A Good Night's Sleep

Since he retired, Edward dreads going to bed at night. He’s afraid that when he turns off his light he will just lie there with his eyes open and his mind racing. “How can I break this cycle?” he asks. “I’m so tired—I need to get some sleep.”

Sleep and Aging

Older adults need about the same amount of sleep as young adults—between 7-9 hours each night. But older people tend to go to sleep earlier and get up earlier than they did when they were younger. And they may nap more during the day. If you sleep too much during the day, it may be hard to fall asleep at night. Also, feeling sick or being in pain can make it hard to sleep. If you don’t get a good night’s sleep, the next day you may be:

• irritable,
• forgetful,
• depressed,
• likely to have more falls or accidents.

There are two kinds of sleep—REM (rapid eye movement) sleep and non-REM sleep. We dream mostly during REM sleep, and have the deepest sleep during non-REM sleep. As people get older, they spend less time in deep sleep, which may be why older people are often light sleepers.

Insomnia

Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling and staying asleep. Insomnia can last for days, months or even years. If you’re having trouble sleeping, you may:

• take a long time to fall asleep,
• wake up many times in the night,
• wake up early and be unable to get back to sleep,
• wake up tired.

There are many causes of insomnia. Some of them you can control, but others you can’t. Insomnia may be a sign of other problems. If you are excited about a new activity or worrying over your bills, you may have trouble sleeping.

Sometimes insomnia is a side effect of a medication or an illness. Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. Worrying doesn’t help and it may make insomnia worse.

Older adults who have trouble sleeping may have memory problems, be depressed, have more nighttime falls, use more over-the-counter sleep aids, or feel very sleepy during the day. Using prescription medicines for a short time may help. But remember, these medicines aren’t a cure for insomnia. You need to develop habits that will help you get a good night’s sleep.

Sleep Apnea

Sleep apnea is another serious sleeping disorder. A person with sleep apnea pauses in his or her breathing while sleeping. These pauses may happen many times during the night. Waking up over and over each night makes you feel very tired the next day.

You may not even know you have sleep apnea. But your loud snoring and gasping for air can keep other people awake. Feeling sleepy during the day and being told you are snoring loudly at night are signs that you may have sleep apnea.

If you think you have sleep apnea, see a doctor who knows about sleep problems. Treatment may include learning to sleep in a way that keeps your airways open. Sometimes a medical device called Continuous Positive Air Pressure (CPAP), a dental device, or surgery can help. If not treated, sleep apnea can lead to other problems such as high blood pressure, stroke, or memory loss.

Movement Disorders

Restless legs syndrome and periodic limb movement disorder are common in older adults. Some people have both problems. These movement disorders can rob you of needed sleep. People with restless legs syndrome, or RLS, feel tingling, crawling, or pins and needles in one or both legs. It’s worse at night. Moving the legs brings some relief, at least for a short time. RLS tends to run in families. See your doctor for more information about medicines to treat RLS.

Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20–40 seconds during sleep. Some people have hundreds of these movements each night, which may result in loss of sleep and feeling tired and sleepy the next day. Medication, warm baths, exercise, and learning to relax can help.

Alzheimer’s Disease and Sleep—A Special Problem

Alzheimer’s disease often changes a person’s sleeping habits. For example, some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night. The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired and out of sorts.

If you’re caring for someone with Alzheimer’s disease, there are steps you can take to protect his or her nighttime safety. Try the following:

• Put a gate across the stairs.
• Make sure the floor is clear of objects.
• Lock up any medicines.
• Put grab bars in the bathroom.
• Put a portable toilet in the bedroom.

Getting a Good Night’s Sleep

Being older doesn’t mean you have to feel tired all the time. There are many things you can do to help you get a good night’s sleep. Here are some ideas.

• Follow a regular schedule. Go to sleep and get up at the same time each day, even on weekends. Napping in the late afternoon or evening may keep you awake at night.
• Develop a bedtime routine. About 30-45 minutes before bedtime each night, do the same things so your body will know that it’s time to sleep. Some people watch television, read a book, listen to soothing music, or soak in a warm bath.
• Your bedroom should be dark, not too hot or too cold, and as quiet as possible.
• Be sure you have a comfortable mattress, a pillow you like, and enough blankets for the season.
• Exercise at regular times each day but not within 3 hours of your bedtime.
• Make an effort to get outside in the sunlight each day.
• Be careful about when and how much you eat. Large meals close to bedtime may keep you awake, but a light snack in the evening can help you get a good night’s sleep.
• Stay away from caffeine late in the day. Caffeine (found in coffee, tea, cola, and hot chocolate) is a stimulant that can keep you awake.
• Drink less liquid in the evening. Waking up to go to the bathroom and turning on a bright light breaks up your sleep.
• Remember that alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.
• Use your bedroom only for sleeping. After turning off the light give yourself about 15 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.

Safe Sleeping

Try to set up a safe and restful place to sleep. Make sure there are smoke alarms on each floor and lock up the house before going to bed. Other ideas for a safe night’s sleep are:

• Keep a telephone with emergency phone numbers by your bed.
• Have a good lamp that turns on easily within reach.
• Put a glass of water next to the bed.
• Use nightlights in the bathroom and hall.
• Don’t smoke, especially in bed.
• Remove area rugs so you won’t trip if you get out of bed in the middle of the night.
• Don’t fall asleep with a heating pad on; it may burn.

Sweet Dreams

There are some tricks to help you fall asleep. You don’t really have to count sheep—just try counting slowly to 100. Some people find that playing mental games makes them sleepy—tell yourself it’s 5 minutes before you have to get up and you’re just trying to get a few extra winks. Other people find that relaxing their body puts them to sleep. You might start with your toes, and tell yourself that your toes are relaxed and sleepy. Work your way up the rest of the body saying the same words. You may drift off to sleep before getting to the top of your head.

If you feel tired and unable to do the things you usually do for more than 2-3 weeks, see a doctor. Sleep problems can cause you to feel bad, but there are changes you can make to get a better night’s sleep.

For More Information

Here are some helpful Federal and non-Federal resources.

National Heart, Lung, and BloodInstitute
Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
301-592-8573
240-629-3255 (TTY)
www.nhlbi.nih.gov

National Institute on Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
800-352-9424 (toll-free)
301-468-5981 (TTY)
www.ninds.nih.gov

American Insomnia Association
One Westbrook Corporate Center
Suite 920
Westchester, IL 60154
708-492-0930
www.americaninsomniaassociation.org

American Sleep Apnea Association
1424 K Street, NW
Suite 302
Washington, DC 20005
202-293-3650
www.sleepapnea.org

Better Sleep Council
501 Wythe Street
Alexandria, VA 22314-1917
703-683-8371
www.bettersleep.org

National Sleep Foundation
1522 K Street, NW
Suite 500
Washington, DC 20005-1253
202-347-3471
www.sleepfoundation.org

Restless Legs Syndrome Foundation
1610 14th Street NW
Suite 300
Rochester, MN 55901
877-463-6757 (toll-free)
507-287-6465
www.rls.org

For more information about health and aging, contact:

National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
800-222-2225 (toll-free)
800-222-4225 (TTY/toll-free)
www.nia.nih.gov

To order publications (in English or Spanish) or sign up for regular email alerts, visit www.nia.nih.gov/HealthInformation.

Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. There are also special features that make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.

National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
December 2005
Reprinted April 2007

Web page last updated: June 25, 2007