older woman in bed and staring up at the ceiling

Why It’s Harder to Sleep As You Get Older and What to Do About It

By Marisa Cohen
Reviewed by Samantha Domingo, Psy.D.
March 18, 2024

Remember when you were in your teens and 20s and could sleep blissfully through the night? Those days of easy slumber can seem like a pipe dream as you get older.

“As people age into their 40s, 50s, and beyond, they often face problems like snoring, changes in their sleep patterns, chronic pain, and restless legs syndrome,” says Shelby Harris, Ph.D., a clinical psychologist in White Plains, New York.

It's bad enough that as we age we naturally experience a decline in our ability to fall asleep, maintain a deep, restorative slumber, and sleep for as long as we need. But other factors that come with getting older may also wreak havoc on your sleep.

Medications like beta blockers, decongestants, and some antidepressants can prevent a good night’s sleep. And let’s not discount that “stress, sadness, and worries about things like health, finances, or loneliness can make it hard to fall asleep or stay asleep,” Harris says, adding that older people dealing with cognitive decline may face even worse sleep problems.

Physical aches and pains can also make it harder to get into a comfortable position to sleep, says Heather Swain, D.P.T., a physical therapist in Toledo, Ohio. “The most common pain complaints that wake patients at night are low back, neck, and hip pain,” she says. “There are also many nerve-related complaints that wake people up or make it hard to fall asleep, including sciatica, carpal tunnel [syndrome], and neuropathy.”

4 Common Problems That Can Block Sleep As You Get Older

Although the list of midlife sleep woes is long enough to keep you up all night, here are four of the most common—and what you can do about them.

Perimenopause and Menopause

It’s estimated that up to 60% of postmenopausal women suffer from sleep disorders, and a large Canadian study suggests postmenopausal women are more likely than pre- or perimenopausal women to take longer than 30 minutes to fall asleep.

“Changes in hormones can mess with your sleep by causing hot flashes, night sweats, insomnia, and mood swings,” Harris says.

What you can do about it: Lifestyle changes, such as using cooling sheets, avoiding spicy food and caffeine before bed, and keeping a fan on full blast in your bedroom, can help—to a point. But if hot flashes and other menopause-related symptoms are making your life miserable, talk to your doctor about potentially helpful medications, including hormone therapy, says Harris.

Restless Legs Syndrome

Restless legs syndrome (RLS), a condition that causes a strong impulse to move the legs, affects up to 10% of adults in the United States. This urge causes uncomfortable sensations that tend to increase in intensity at night. Although it can happen at any age, the symptoms tend to get more severe as you get older, according to the Sleep Foundation.

Although there may be a genetic connection, researchers are unsure what causes RLS. It can be more common in people living with other chronic conditions such as kidney disease, multiple sclerosis, or Parkinson’s disease—but you may experience it for no reason at all. RLS may occur or worsen in people who have an iron deficiency.

What you can do about it: There’s no cure for RLS, but avoiding triggers such as alcohol, caffeine, and smoking can help lessen symptoms. If you have anemia, talk to your doctor about taking an iron supplement, which may help. Certain anti-seizure medications may also help, as well as some muscle relaxants.

Sleep Apnea

It’s estimated that about 39 million adults in the United States—and 936 million adults worldwide—are living with obstructive sleep apnea (OSA), a condition in which breathing stops and restarts many times a night. The pause in breathing causes people with the condition to gasp for air (loud snoring is a common symptom). The result is poor sleep quality and daytime drowsiness.

The majority of people with sleep apnea are older—in fact, one study suggests that 56% of those over 65 are at risk for the condition. OSA occurs when muscles at the back of the throat relax causing the soft tissue to collapse and block the upper airway. OSA is more common in people of Black, Latinx, and Asian descent.

What you can do about it: Because excess weight is associated with a higher risk for sleep apnea, losing weight may help reduce symptoms. Talk to your doctor about healthy ways to approach weight loss. You should also talk to a doctor who specializes in sleep—they can do a sleep study to pinpoint what’s going on and recommend a range of treatments, including oral devices that help keep the lower jaw or tongue from blocking the airway, the use of a continuous positive airway pressure (CPAP) machine, or even surgery.

Urinary Issues

Getting up to urinate multiple times a night might seem like a rite of passage in midlife, but it could be a sign there’s something else going on. “It’s considered normal to go to the bathroom once in the middle of the night after age 65,” Swain says. “More often than that, you should talk to your doctor.”

Having to get up to urinate more than twice per night, known as nocturia, occurs in about 50% of people over the age of 60. Numerous conditions can lead to nocturia, including some medications; alcohol and caffeine consumption; underlying conditions like diabetes, hypertension, and heart disease; an overactive bladder; and pelvic floor muscle dysfunction.

What you can do about it: Your healthcare provider can uncover the cause of your frequent urination. Depending on the cause, treatment may include lifestyle changes like limiting your fluid intake before bedtime, taking or changing medication, and treating the underlying condition.

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