Understanding Sleep Changes in Older Adults


Paige Greenfield

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With advancing age come predictable changes such as moments of forgetfulness and new aches and pains. But how many older people talk about a new difficulty: staying asleep?

Middle-of-the-night insomnia is actually a common experience for seniors, and it can have several causes. For instance, as you age, your brain produces less of the hormone melatonin, which is essential for sleep. Another culprit might be a medical issue such as nocturia.

The good news? There are many ways to put sleep problems to rest. Here's a look at three common causes of middle-of-the-night insomnia in seniors and what you can do to sleep like a baby—no matter your age.

Obstructive Sleep Apnea

Sometimes loud snoring is a bigger issue for you than it is for your bedmate. In fact, it could signal a serious health problem called obstructive sleep apnea (OSA). With OSA, you stop breathing for as long as 10 to 60 seconds. Your brain responds to the drop in oxygen and causes you to wake up and breathe again. This can occur many times throughout the night.

Untreated, OSA can lead to a variety of other health complications, such as high blood pressure, heart disease, depression, and more. If you snore loudly or sound like you're gasping for air at night, you could have OSA. Make an appointment to discuss the problem with your doctor. There are many different treatments available, including making lifestyle changes, wearing a special mask at night that keeps your airway open, or even having surgery if necessary.

Restless Legs Syndrome

As you may imagine, restless legs syndrome causes an uncomfortable feeling in your legs when you're sitting or lying down. You may feel the urge to move them or tingling, creeping, or pulling feelings. Although restless legs syndrome can occur at any age, it's more common in older adults and is worse in the evening than during the day, which makes it difficult to stay asleep through the night.

Tell your doctor about any discomfort you feel in your lower limbs. Over-the-counter or new FDA-approved prescription medications, as well as taking a warm bath before bed, may help.


Nocturia, also known as frequent nighttime urination, can certainly wake you up. Getting up two or more times per night to use the bathroom can make you feel sleepy during the day. People with severe nocturia may get up five or more times at night to urinate.

If you experience frequent nighttime urination, it's important to talk with your doctor. It could signal an even more serious problem such as a urological infection or a bladder or prostate tumor. If a more serious cause isn't to blame, your doctor may advise you to adjust certain habits, such as limiting liquid intake two hours before bed.

Smart Ways to Sleep Through the Night

No matter the cause of your waking, there's plenty you can do to minimize obstacles to a good night's rest:

  • Avoid consuming caffeine eight hours before sleep.
  • Go to bed at the same time every night and wake up at the same time every morning.
  • Avoid drinking alcohol in the late evening; it can cause you to wake up at night.
  • Skip the late-night snacks. You don't need the added calories or the acid reflux (a major cause of insomnia).
  • Exercise around the same time every day. Aim to finish your workout at least three hours before bed.
  • Try to avoid taking naps during the day, which can affect your ability to sleep at night.

Key Takeaways

  • Middle-of-the-night insomnia is common in seniors, and it can have several causes. For instance, as you age, your brain produces less of the hormone melatonin, which is essential for sleep.

  • Some older people have the condition nocturia, causing them to get up often during the night to use the bathroom.

  • Obstructive sleep apnea and restless legs syndrome are two other common culprits. Talking with your doctor is the first step to a better night's rest.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 17, 2017

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Medical References

  1. Restless Legs Syndrome. American Academy of Family Physicians. http://familydoctor.org/familydoctor/en/diseases-conditions/restless-legs-syndrome.html
  2. Sleep Changes in Older Adults. American Academy of Family Physicians. http://familydoctor.org/familydoctor/en/seniors/staying-healthy/sleep-changes-in-older-adults.html
  3. About Sleep. National Institutes of Health. NIH SeniorHealth. http://nihseniorhealth.gov/sleepandaging/aboutsleep/01.html
  4. Sleeping Well. National Institutes of Health. NIH SeniorHealth. http://nihseniorhealth.gov/sleepandaging/sleepingwell/01.html
  5. Your Guide to Healthy Sleep. National Institutes of Health. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf
  6. Nocturne or Frequent Urination at Night. National Sleep Foundation. http://www.sleepfoundation.org/article/sleep-related-problems/nocturia-and-sleep
  7. Aging and Sleep. National Sleep Foundation. http://www.sleepfoundation.org/article/sleep-topics/aging-and-sleep
  8. Aging and Sleeping - Coping. National Sleep Foundation. http://www.sleepfoundation.org/article/topics/aging-and-sleep-coping

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