lower quality of life (due to poor sleep)
• Poor focus and concentration
• Depression

Treatment options: Your treatment options could include medication or lifestyle changes, like establishing a healthy sleep schedule and exercising regularly, depending on how severe your symptoms are.

Tips for Developing Better Sleep Habits

How we spend our day and how we prepare–or don’t prepare–for bed affects our sleep quality.

We connected with multiple health experts to learn how to develop better sleeping habits and routines. Listed below are some sleep hygiene tips from Heidi Huynh, occupational therapist and owner of Ascend Therapy Services, and Beth Hawkes, MSN, RN-BC and owner of Nursecode.

4 Daytime Tips for a Better Night’s Sleep

1. Exercise during the day

Exercise is linked to better quality sleep. Sticking to a consistent exercise routine is great for our health at any age. Even if exercise hasn’t been a regular part of your day, it’s never too late to start.

You can take small steps, like going for a 15-minute walk at least three times a week. Once exercise becomes a natural part of your routine, you can set a goal to meet the weekly exercise recommendations set by the Centers for Disease Control and Prevention (CDC).

The CDC recommends the following exercise guidelines for adults age 65 and older each week:

• 150 minutes of moderate-intensity activity like walking or 75 minutes of vigorous-intensity activity like jogging or hiking
• 2 days of strength training, such as weight-lifting, or exercises that use your own body weight like squats
• 3 days of balance exercises, like standing on one foot for a set amount of time or walking heel to toe

2. Develop healthy eating habits

Making changes to your diet—even small ones—may help improve sleep. ​​There is a possible link between improved sleep quality and the Mediterranean diet, according to a study published in the journal Nutrients. The Mediterranean diet is high in olive oil, fish, vegetables, and fruit. Red meat and refined carbohydrates are eaten rarely if at all.

Swapping out red meat with fish or even a vegetarian entrée a couple of times a week is one simple way to incorporate the Mediterranean diet into your routine.

Specific foods and beverages may even help you get a good night’s sleep if you eat them before bed. Healthline offers a list of snacks and drinks to help get a better night’s sleep.

We spoke with Vanessa Ling, a licensed naturopathic doctor and certified nutrition specialist, to learn more about how the following food and drinks may act as a sleep aid: 

• Milk is a good source of the amino acid trytophan, which can make you feel sleepy after a meal and helps with melatonin production.

• Almonds, walnuts, and pumpkin seeds are great sources of protein and fats that help prevent blood sugar from dropping at night, which is important since low blood sugar can cause insomnia for some people. Walnuts and almonds are also good sources of tryptophan.

• Fatty fish like salmon, tuna, or trout are all good sources of omega-3 fatty acids and vitamin D, which may help regulate our sleep-wake cycle. Proteins in fatty fish can also keep blood sugar stable.

• Chamomile and passionflower tea are two popular herbal teas used to support calm moods and sleep. Both have properties that slow down body and brain activity, which can make you feel more relaxed.

3. Be mindful of what you’re drinking (and when)

Coffee and caffeinated tea are great pick-me-ups in the morning, but be careful when you plan that last cup of the day, so you can ensure that it won’t stop you from getting a restful, deep sleep.

Consuming alcohol and water too close to bedtime can also cause sleep disruptions, such as intermittent tossing and turning or getting up in the middle of the night to go to the bathroom.

What time in the day should you stop drinking caffeine, alcohol, and water for a more restful sleep? Experts suggest:

• Caffeine: 8 hours before bedtime
• Alcohol: 3 hours before bedtime
• Water: 2 hours before bedtime

4. Plan shorter naps earlier in the day

Your naps should last no longer than 10–20 minutes, and you shouldn’t nap after about 2 p.m. or 3 p.m. The later in the day we nap, the more likely we are to experience deep sleep while napping. This can cause us to get less sleep later that night.

4 Small (But Powerful) Bedtime Habits You Can Start Tonight

1. Put away your electronics

Scrolling through Facebook, checking your email, or answering texts before bed may seem harmless, but your phone’s blue light (which mimics sunlight) can throw off your body’s internal clock.

Watching TV before bed can also seem like a relaxing ritual, but the artificial light and visual stimulation can make it harder to fall asleep.

Avoid using your phone or digital tablet at least 30 minutes before bedtime, and try to cut off the TV 30 minutes to an hour before bed to give your mind and body time to wind down.

2. Set the optimal lighting and temperature

External cues are an excellent way to give your body the hint that it’s time for bed. Dr. Po-Chang Hsu suggests dimming artificial light at least two hours before bedtime. You should also close your blinds or curtains to avoid bright street lights creeping into your bedroom.

Also, cooling down our room helps our body realize it’s time to relax and prepare for sleep since our core body temperature drops at night.

The optimal temperature for sleep is 60–67 degrees Fahrenheit, according to multiple sources including Sleep Foundation and Cleveland Clinic. If that’s too low for your thermostat, consider adding a portable fan to your bedroom to help cool down the room.

3. Save your bed for sleep

Associate your bed with restful sleep by using it only for sleep. Don’t eat or watch TV in bed. Remove clutter like documents, electronics, and other distractions for a stress-free sleep environment.

4. “Wind down” at the same time every night

Waking up and going to bed at the same time helps regulate and reinforce our circadian rhythm. It may be difficult to establish this habit at first, especially if you’re retired and don’t have a consistent schedule during the day.

How to Establish a Bedtime Routine That Works for You

Your wind-down time should be 30 minutes to an hour before you’re actually ready to fall asleep. Set your bed and wake-up time with the goal of getting 7–8 hours of sleep.

For example, if you’re more likely to naturally wake up around 5 a.m. or 6 a.m., then aim to be in bed by 9 p.m. or 10 p.m.

Once you’ve chosen a set “wind down” time, you’ve already taken one of the most important steps toward establishing a bedtime routine.

Relaxing “wind down” activities that you can incorporate into your bedtime routine include light stretching, listening to relaxing music, taking a warm bath, and reading before bed.

A Sleep Expert’s Nighttime Routine

What does a good nighttime routine look like? We asked Dr. Abhinav Singh (MD, FAASM), Medical Director of the Indiana Sleep Center and Medical Review Expert at SleepFoundation.org, to share with us his routine for optimal sleep.