Sleep Problems

Basic Facts

A good night’s sleep may feel more and more like a thing of the past as the years go by. You may no longer feel refreshed when you wake up in the morning. Daytime sleepiness and an afternoon nap may have become a normal part of your routine. The idea that we need less sleep as we age is really just a myth. What we do know, though, is that it is more difficult to get into and stay in a deep sleep as we age, and our brain rhythms don’t follow the usual patterns as younger people’s brains do when they sleep. 

Even in older age, seven or eight hours of good quality sleep is important for keeping us healthy. If you are not getting enough sleep (or if you're getting too much sleep) and you feel tired when you wake up in the morning, you may have a sleep problem. Sleep problems can lead to:

  • Fatigue and sleepiness during the day
  • Mood changes such as depression and irritability
  • Difficulties with work and concentration
  • Injuries
  • Increased risk of illness 

Disrupted sleep may take many forms. You may have trouble falling or staying asleep, or you may sleep too much. You may be going to sleep earlier and waking earlier.  You may feel that you need to nap during the day, but napping might mean you sleep a bit less at night. You might also experience disturbing movement disorders or abnormal breathing patterns that prevent you from getting the rest you need.

These challenges can lead to a number of issues, including the fact that older adults with sleep problems use healthcare services more often than older people who sleep normally.

See your healthcare provider if a sleep disruption starts to interfere with your daily life.

The Most Common Types of Sleep Problems

The types of sleep problems that most often affect older people fall into the following categories

Insomnia

Insomnia refers to not being able to fall asleep when you think you should, to stay asleep, or to the feeling that you have not slept enough when you wake up in the morning.

Sleep Apnea & Breathing Problems

In this condition, you may repeatedly stop breathing for a while (usually at least 10 seconds) while you are asleep. The lack of oxygen turns on an internal alarm system that causes you to partially wake up whenever your breathing stopsIt can also bring on heart problems and high blood pressure. 

Sleep apnea occurs as one of the following two types or a combination of both:

Obstructive Sleep Apnea (OSA)

This type of apnea is caused by a collapse and blockage of the airway while you are sleeping. Often people with this type of breathing problem snore loudly when they sleep as the airway starts to close.  They then appear to snort or choke while sleeping. They may not be aware of frequent arousals at night.  A bed partner may report loud snoring, intervals when breathing has stopped, and choking sounds during sleep.

Central sleep apnea (CSA)

This type of apnea can cause your breathing effort to stop as you sleep. 

Movements that Affect Sleep

Restless Leg Syndrome

In restless leg syndrome, you may experience very uncomfortable, abnormal feelings in your legs when you are lying down or even just while sitting. Relief comes when you get up and walk around, but the feeling comes back when you lie down, making it very difficult to fall asleep.

Periodic Leg Movement Syndrome

People with this condition move either one or both legs repetitively during sleep. The legs will move in a specific pattern in which the muscles of the leg, feet, and toes tense up in a slow-motion “kicking” movement. You will probably be unaware that you have this disorder, unless your bed partner tells you about it. However, the repeated spasms may make your legs feel quite tired when you wake up the next day. These movements interfere with your ability to get a good rest while you sleep. You may have both restless legs syndrome and periodic limb movement disorder at the same time.

Sleep Disorders Related to Living in Long-term Care Facilities

Older people who live in long-term care institutions often have trouble sleeping. The special circumstances of life in chronic care facilities may contribute to this problem. If you or someone in your care is a resident of a long-term care home, make sure to let the healthcare providers know that when a sleep problem is present.

Sleep Problems Related to Medical or Psychiatric Conditions

Many older people suffer from physical conditions or disabilities that make it hard to find a comfortable sleeping position. Psychiatric conditions common in older people, such as depression and anxiety, also interfere with sleep.

Sleep-Wake Cycle (Circadian Rhythm) Sleep Disorders

A common sleep rhythm disturbance for older people is the tendency to wake up earlier in the morning and fall asleep earlier at night. Also, older people often have more trouble with adjusting to travel through many time zones.

Other Common Sleep Problems

Other common sleep problems may be caused by the medications you take or by pain you might experience, which can keep you up when you should be sleeping.

How Common are Sleep Problems?

Sleep problems, especially insomnia, are extremely common among adults, but occur even more often in older people. About 30% of all adults over age 65 suffer from insomnia. For most people, the problem does not occur every night, but comes back after a few nights of better sleep. Older women have more frequent sleep disturbances, in some cases associated with menopause. Older black Americans, particularly women, have an even higher risk for sleep problems. Most adults (86%) report feeling sleepy at least three times each week, and that sleepiness interferes with their daily activities. Among adults who nap during the day, 62% report that they have symptoms of insomnia. 

Updated: May 2017