Sweet Dreams: Managing Sleep Changes in Seniors

Changing poor sleep-related habits and attitudes about sleep are as effective or more effective than taking sleep medications.

Insomnia and the inability to stay asleep are common complaints of older adults. While it is not uncommon for older adults to sleep more lightly than they did when they were younger, they still need a good night’s sleep. Having insomnia or feeling sleepy throughout the day could be indicative of underlying problems.

Just as with other physical symptoms, sleep quality can be associated with general health. Older adults with healthy sleep patterns may sleep less or less deeply but will feel rested and energetic during the day. Seniors who get less sleep and are tired and lack energy may need to address the underlying causes of their insomnia and nocturnal wakefulness.

What causes insomnia and nighttime wakefulness in seniors?

Many factors can contribute to insomnia and wakefulness. Lack of exercise, improper diet, and unstructured days may cause some seniors to have insomnia. Medications can interfere with normal circadian rhythms and cause drowsiness during the day or alertness at night. Physiological factors such as nighttime pain, illness, dementia, heart disease, or problems breathing while sleeping (sleep apnea) can interfere with sleep. Insomnia and wakefulness are also strongly associated with psychological factors such as depression or anxiety. Finally, poor sleep habits (see below) can strongly contribute to insomnia.

How can elders improve their sleep quality?

The first step is to assess and change any poor sleep habits. Poor sleep habits include drinking alcohol, caffeine, or too many fluids in the evenings; smoking (nicotine affects sleep); exercising before bed; and eating late meals. It is important to associate the bed with sleep and intimacy by not reading, working, eating, or watching television in bed. Also, seniors should not try to go to bed when they just are not tired. Some studies indicate that increasing the amount of time spent in bed can actually interrupt normal circadian rhythms. Limiting bed time to 7 to 8 hours may improve sleep quality. Additionally, seniors should limit napping, which can cause nighttime wakefulness and engage in relaxation techniques before bedtime.

Senior adults who experience insomnia may want to talk with their doctors to determine if physical problems or medications are affecting their sleep. They should be sure to discuss any physical or breathing discomfort, pain, urinary problems, or other factors they notice are keeping them up at night. They should also note the amount of caffeine and alcohol they ingest and whether they feel anxious, stressed, sad, depressed, or nervous. Identifying physical or psychological problems or sleep disorders and treating them can help individuals overcome insomnia and sleep interruptions, so they can get a better, more restful night’s sleep.


  • Carskadon, M.A., Brown, E. and Dement, W.C. (1982). Sleep fragmentation in the elderly: Relationship to daytime sleep tendency. Neurobiology of Aging, 3, 321-327.
  • Geriatric Mental Health Foundation. (n.d.). Sleeping well as we age: Insomnia is not a normal part of aging. Retrieved from http://www.gmhfonline.org/gmhf/consumer/factsheets/hlthage_sleep.html.
  • WebMD. (2013). Aging and sleep. Retrieved from http://www.webmd.com/sleep-disorders/guide/aging-affects-sleep.

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