How Does Ageing Affect Sleep?

Older people often get less sleep – but for all the wrong reasons. As we age, our bodies need just as much sleep as they did when we were younger. The only thing that changes: sleeping well becomes harder.

Find out why older people sleep less and what you can do to offset age-related sleep loss.

Do Older Adults Sleep More or Less?

You’ve probably heard that older adults struggle with sleep – and that they sleep more. Both are true.

We’re more likely to experience lighter, more fragmented sleep at night as we get older [1]. That’s caused by a few different factors (which we’ll cover in the next section). To compensate for not getting enough sleep at night, many older people also nap more during the day [1].

Maybe you’ve noticed that behaviour in yourself or people you know. You wake up early but tired. You still feel tired during the day, so you take a long nap in the afternoon. You then stay up later because you don’t feel quite ready for bed. When you do go to sleep, you wake up regularly – sometimes to go to the bathroom, sometimes because you’re uncomfortable, and sometimes for no clear reason at all.

That’s the sleep pattern experienced by many older adults. It’s common, but it’s not healthy.

Do You Need Less Sleep as You Get Older?

Every adult needs 7 to 9 hours of good-quality sleep each night [2, 3]. Sleep is essential across your entire life, and that doesn’t change as you get older.

Not getting enough sleep negatively affects every part of your body, including your brain, heart, and immune system. Getting too much sleep may also be harmful. Some studies have indicated that sleep has an ‘optimal range’ and that regularly getting more than 9 hours causes worse functioning [4].

Why Do Older Adults Sleep Less?

As we age, our sleep suffers. Older adults sleep less, wake up more, and enjoy less REM and non-REM time [6]. That’s caused by 3 main factors: changes to our circadian rhythms, declines in certain hormones, and more chronic health conditions.

Circadian Rhythm Changes

Our sleep is controlled by our circadian rhythms, which are like our internal 24-hour clocks. Those circadian rhythms are set by a part of our brains (the suprachiasmatic nucleus (SCN) in the hypothalamus).

As we age, our clocks start to malfunction. Our rhythms get weaker, more fragmented, and more easily disturbed by changes to our routines [7]. That can make it more difficult to enjoy high-quality sleep, especially if you developed poor sleeping habits when you were younger.

Ageing also causes our circadian rhythms to move forward. Older people often wake earlier and sleep earlier than they did when they were younger [8]. While that’s not necessarily a bad thing, it can lead to social jetlag if you don’t adjust social and family time accordingly. That could mean, for example, having family dinners at 5:30 pm instead of 7:00 pm, or swapping a late night out for a brunch.

How to Strengthen Your Circadian Rhythm

Try starting with these 6 sleep hygiene steps:

1. Go to bed and wake up within +/- 30 minutes of the same time each day.
2. Go outside and get direct sunlight (no sunglasses) within 30 minutes of waking up. If you can’t, use a 10,000-lux SAD lamp instead.
3. Create a sleep sanctuary. That means investing in a high-quality sleep surface in a cool, dark, distraction-free space.
4. Avoid bright lights (especially screens) at least 1.5 hours before bed.
5. Have a sleep routine. Set aside an hour to relax and unwind (without screens) before bed.
6. Avoid heavy meals, alcohol, and exercise at least 2 hours before bed.

Remember: light is the most important external cue our bodies have. Getting sunlight upon waking and avoiding bright lights at night is the best way to strengthen your circadian rhythm.

If you have trouble seeing in low light at night, try turning on your normal lights and wearing blue-light-blocking glasses instead. You can buy blue light glasses online or have your optometrist apply a coating to prescription lenses. Using red light bulbs for bedside lamps is also a good idea. (Red light doesn’t affect your circadian rhythm as much and can help you relax before bed.)

Hormonal Declines

Sleep and hormones have a complicated relationship. Many of our hormones are produced during sleep, but sleep can also be affected by disruptions to those hormones – which leads to a vicious spiral of hormone decline and sleep loss. The main players include melatonin (the sleep hormone), cortisol (the stress hormone), testosterone, and progesterone.

Melatonin may decrease as we get older (although some studies suggest that, in healthy adults, it doesn’t) [8]. Cortisol production peaks earlier and more weakly, which is why older adults tend to wake up earlier than they did when they were younger [8].

Testosterone and progesterone are different. Both of them are essential for good sleep in men and women, affecting everything from sleep quality to the risk of sleep apnoea [9, 10]. And both of them decline as we get older. Testosterone starts declining in both men and women from our early 20s and 30s onwards [11]. In women, progesterone plummets during menopause, although it’s not clear whether men experience something similar [11, 12].  

How to Offset Hormone Declines

The simplest thing you can do to offset hormone declines is also one of the hardest: get better sleep. Sleep and testosterone have a 2-way relationship. Not enough sleep can negatively impact testosterone levels – which can then make getting good sleep even more difficult [13].

Diet, weight, exercise and stress also all have a big impact on your hormones. Try these 10 lifestyle tips.

1. Get 80% of your calories from single-ingredient foods (fruits, vegetables, cereals, meat and fish, eggs, dairy, nuts and seeds).
2. Eat at least 1.6 grams of protein per kilogram of bodyweight per day.
3. Consume one to 2 grams of omega-3 fatty acids per day.
4. Get 30 ‘plant points’ per week.
5. Consume at least 0.75 grams of fibre per kilogram of bodyweight per day.
6. Do at least 2 resistance exercise sessions and 150 minutes of cardio per week. Book a few sessions with a personal trainer to help you find activities that match your ability level.
7. Have a morning routine and a sleep routine to bookend your day.
8. Try activities like breathing exercises, forest bathing, or mindfulness.
9. Use CBT to help manage anxiety and overthinking. You can find a low-cost/free program here.
10. Spend at least 2 hours a week talking with friends or family. In-person conversations are best.

Remember: these are general tips – everyone is different. Always follow your health professional’s advice. If you’re still concerned about your hormone levels, ask your healthcare provider whether hormone replacement therapy could help.

More Health Problems

As we get older, we’re more likely to have chronic health conditions. Eighty per cent of Australians aged over 65 have at least one chronic health condition. That figure rises to 95% of people aged 85 years and over.

The most common health problems include:

• cardiovascular disease
• arthritis
• back problems
• osteoporosis
• chronic kidney disease
• COPD
• dementia
• diabetes
• mental health conditions
• oral diseases
• hearing loss
• chronic eye conditions
• sleep disorders
• chronic pain.

Many of those chronic health conditions directly impact our comfort – especially when we’re sleeping. That can make getting to sleep and staying asleep much harder. Even when you finally drift off, persistent pain or discomfort can lead to lighter, less restorative rest.

People with chronic health conditions are also more likely to take medication. While medications are often lifesaving, most – including antidepressants, antihypertensives, and even over-the-counter products – have side effects that negatively impact sleep in some way [14]. That effect becomes worse when we take multiple medications at the same time.

How to Sleep Better With Health Problems

Like our hormone health, our ability to live with chronic conditions hinges on good sleep. But, if those conditions are stopping you from sleeping well in the first place, what are your options?

Improving the comfort of your sleeping surface is a simple, high-impact option. It doesn’t require any discipline, lifestyle changes, or ongoing costs. Many people with lower back pain, for example, find that adjustable beds can help alleviate discomfort that prevents them from getting to sleep. Enhanced features like CELLIANT and whole-body vibration therapy can also help people with everything from diabetes to anxiety get to sleep faster and sleep more soundly.

If you’ve already found a sleeping surface that matches your body type, try these tips.

1. Ask your doctor about the sleep impacts of any medication. See if they can help you switch to an option that’s less disruptive.
2. Don’t lie in bed awake. If you can’t sleep for 20 minutes or more, get up and do a relaxing activity until you feel sleepy.
3. CBT-I is a variant of CBT that can help you relax and sleep (even if you’re experiencing discomfort or pain). You can find a low-cost/free program here.  

What About Sleeping Pills?

If you want to improve your nights, sleeping pills should be your last resort. They’re sedatives, which means they knock you and deprive you of the many, many benefits of good sleep.

Here’s an explanation from leading sleep scientist Dr Matthew Walker [15].

Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases. […] [They] target the same system in the brain alcohol does [..] and effectively knock out the higher regions of your brain’s cortex.

The electrical type of “sleep” these drugs produce is lacking in the largest, deepest brainwaves. Adding to this state of affairs is a number of unwanted side effects, including next-day grogginess, daytime forgetfulness, performing actions at night of which you are not conscious (or at least have partial amnesia in the morning), and slowed reaction times during the day that can impact motor skills, such as driving.

Next Steps

Ageing can and does impact our sleep in different ways. But getting older doesn’t mean restful nights are out of reach – even if you’re living with a chronic health condition.

Try the tips we’ve shared throughout this guide. You’ll almost certainly see some improvements. (And, if you have a sleep tracker, like a Garmin, Apple Watch, Whoop, or Oura, experiment with different lifestyle changes and see what works.)