Ageing and insomnia: Why older adults sleep worse and what actually helps

From business-standard.com

From early awakenings to lighter sleep, ageing changes how we rest. A neurologist explains when disturbed sleep is normal, when it points to disease, and what to do to rest better

Lighter sleep, more night-time waking, or early-morning awakenings, many people notice their sleep deteriorating with age. While some of this is part of ageing, experts warn that persistent poor sleep can point to medical issues and is often more treatable than people realise.

 

“As a neurologist, I often see older adults struggling with sleep issues and assuming it’s just age,” says Dr Kapil Kumar Singhal, Director of Neurology at Medanta Hospital, Noida. “Ageing does affect the brain’s sleep centres and body clock, but not all poor sleep is normal, and ignoring red flags can mean missing treatable conditions.”

What biological changes occur in the ageing brain that affect sleep quality?

According to Dr Singhal, ageing does not shrink your need for sleep, it shrinks your brain’s ability to produce good sleep.

“The body’s internal clock, or circadian rhythm, is controlled by a brain structure called the suprachiasmatic nucleus,” explains Dr Singhal. “With age, this clock weakens and tends to run faster, pushing sleep earlier in the evening and wake-up times earlier in the morning.”

 

Add to that shrinking brain cells, reduced melatonin production, and changes in sleep-regulating centres, and the result is lighter, more fragmented sleep and less time spent in deep, restorative stages.

“The requirement remains the same, about seven to nine hours, but the brain struggles to deliver it without interruptions,” Dr Singhal says.

Sleep often becomes lighter and more fragmented with age, but it can be fixed, say doctors. (Photo: AdobeStock)

Why does losing deep sleep matter for memory, immunity and long-term health?

Dr Singhal explains that deep sleep, also called slow-wave sleep, is where the real repair work happens in the brain.

“This stage clears toxic waste from the brain, consolidates memories, regulates hormones and supports immunity,” says Dr Singhal.

 

As slow-wave sleep declines with age, memory suffers first. Connections in the hippocampus, which is the brain’s memory hub, weaken, increasing forgetfulness and long-term dementia risk.

 

Metabolic health takes a hit too. Less deep sleep raises blood sugar levels and insulin resistance, increasing the risk of type 2 diabetes. Chronic inflammation rises, pushing up the likelihood of heart disease, stroke and Alzheimer’s.

 

“This is not a benign change,” Dr Singhal warns. “Studies show that every one per cent yearly drop in deep sleep can raise dementia risk by nearly 27 per cent. Early intervention matters.”

How much night-time waking is normal among older adults?

Some broken sleep after midlife is expected. But there are limits.

 

“After 50, one to three brief awakenings a night, say under five minutes, is considered physiological,” says Dr Singhal. “That adds up to roughly 20–30 minutes of wake time after sleep onset.”

 

Trouble starts when awakenings become frequent, prolonged or exhausting. “If someone is awake for more than 30 minutes most nights, has four or more awakenings, and this causes daytime fatigue or poor concentration for over three months, it meets criteria for insomnia,” he explains.

 

Dr Singhal warns about certain patterns and recommends immediate medical attention.

“Sudden insomnia with daytime sleepiness raises suspicion of sleep apnoea,” says Dr Singhal. “Acting out dreams can be an early sign of Parkinson’s. Confusion during night awakenings may signal cognitive decline.”

 

Other red flags include leg discomfort at night (restless legs syndrome), persistent early-morning waking with anxiety (depression), and sleep tied closely to pain or breathlessness.

 

“Nearly half of so-called ‘age-related insomnia’ is actually driven by arthritis, medications like diuretics, or chronic diseases such as heart failure,” he notes. “Blaming age alone leads to missed diagnoses.”

Is age-related insomnia really about ageing or about poor health?

“Chronic inflammation and metabolic disorders disrupt the brain’s sleep signals,” Dr Singhal explains. “Conditions like diabetes, obesity and heart disease fragment sleep and worsen deep sleep loss.”

The relationship is bidirectional. Poor sleep fuels inflammation and raises diabetes risk by 30–50 per cent, and those conditions, in turn, further damage sleep.

 

“Insomnia is frequently a symptom of underlying ill-health rather than ageing itself,” he says.

Why are women more vulnerable, and does hormone therapy help?

Women face a steeper sleep challenge. “Women are about 1.5 to two times more vulnerable to insomnia after menopause,” says Dr Singhal. Falling oestrogen and progesterone levels trigger hot flashes, night sweats and repeated awakenings, cutting into deep sleep.

 

Hormone replacement therapy (HRT) can help, but selectively. “In women with significant vasomotor symptoms, HRT can reduce night awakenings by nearly 50 per cent,” he says. “But it’s not a universal solution and should be used short-term in carefully selected patients.”

Men aren’t spared either. Declining testosterone during andropause worsens sleep apnoea and night-time awakenings.

What lifestyle changes can improve sleep among older adults?

“Regular exercise, consistent sleep schedules and cognitive behavioural therapy for insomnia can reduce awakenings by 50–70 per cent,” says Dr Singhal.

 

Morning sunlight is especially potent. “Thirty minutes of morning light helps reset the ageing body clock,” he explains.

 

Other non-negotiables include early, light dinners; limiting caffeine; and avoiding alcohol, which disrupts sleep more severely with age than in youth.

 

“These changes fix the circadian and metabolic roots of poor sleep,” he adds. 

Can sleep aids like melatonin help in old age? 

“Melatonin can help older adults who have low natural levels,” says Dr Singhal. “The effective dose is usually 0.5 to 3 mg, taken one to two hours before bedtime.”

 

However, Dr Singhal warns that long-term or unsupervised use can suppress the body’s own production. He further says that popular herbs like valerian and ashwagandha carry no strong proof for treating sleep disorders. “They are safer than sleeping pills, but lifestyle changes work better.”

Why are sleeping pills risky?

According to Dr Singhal, sedatives are particularly dangerous in older adults. “They slow brain signals, increasing dizziness and doubling fall risk,” Dr Singhal explains. “They impair memory and raise dementia risk by 50–80 per cent. Dependence is common because older bodies clear drugs more slowly.”

Short-term use, say one to two weeks, may be justified during acute crises like bereavement.

 

Dr Singhal stresses that good functional sleep means feeling rested and alert during the day, even if one wakes up at night. “Ageing changes sleep,” Dr Singhal says, “but suffering through bad sleep is not a requirement of growing older.”

https://www.business-standard.com/health/ageing-insomnia-older-adults-sleep-worse-how-to-fix-it-neurologist-126012200676_1.html

Do phone sleep trackers work?

From delawarepublic.org

SARAH MCCAMMON, HOST:

Wearable sleep tech, like smart watches or rings that take real-time health metrics, have made it super easy for the average snoozer to track their sleep from one night to the next. But is all that data giving you more rest or more stress? Life Kit reporter Andee Tagle investigates.

ANDEE TAGLE, BYLINE: One of the first things that Dr. Ravi Aysola often tells his patients is that insomnia, that is, trouble falling or staying asleep, is normal, at least from time to time. There's no need to fear the occasional bad slumber.

RAVI AYSOLA: Whether you're particularly stressed or excited, perhaps, or anxious. What we want to avoid is a chronic pattern of insomnia, and I think that has significantly worsened in our society for a number of reasons.

TAGLE: Aysola is a clinical professor of medicine, and the director of the Center for Sleep Medicine at UCLA. Among some of the modern threats to our sleep, he says, over-caffeinating, irregular schedules and the abundance of sensory input from our environments and our tech. And Aysola says there's an increasingly common issue to add that list, a condition called orthosomnia.

AYSOLA: It's a huge problem. I think all sleep physicians have experienced this. A patient comes in, and - well, what's the reason you're coming in today? Well, my tracker tells me I'm not getting enough X, Y, Z sleep, you know, slow-wave sleep or deep sleep or REM sleep.

TAGLE: Aysola says sleep trackers, like the kind on your phone or health ring or smart watch, can be very helpful for identifying patterns in your sleep, especially for people being treated for acute or chronic levels of insomnia. But they can also create a lot of sleep anxiety.

AYSOLA: The fear that I'm not going to sleep, and what are the consequences of that going to be the next day? How am I going to perform? And that pattern is very activating to our nervous system. It sets us on kind of the high alert, fight or flight kind of path, and that's not compatible with sleep.

TAGLE: That kind of thinking can lead to a slow sleep score, can lead to staying in bed longer to try and force it, can lead to more stress, can lead to even less sleep, can quickly spiral into a pattern of insomnia. Trackers can make it easy for you to want to gamify or perfect your sleep. But...

AYSOLA: It's not something that has to be achieved. And especially personality types that are focused on, you know, fixing problems and, you know, coming up with solutions, that sometimes is a hard place to get to.

TAGLE: If you're set on tracking, Aysola says make sure to have a set goal in mind. Maybe you're trying to get at least seven hours every night, or you want to see how your new workout schedule is impacting your rest. Whatever you're aiming for, when you wake up each morning...

AYSOLA: Feel your body first.

TAGLE: As in, before you check your tracker, tune in. Are you energized or could you sleep for another three hours? Is your brain foggy and full of cobwebs or is that morning run calling your name? Don't let those sleep scores skew your memory.

AYSOLA: This told me that I had a bad night last night, and I remember waking up X number of times and tossing and turning, and I feel terrible today. And the tracker kind of confirms that. I think that is meaningful information to at least tell you that this is matching up with how I feel.

TAGLE: To get the clearest picture, you want to log your data over a longer period of time, like, weeks or months, not just days. And if you find your numbers aren't matching up with your experience on a consistent basis, you could consider talking to your doctor or just ditching your tracker because you don't need tech to keep tabs on your sleep. Paper and a pen by your bedside work well, too, and are actually standard practice in many insomnia treatment programs because they can help you focus on the feeling of your rest, rather than the data. And Aysola says remember, that's the important part.

AYSOLA: Persistent insomnia is not out of your control. The real goal is to try to take that power away from the devices and the things that drive our fear and anxiety and bring that power back internally, being able to self-regulate to allow sleep to happen. 

Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

https://www.delawarepublic.org/2026-01-18/do-phone-sleep-trackers-work 

What Good Sleep Looks Like in Your 20s, 30s, 40s, 50s, and 60s

From realsimple.com

Sleep experts share how to get a good night's sleep the older you get 

As you age, your sleep patterns can change. It can become totally normal to need more daytime naps or deal with shortened sleep cycles at night. Some of it is due to the number of birthday candles on your cake, but your environment and lifestyle can also play a huge role in your sleep health. How often you exercise, the food you eat, how much water you drink and your stress levels can all impact quality of sleep.

"Once you reach your 20s, your body has more or less established a stable sleep-wake cycle," explains Nicole M. Avena, Ph.D., assistant professor of neuroscience at Mount Sinai School of Medicine and author of Sugarless: A 7 Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction. "However, many people may not understand this cycle until later in life, such as in their 30s or 40s." Just in time for things to change!

Whether you're in your 20s, 30s, 40s, 50s, or 60s, here's everything you should know about common age-related sleep changes to look out for and what you can do to navigate them, according to sleep experts.

Sleep in Your 20s

The CDC recommends that all adults ages 18 to 60, regardless of age group, aim to get seven or more hours of sleep per night. Of course, that can be hard. Maybe you feel like you're fine with less than that. Or maybe you're in your 20s, points out Charissa Chamorro, Ph.D., Assistant Clinical Professor at Icahn School of Medicine at Mount Sinai in New York City. "Young adults often have irregular sleep patterns due to work, socializing, and screen time," she explains. She recommends keeping your sleep and wake times within one to two hours of your weekday patterns. "Establishing a stable sleep schedule can set a strong foundation for lifelong healthy sleep," Chamorro adds.

That said, life can be unpredictable. People in this age group have more flexibility in their physical needs, so there is some flexibility in how consistent they need to be in maintaining good sleep habits, says Paul Kaloostian, M.D., a California-based neurosurgeon. If you can't be perfect with your sleep schedule, aim to practice good sleep habits more often than not, Dr. Kaloostian advises.

The brain, as he explains, is "very plastic" in this age group. However, there are still steps 20-somethings can take to build lifelong healthy sleeping habits. "People in their 20s should avoid significant intake of caffeine (more than one cup a day), minimize stress, and exercise at least 30 minutes a day to ensure adequate sleep," he suggests.

Dr. Lynelle Schneeberg, Psy.D., a fellow of the American Academy of Sleep Medicine and the author of Become Your Child's Sleep Coach, says people in their 20s who are struggling to establish an earlier rise time can use simple steps to wake up earlier. The key, she says, is consistency: Getting up at the same time every day (or at least trying to) can help you wake up earlier and fall asleep earlier (and more easily). Exposing yourself to natural sunlight and eating breakfast within an hour of waking up can also help your mind associate the morning with getting ready to start the day.

Sleep in Your 30s

Avena explains that the amount of sleep people get tends to decrease with age. "Research has shown that Stage 3 of non-rapid eye movement (NREM) sleep decreases by 2 percent each decade up until the age of 60," she says. "Rapid eye movement (REM) also decreases until about 60 with each decade."

Though 30-somethings may start to feel these expected age-related effects, one of the biggest hurdles to overcome at this point in life are environmental factors (e.g. work schedule, technology use, family obligations, financial stress). Your 30s are also a smart time to address any sleep disorders, like insomnia or sleep apnoea, which can both affect overall health in the long term if left untreated.

"People in their 30s are typically now out of school and working and/or raising a family," Dr. Kaloostian says. This means parents often have to balance their own sleep (and sleep quality) on the sleep habits of their children, especially babies and toddlers. Schneeberg adds that parents in their 30s can teach their children to be good sleepers, which can then help parents develop healthy sleep patterns themselves.

"Most plans [for children] include a consistent and calming bedtime routine each night followed by the use of self-comforting objects (a blanket or stuffed animal for a younger child and a reading light and some books for older ones)," she says. "Once the routine is over and your child has items for self-comfort, you can gradually taper away your presence."

The general advice for 20- and 30-somethings remains the same: consistent sleep-wake schedules, limiting caffeine, getting enough exercise, drinking plenty of water and eating healthy foods to promote good sleep.

Sleep in Your 40s

According to Chamorro, this period is often when adults report the most disrupted sleep due to the stress of career and family life. For example, stress can make it harder to fall asleep or cause you to wake up throughout the night. "This is the decade where it is most important to establish regular self-care routines," Chamorro says. "Make it a priority to incorporate regular relaxation techniques like deep breathing, mindfulness, and yoga—both before bed and throughout the week. Establishing regular self-care routines can help you manage your stress, which will help you establish and maintain more restorative sleep."

Beyond that, Kaloostian says people in their 40s should follow the same sleep health advice as those in their 20s and 30s. During this decade it's also important to educate yourself on how your sleep may change in the decades that follow (and what you can do ahead of time to prevent some of those changes).

"Sleep doesn't just mirror your age, it mirrors your health, too," Avena explains. "Certain health conditions and even your health from day to day can impact how well you sleep at night."

While healthy sleep guidelines are mostly universal, Avena recommends tailoring them to your own specific needs for maximum benefits. "When do you function best? Early in the morning or late at night?" she says to ask yourself. "When you understand your body's internal clock, you can start to build a healthy sleep routine around that."

Establishing a ritual before bed can also help signal to your brain that you'll be going to sleep soon, Avena continues, "like taking a shower and brushing your teeth before hopping into bed." Avoiding too much napping (especially later in the afternoon) can also be helpful in sleeping better through the night.

Sleep in Your 50s

Your 50s may bring on the most pronounced sleep changes. "People in their 50s start to develop medical co-morbidities often requiring numerous medications, which can greatly affect one's ability to obtain adequate sleep," Kaloostian says. In addition to leading a healthy lifestyle, he also suggests consulting with your primary care doctor to "ensure that there are no medications contributing to causing insomnia."

This decade in life also sees gender-based sleep changes, particularly for women going or beginning to go through menopause. "During menopause, rates of insomnia in women drastically increase," Avena says. The latest studies suggest that up to 26 percent of menopausal women experience sleep difficulties that qualify as insomnia. "This means that we may see sleep quality decline in the 50s for women specifically."

Kaloostian adds that a decreased function of the hypothalamus portion of the brain, and changes in melatonin and cortisol hormones, begin to occur in the 50s age group as well, which can also impact quality and duration of sleep. This is why people often begin to sleep less as they get older or wake up more frequently throughout the night.

A great way for people in their 50s (and everyone, really) to promote good sleep is to get as much natural sunlight as possible, which Kaloostian says people tend to get less of as they get older. Stress management is also crucial for falling and staying asleep better (here are some helpful strategies for managing stress).

Sleep in Your 60s

It's common to experience more fragmented and less restful sleep during this decade for numerous reasons, according to Chamorro. "As we age, our bodies produce less melatonin, which can make falling and staying asleep more difficult," she says. "In addition, health conditions like arthritis, sleep apnea, or the need to use the bathroom at night can also contribute to disrupted sleep," Chamorro points out. Sleep may also feel less restorative because older adults spend more time in the earlier, lighter stages of sleep and less time in the later, deeper stages of sleep, Chamorro adds.

What's more, people in their 60s tend to nap during the day, which only exacerbates their sleeping problems at night, Avena says.  "Daytime napping can disturb circadian rhythm," Avena says.

To get the best sleep possible, you'll want to stick with all the basics: Have a consistent sleep schedule, limit alcohol, avoid caffeine past 1 p.m. get physical activity throughout the day, and keep your bedroom cool, dark and quiet, Chamorro advises. If you can, establishing a nighttime routine can help signal your body that it's time to wind down, she says. "I encourage people to create a routine that they can follow and enjoy. This may include first washing your face, then enjoying a warm cup of herbal tea, engaging in some light stretching, and finally, reading a book or listening to a sleep story before bed," Chamorro says.

The bottom line: regardless of age, leading a healthy lifestyle is important to quality sleep. Whether you're in your 20s, 30s, 40s, 50s or 60s, give yourself enough time to get a good night's sleep and take care of yourself throughout the day by eating healthy foods, exercising regularly, and drinking plenty of water. For any sleep concerns, always consult a doctor first to figure out a sleep management plan that works best for your individual needs.

https://www.realsimple.com/sleep-health-in-20s-30s-40s-50s-11886849

4 ways to beat the anxiety of insomnia — and get back to sleep

From kpbs.org

Clinical psychologist Steve Orma was in his early 40s when he developed insomnia — difficulty falling asleep or staying asleep.

He couldn't stop fixating on it. "I started getting into the frame of mind most people get sucked into. I worried, 'What's going on? Is there something wrong with me?'" he says.

That fear of not being able to sleep is a phenomenon called "sleep anxiety," says Orma, who went on to become a specialist in insomnia treatment. Left untreated, that anxiety can prevent people from actually falling asleep.

"The more you focus on it, the less chance you'll sleep, which then makes you more anxious. That's the cycle that spins," he says.

One of the most powerful ways to overcome sleep anxiety is cognitive behavioural therapy for insomnia (CBT-I). It's well studied, doesn't rely on sleep drugs and has been shown to be effective for clinical insomnia. Orma used this treatment to heal his sleep, and it's now the main focus of his therapy practice.

Typically, a CBT-I program lasts about six to eight weeks, and each week, you and a provider work on a strategy to reset sleep behaviours and restructure your thinking around rest.

But you don't have to be in an official program to benefit from CBT-I. Whether you're dealing with some sleep stress or just the occasional off-night, these CBT-I practices can help.

Wake up at the same time every day

                                                                                                                               Antoine Doré for NPR

Having a consistent wake-up time helps your body know when it's time to get sleepy, says Aric Prather, a sleep scientist and the author of The Sleep Prescription: 7 Days to Unlocking Your Best Rest. The sleepy cues are managed by your circadian rhythm, or your body's internal clock. A set wake-up time keeps your internal clock ticking on time.

Prather uses the analogy of a "sleep balloon." When you wake up, your sleep balloon is empty. Your balloon fills up with sleepiness throughout the day. Once it's full, you feel ready to sleep. Waking up at the same time every day, even on weekends, keeps your sleep cues consistent.

Focus on a wind-down time, not a bedtime 

Instead of trying to force yourself to go to bed at a specific time, even though you're not sleepy, focus on winding down for bed earlier, says Dr. Ravi Aysola, director of the Sleep Disorders Center at the University of California, Los Angeles.

Pick a time to transition from daytime activities to night-time activities. This can look like unplugging from screens, putting on comfortable clothes and dimming the lights in your home.

He says having a wind-down time instead of a strict bedtime can help lessen the feeling that you must get to sleep immediately — and can reduce the anxiety that can occur when you don't.

Schedule your "worry time"

If all your stress comes flooding in at bedtime, put some dedicated "worry time" on your calendar during the daylight hours, says Prather. "Use your brain space when you're more rested to do some worrying."

That way, if your brain starts to drift to tax season, child care troubles or that big mess in the garage while you're in bed, "you have a way of saying, 'I did this worrying already,'" he says.

Try taking just 10 or 15 minutes at the same time each day to write out what's bothering you. It can help your brain relax when your head hits the pillow, Prather says.

Be mindful when tracking sleep

Managing sleep anxiety means also being cognizant of how much information you're taking in about your sleep.

The prevalence of sleep-tracking devices and wearables has led to the advent of orthosomnia, a type of insomnia developed from anxiety over wanting to achieve perfect sleep data, says Aysola. 

Sleep trackers can give you helpful information about how you slept, but it's important to have a healthy level of scepticism when it comes to the data and a plan for what you'll do with it, he adds.

If you use these devices to track your sleep, he says to ask yourself: "Is that information helping you make changes in your behaviour or lifestyle, or is it stressing you out and making the insomnia worse?"

If you notice you've been waking up feeling more rested, for example, that could tell you that your new wind-down time and earlier morning alarm are starting to work for you.

If you tend to fixate on your sleep-tracker data, try tracking your sleep with a pen and paper instead. It can help you focus on how your sleep is feeling to you instead of the numbers.

Reshaping your sleep habits is only half the battle, Orma says. The rest of the work comes down to shifting your mindset. Sleep will vary from night to night and everyone has a bad night of sleep now and then, so adjust your expectations accordingly.

"When you have that frame of mind, your sleep starts to get better," he says.

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The digital story was edited by Malaka Gharib, with art direction by Beck Harlan. We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.

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https://www.kpbs.org/news/health/2026/01/15/4-ways-to-beat-the-anxiety-of-insomnia-and-get-back-to-sleep

What Happens to Your Sleep When You Take Apple Cider Vinegar Before Bed

From verywellhealth.com

Key Takeaways

• Apple cider vinegar (ACV) may indirectly promote sleep by regulating blood sugar levels and supporting weight loss.
• ACV is typically safe to try, but you should not consume it in large doses.
• A healthcare provider can help diagnose and treat insomnia, as well as other sleep-related conditions.

Apple cider vinegar's (ACV) potential benefits for sleep are primarily linked to its impact on specific health concerns, rather than its direct effect on sleep.

                                                                                                New look casting / Getty Images

Apple Cider Vinegar May Help Conditions That Interfere With Sleep

Apple cider vinegar may impact various health conditions and indirectly improve sleep in the following ways:

• Regulates blood sugar: ACV may help regulate blood sugar. When blood sugar levels are too high or too low, they can interfere with sleep. People who have diabetes or insulin resistance may benefit the most from ACV for sleep.
• Helps manage weight: Several studies suggest that taking a daily dose of 30 millilitres (ml) is associated with significant weight loss over a period of 12 weeks. People who are overweight, obese, or have type 2 diabetes have the most improvement. Excess weight is a risk factor for getting a lower quality of sleep.

The evidence supporting these potential uses of ACV is limited, and there is no recommended dose for taking ACV to promote sleep.

ACV is generally safe for most people, but it is recommended to consult a healthcare provider first to understand the potential risks and side effects.

Potential Downsides to Taking ACV For Sleep

Some risks are associated with taking ACV, particularly when taken in larger quantities. Taking the lowest effective dose can reduce your risk of these potential side effects.

Potential downsides include:

• Decreased mineral levels (e.g., potassium)
• Digestive tract irritation
• Tooth erosion (when taken as a liquid with water)
  

Minimize the risk of tooth erosion by taking it in pill form to avoid direct contact with the vinegar on the teeth.

https://www.verywellhealth.com/apple-cider-vinegar-sleep-11883363