If getting a good night’s sleep seems harder than it used to be, you’re not imagining it.
Adults over 50 frequently report getting less sleep — and often find themselves waking earlier, sleeping more lightly, or getting up several times throughout the night.
“While older adults may find it harder to obtain adequate sleep, the biological need for sleep does not significantly decrease as you age,” says Saema Tahir, MD, a board-certified sleep medicine physician and pulmonologist with a private practice in New York City. “Changes in sleep duration and quality are common with age, but should not be considered simply ‘normal’ or ignored — they carry real health consequences.” Poor sleep has been linked to a higher risk of heart disease, cognitive decline, and mental health conditions like depression.
Fortunately, understanding age-related biological changes — including shifts in metabolism, hormones, and the body’s internal clock — can help you take steps to improve your sleep and support healthy aging.
iStock
1. Metabolism Changes Can Interfere With Sleep — Support Both With Healthy Daily Habits
As you age, your metabolism naturally changes. Muscle mass tends to decline, fat distribution shifts, and age-related changes in fat tissue can contribute to insulin resistance, which makes it harder for the body to regulate blood sugar efficiently.
Your metabolism is also closely linked with sleep. Poor or insufficient sleep can disrupt blood sugar regulation, appetite hormones, and other metabolic processes — potentially contributing to insulin resistance and weight gain. In turn, metabolic conditions such as obesity and type 2 diabetes are commonly linked to sleep disorders like obstructive sleep apnoea. Over time, this can create a cycle in which poor sleep contributes to poorer metabolic health, which may further interfere with healthy sleep.
“What I really emphasize is that no hack, pillow, or supplement will fix sleep,” Dr. Tahir says. “Eating your last meal at least three hours before bed, reducing refined carbohydrates and alcohol, and maintaining physical activity all have evidence supporting improved sleep quality through metabolic pathways.”
2. Melatonin Naturally Declines With Age, but You Can Still Strengthen Your Body’s Sleep Signals
Melatonin is a hormone that helps regulate your body’s internal clock by signalling when it’s time to feel sleepy. Its production is closely tied to light exposure, rising in response to darkness to promote sleepiness and falling with morning light to help you wake up.
Beginning around age 40, the body gradually produces less melatonin at night, and the timing of its release may also shift — making it harder to fall and stay asleep.
Rather than relying on melatonin supplements alone, which can interfere with medications and cause daytime drowsiness in older adults, experts recommend strengthening your body’s natural sleep signals through light exposure and daily routines.
“Get bright outdoor light during the day, especially in the morning, and keep your evenings dim and relaxing by reducing bright screens and overhead lights close to bedtime,” says Junxin Li, PhD, RN, an associate professor at Johns Hopkins School of Nursing in Baltimore, who researches the impact of aging on sleep. “A regular sleep-wake schedule, consistent meal timing, and limiting alcohol near bedtime can also support the circadian system.”
3. Addressing Hormonal Changes Can Help Relieve Sleep Issues in Menopause and Beyond
For many women, declining oestrogen, which helps regulate body temperature, and progesterone, which has sleep-promoting effects, can contribute to night sweats, night-time awakenings, and difficulty falling asleep. Mood changes and other menopause-related symptoms can further disrupt sleep. And these sleep issues may persist years after your final menstrual period.
“Often what happens is that hormonal changes and other symptoms, like hot flashes, first cause insomnia to develop during menopause,” says Philip Gehrman, PhD, a professor of clinical psychology in psychiatry at the Hospital of the University of Pennsylvania in Philadelphia, and a behavioural sleep medicine research expert who has researched sleep disorders in older adults. “But then the insomnia takes on a life of its own, persisting into the postmenopausal period.”
Dr. Gehrman suggests tailoring sleep strategies to symptoms. For night sweats, consider tactics like keeping your bedroom cool, choosing lightweight bedding and sleepwear, and discussing persistent symptoms with your healthcare provider. Treatments like cognitive behavioural therapy for insomnia (CBT-I) involve working short-term with a healthcare professional to work on your bedtime routine and other sleep-related behaviours and can help improve sleep over time.
4. If You’re Getting Less Deep Sleep Than You Used to, Focus on Sleep Quality
The structure of your sleep naturally changes with age. Beginning in midlife, adults gradually spend less time in deep, slow-wave sleep — the sleep stage most associated with physical recovery and feeling refreshed — and may wake more often throughout the night.
This shift is thought to stem, in part, from age-related changes in the brain’s sleep-regulating neurons, Tahir explains. Research suggests that aging can weaken the body’s internal clock and its ability to build up the pressure needed to sleep, which contributes to earlier and more fragmented sleep. As a result, even spending enough hours in bed can leave you feeling tired the next day.
Although researchers haven’t identified an evidence-backed way to restore the deep sleep lost with aging, healthy habits can help you get more restorative sleep. Exercise may promote deeper sleep, while limiting alcohol near bedtime and treating sleep disorders can prevent disruptions that fragment sleep.
Many older adults can train their brains for more effective sleep. Gehrman says CBT-I uses behavioural strategies to train the brain to associate the bed with sleep rather than wakefulness and establish a more consistent sleep-wake pattern.
“Cognitive behavioural strategies can help reduce time spent awake — including keeping a regular sleep and wake schedule, winding down before bed, and getting out of bed to do relaxing activities if you’re unable to sleep,” he adds.
5. Cortisol Level Shifts Can Be Managed With Stress Relief Techniques
Cortisol, a main stress hormone, normally follows a daily cycle — dropping at night to promote sleep and rising in the morning to wake you up. For some, this rhythm may become altered during menopause, prompting higher evening cortisol levels that can contribute to difficulty falling asleep or night-time awakenings.
To support a healthy cortisol rhythm for sleep, Li underscores the importance of sticking to a set bedtime and prioritizing stress management in your daily routine.
“A calming wind-down routine before bed — such as slow breathing, meditation, gentle stretching, reading, or other relaxing activities — can help signal safety and reduce night-time alertness,” Li says. “It’s also helpful to avoid stressful work, intense conversations, news, TV shows, or problem-solving right before bed.”
6. Bladder Changes Can Be Mitigated by Tweaking Your Fluid Intake
Getting up to use the bathroom more than once, known as nocturia, is a common reason adults over 50 wake up during the night.
Age-related changes in the bladder and kidneys can increase night-time urine production, making bathroom trips more frequent.
Shifts in hormones that regulate fluid balance, along with medical conditions that are common with age, like an enlarged prostate and obstructive sleep apnoea, can also contribute to nocturia.
“Nocturia is one of the most common causes of sleep fragmentation in this age group,” Tahir says. “Evidence-based strategies include restricting fluids after 6 p.m., reducing caffeine and alcohol intake, treating underlying contributors like prostate or bladder issues, and timing any diuretic medications to the morning rather than evening.”
Melatonin has become the bedtime routine many people barely think about anymore: brush your teeth, plug in your phone, take a gummy, and turn out the lights. Because melatonin is available without a prescription and is naturally produced by the body, it’s easy to assume that taking it nightly is essentially harmless. Yet sleep experts draw an important distinction between occasional short-term use and relying on a supplement indefinitely to treat persistent insomnia. The National Center for Complementary and Integrative Health says melatonin appears relatively safe for short-term use, but its long-term safety has not been established.
That uncertainty doesn’t mean nightly melatonin has been proven dangerous; it means researchers don’t yet have enough high-quality evidence to say with confidence what years of routine use may mean for everyone. If taking melatonin every night has become something you do automatically, there are several things worth understanding before tonight’s dose.
Melatonin Isn’t Really a Traditional Sleeping Pill
Melatonin is a hormone your brain naturally produces in response to darkness, helping regulate the body’s circadian timing and sleep-wake cycle. Supplemental melatonin is often used when the problem involves sleep timing, including situations such as jet lag, while research into its effectiveness for shift workers has produced more limited or inconclusive results. NCCIH reports that research suggests melatonin may also modestly improve how quickly some people with insomnia fall asleep and reduce daytime sleepiness. However, a review cited by NCCIH found that it did not improve other important outcomes such as overall sleep quality or the amount of time people remained awake during the night. That means taking melatonin every night may not address the actual reason you’re struggling to sleep.
Sleep Experts Don’t Recommend It as the Go-To Treatment for Chronic Insomnia
This is probably the biggest misconception surrounding nightly melatonin use. The American Academy of Sleep Medicine’s pharmacologic guideline recommends against using melatonin to treat sleep-onset or sleep-maintenance insomnia in adults because the evidence supporting its effectiveness was considered insufficient. That recommendation doesn’t mean melatonin never helps anyone, nor does it mean a clinician will never suggest it for a particular sleep problem. It means chronic insomnia shouldn’t automatically be treated by indefinitely adding an over-the-counter supplement to your nightly routine. If you’ve been taking melatonin every night for months because you cannot sleep without it, persistent insomnia itself deserves attention.
Melatonin may help certain sleep problems, but its long-term safety isn’t fully established. If nightly use has become a months- or years-long habit, consider discussing the dose, medications, and underlying sleep problem with a healthcare professional. Poh Smith/Shutterstock
We Know More About Short-Term Use Than Years of Nightly Use
One of the challenges with melatonin is that widespread availability can create more certainty about long-term safety than the evidence actually supports. NCCIH specifically says short-term use appears relatively safe for most people, while the long-term safety of melatonin supplements has not been established. That’s different from saying researchers have proven that taking it for years is dangerous; rather, the evidence isn’t strong enough to make confident conclusions about prolonged routine use. People sometimes hear “natural” and translate that into “safe at any dose for any length of time,” which isn’t how hormones or supplements work. A person who has used melatonin nightly for years shouldn’t panic, but discussing continued use with a healthcare professional is reasonable.
The Side Effects Can Show Up the Next Day
Melatonin’s potential drawbacks aren’t limited to questions about years of use because some people notice effects much sooner. NCCIH says mild side effects reported in short-term studies have included headache, dizziness, nausea, and sleepiness. Daytime drowsiness deserves particular attention if you’re driving, operating equipment, or already taking medications that can make you sleepy. Older adults may also process melatonin differently; it may remain active longer in older people and contribute to daytime drowsiness. If taking melatonin every night leaves you groggy the following morning, that is worth discussing with a healthcare professional rather than assuming feeling sluggish is simply the price of getting to sleep.
What’s in the Bottle May Not Match What’s on the Label
Another issue has nothing to do with melatonin itself and everything to do with the supplement marketplace. TheFood and Drug Administrationdoes not approve dietary supplements for safety and effectiveness before they reach consumers, placing responsibility on manufacturers to comply with applicable safety and labelling requirements. NCCIH highlights a 2023 analysis of 25 melatonin gummies in which 22 were inaccurately labelled, with measured melatonin ranging from 74% to 347% of the labelled amount among products containing detectable melatonin. FDA researchers have separately analysed supplement products and found wide variation in melatonin content relative to label claims, reinforcing concerns about quality control. Consequently, taking melatonin every night doesn’t necessarily mean you’re consistently consuming exactly the dose printed on the bottle.
Quality-control concerns aren’t limited to one small study. FDA researchers analysing 110 melatonin supplement products marketed for children found measured amounts ranging from zero to 667% of the label claim, further illustrating why consumers should not assume every supplement precisely matches its packaging.
More Melatonin Isn’t Necessarily Better
Melatonin has become a nightly habit for many adults, but sleep experts say long-term safety has not been established and persistent insomnia may warrant a closer look at what is disrupting sleep. Microgen/Shutterstock
Walk through the supplement aisle and you’ll find melatonin products marketed in dramatically different strengths, which can make larger numbers look more powerful. But melatonin isn’t a medication where doubling the dose automatically produces twice the sleep benefit, and taking more can increase the opportunity for unwanted effects without addressing the cause of poor sleep. The uncertainty surrounding supplement content makes casually escalating the dose even less appealing when the amount inside some products may already differ from what’s printed on the package.
Timing matters too because melatonin is involved in signalling the body’s biological night, so taking an arbitrary dose at an arbitrary bedtime isn’t necessarily equivalent to using it strategically for a specific circadian problem. There also isn’t one universally appropriate over-the-counter dose for every adult, making self-escalating from one gummy to several a poor substitute for determining why sleep remains difficult.
Rather than repeatedly increasing the dose because the previous amount “stopped working,” that’s a good point to talk with a physician, pharmacist, or sleep specialist about what’s actually disrupting sleep. Persistent trouble falling asleep, frequent awakenings, or poor daytime functioning can have causes that another gummy won’t solve.
Melatonin Can Matter When You Take Other Medications
Over-the-counter doesn’t mean interaction-free, particularly for older adults taking several prescription medications. NCCIH advises people taking medications to consult their healthcare providers before using melatonin and specifically notes that people taking blood thinners or those with epilepsy should use it under medical supervision. This is especially relevant because supplement use can easily be forgotten when a doctor asks someone to list their “medications.” Bring the bottle or write down the product, dose, and frequency at your next appointment so your clinician or pharmacist knows exactly what you’re taking. If taking melatonin every night is part of your routine, it belongs on your medication-and-supplement list just like everything else.
Your Sleep Problem May Need a Different Treatment
Taking something every night can gradually shift attention from the question that matters most: Why aren’t you sleeping? Chronic insomnia can coexist with medical conditions, medication effects, mood disorders, restless legs, sleep apnoea, irregular schedules, and behavioural patterns that need different approaches. For chronic insomnia, current American Academy of Sleep Medicine guidance strongly recommends cognitive behavioural therapy for insomnia, or CBT-I, which combines techniques designed to change sleep-related behaviours and thought patterns.NCCIH’s review of that guidanceidentifies CBT-I as a strongly recommended treatment for adults with chronic insomnia. Someone who has spent months taking melatonin every night without consistently sleeping well may benefit more from evaluating the underlying sleep problem than simply continuing the same routine.
Don’t Panic About Tonight’s Dose
None of this means everyone using melatonin should suddenly throw the bottle away. Melatonin has legitimate uses, short-term use appears relatively safe for most people, and individual circumstances matter when deciding whether it belongs in someone’s sleep routine. The concern is turning an occasional sleep aid into an indefinite nightly treatment without ever asking whether it’s working, whether the dose is appropriate, whether it interacts with other medications, or why insomnia continues. If you’re taking melatonin every night, particularly for months or years, consider reviewing the habit with your doctor or pharmacist rather than automatically increasing the dose or assuming long-term use has been thoroughly studied.
Keeping a simple sleep diary for a week or two (recording when you take melatonin, when you go to bed, approximately how long it takes to fall asleep, night-time awakenings, wake time, and next-day grogginess) can also give a clinician more useful information than simply saying the supplement “works” or “doesn’t work.”
Experts break down what to make of the latest study
Key Points
A new clinical trial suggests that eating almonds may help with sleep.
People who ate about 50 almonds a day reported better sleep quality—but the study was funded by the Almond Board of California.
Experts say there may be some nutritional health benefits to almonds and other nuts that may help with sleep, and that more research is needed.
Even though you’re well aware of the importance of getting enough sleep each night, sometimes it’s just not easy to fall asleep when you’d like. If it happens more often than not, it’s easy to find yourself in a panic spiral of worrying that you’ll never sleep well again.
Now, a new clinical trial published in Frontiers in Nutrition suggests that adding almonds to your daily diet might help you get better sleep. Keep in mind the study was funded by the Almond Board of California, but dietitians say almonds may have something in their nutritional makeup that makes this research worth looking into further.
And though almonds might be one more tool in your sleep-promoting toolbox, they’re unlikely to magically make all of your sleep woes disappear. If you’re seriously struggling with insomnia or other sleep problems, you should talk to a healthcare provider. But for those just looking to snack mindfully, here’s what to know about the latest link between almonds and sleep.
What did the study find?
For the clinical trial, researchers recruited 175 adults in India aged 21 to 55 with poor sleep quality (but excluded those with major sleep disorders like sleep apnoea, narcolepsy, chronic insomnia, and more). Participants were randomized to eat about 50 whole almonds a day (provided by the same Almond Board of California) or another calorie-matched snack for five months. The researchers took a range of measurements on the participants’ sleep quality, like brain-wave recordings and various biochemical markers, including blood tests, at the start of the study and after five months, and also collected participants’ self-reported data on sleep quality.
After crunching the data, researchers found that people in the almond group reported having fewer sleep disturbances and an easier time falling asleep than those in the non-almond group. Their blood tests also showed slightly higher levels of the sleep hormone melatonin than in the non-almond group. People in the almond group were also more likely to achieve a clinically significant improvement in their sleep scores.
“These findings suggest that almonds may enhance perceived sleep quality, with slight objective improvements among responders,” the researchers wrote in the study’s conclusion.
Why might almonds help you sleep better?
The study found that almonds mostly improved perceived sleep quality—meaning, the participants felt (and self-reported) better sleep, while objective sleep changes were more limited. Still, dietitians say there may be something to adding almonds to your sleep regimen.
“Almonds are a good source of magnesium, which has been found in many studies to promote restful sleep because of its impact on muscle relaxation, regulation of melatonin production, and nervous system regulation,” says Jessica Cording, RD, author of The Little Book of Game-Changers.
They also contain tryptophan, which the body uses to make serotonin and melatonin, says Keri Gans, RD, author of The Small Change Diet. “Researchers also observed higher melatonin levels in the almond group at the end of the study, but we can’t say the almonds caused that increase or that melatonin was responsible for the sleep improvements,” she points out.
Beyond outright sleep-boosting nutrition, almonds also deliver a satisfying combination of protein, healthy fat, and fibre, which supports stable blood sugar—which is itself an important aspect of good quality sleep, Cording says.
Could other nuts have the same impact?
It’s tough to say. “Because this study focused specifically on almonds and the evidence is still limited, we can’t assume that other nuts would have the same effect on sleep,” Gans says.
Still, Cording notes that other nuts can support stable blood sugar through protein, fat, and fibre, and some specific nuts offer nutrients similar to almonds. “Cashews also contain magnesium, walnuts contain omega-3 fatty acids and melatonin, and pistachios also provide some melatonin,” Cording says.
What’s the takeaway?
More research is definitely needed, but experts say there may be something here. “Almonds are a nutritious food that can easily fit into an overall healthy eating pattern,” Gans says. “Fit into” is the key part here—50 almonds offer a solid amount of protein, fat, and calories, so you don’t want to just tack that onto what you’re already eating.
If you’re hungry before bed, a nutrient-dense snack that’s easy to digest like almonds can be part of a healthy sleep routine, Cording says. “Also, what you eat throughout the day and your daytime habits are important too,” she says. “Just eating almonds before bed isn’t a replacement for sleep-supporting habits like practicing good sleep hygiene, having consistent sleep and wake-up times, limiting caffeine late in the day, being physically active, and managing stress.”
Neurologist and author Dr. Pedram Navab reveals the simple routine he uses to calm stress and skip 3 a.m. wake-ups
The end of summer is a stressful time for many of us, and if you’re suddenly waking up in the middle of the night, staring at the ceiling, you’re not alone. Many of us on the Tom’s Guide Sleep Team are in the same boat, waking up at 3 a.m. thanks to impending back-to-school routines and stresses, and other big life changes.
Neurologist and sleep medicine specialist Dr. Pedram Navab knows just what it’s like to live with broken sleep at night—a near-fatal car accident, caused by his own extreme fatigue, inspired him to dedicate his career to solving chronic sleep deprivation and insomnia.
According to Dr. Navab, author of the forthcoming new book The Alchemy of Sleep, calming stress before bed is the best way to stop waking up through the night. And you don’t need any fancy sleep tech to do it either. Here Dr. Navab reveals the simple yet effective 3-step routine he uses to calm racing thoughts, fall asleep fast, and sleep through until morning.
3-step routine for better sleep
1. Set a consistent wake time
“The most important advice that I give to my patients all the time is to keep a consistent schedule," explains Dr. Navab. "Basically, try to wake up at the same time each morning. Try to go to sleep at the same time each night."
(Image credit: Future)
Routine is the foundation of good sleep. It's even been linked to longer lifespans; a study by Vitality found going to sleep within a set one hour time frame five nights a week was a key indicator of mortality.
"Sleep likes that routine," says Dr. Navab. "That's why we do so well with a sunrise and sunset time. Because our body runs on the circadian rhythm in tune with the natural rhythm of the sun rising and sun setting."
He notes that a set wake up time allows you to "start that rhythm again." So no oversleeping, even when you're dog-tired. By getting up early, you leave plenty of time for sleepy-chemical adenosine to build up. As a result, you're more likely to drop off quickly the next night.
"Keeping that consistent schedule as much as you can is probably the biggest factor in helping you sleep better,” explains Dr. Navab.
2. Write down 3 things from your day before bed
Find yourself waking up at 3 a.m. in a cold sweat over your to-do list? Or unable to go to bed until you've finished that one last task? Dr. Navab has a fix.
"I tell [my patients], write down one thing that went well today, one thing that could have gone better," he advises.
There's a reason why your thoughts start to race when you climb into bed. Without the hustle of day-to-day life to keep you busy, your brain is free to recall all the anxieties normally kept bubbling under the surface.
"At night, when you're lying alone, it's you and your brain, and you just start thinking," he explains. "So that's why I like the idea of writing one thing that went well, one thing that went badly, things that you could have done differently, to set that day apart. And the next day is the new day."
He describes it as the "tabula rasa" — a blank slate.
3. Get sunlight first thing
Your alarm's gone off and even though you're tired, you know if you want to keep up your new routine, you need to get out of bed.
Dr. Navab's final tip is just what's needed to feel fresher on groggy mornings: a little dose of sunshine.
"Try to get out there and get some sun when you wake up in the morning, at least half an hour," he says. "Even on cloudier days, because you're still getting a little bit of light."
(Image credit: Getty Images)
He notes that sunshine in the morning helps "reset your circadian rhythms". This is because light signals to your body clock that it's time to get up, clearing away the fatigue of sleep inertia.
Keeping healthy circadian function helps with sleep "in general", according to Dr. Navab. It's almost like winding up a watch; it keeps your internal body clock ticking along in time.
What is 'adjustment insomnia' — and why might it be behind your poor sleep?
The end of summer often brings with it a change in routine, particularly for parents and children. You have a new schedule to get used to, new routines to learn, and new pressures rearing their head.
As a result, the relaxed sleep you enjoyed all summer is now taking a downturn.
Upheaval can have a negative impact on your sleep, a phenomenon Dr. Navab describes as "adjustment insomnia." (Often known as short-term insomnia or acute insomnia.)
According to the American Medical Association, roughly one-third of Americans will experience acute insomnia in their lifetime. It can be triggered by a range of factors, with stress a frequent cause.
Following Dr. Navab's tips can help you get your sleep back to its best. And set you up with the healthy routine you need to weather the next sleep storm (...it'll be the holidays before you know it.)
When to speak to a doctor about your sleep?
If you've been experiencing long-term sleep deprivation (three months or longer), your sleep has taken a sudden downturn with no obvious cause, or you suspect you're experiencing sleep apnoea, we recommend speaking to a healthcare professional.
