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.”
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.
Experts reveal the habits to adopt and the ones to drop if you want to get at least seven hours of good quality sleep a night
We've all been there. You arrive at work feeling tired and bleary-eyed after a night plagued by insomnia, only to be greeted by your bright-eyed co-worker who's running on a full sleep. Pouring yourself an extra-strong black coffee, you ask yourself, "What's the difference between me and them?"
Turns out, there can be a number of key differences between an insomniac and someone who gets at least seven hours of sleep a night. "People who consistently sleep well don't necessarily have perfect routines, but they often share certain behaviours," says Sam Sadighi, a certified sleep practitioner at Get Laid Beds.
Although everyone's experience is different, Sadighi says that people with insomnia also "often share some common patterns" that can disrupt sleep.
Here Saighi and Mike Wakeman, a pharmacist and sleep researcher at Evera Nutrition, reveal the key habits that separate the sleep deprived from those getting plenty of rest. Here are the five habits of insomniacs vs the top three habits for better sleep...
Key takeaways
Insomniacs often worry about not getting enough sleep and clock watch, which can exacerbate their sleep issues.
Irregular betimes and wake-up times are also common among insomniacs.
People who consistently get 7 hours+ sleep a night often get enough daylight and establish a consistent sleep schedule and relaxing night-time routine.
However, good sleep habits aren't always enough to treat chronic insomnia. Anyone experiencing persistent sleep problems should speak to a doctor.
5 key differences: What insomniacs do
1. They try to force sleep
(Image credit: Future)
If you've ever found yourself, in the middle of the night, clock watching or calculating how much time you have left before you need to get up, then you're likely just making the problem worse.
2. They have irregular sleep patterns
One of the most common sleep habits associated with insomnia is going to bed and waking up at different times every day.
"Going to bed at 10 p.m. one night and 1 a.m. the next makes it difficult for the body's internal clock to establish a consistent rhythm," says Wakeman.
"Trying to grab sleep whenever they can (understandably), means that they disrupt their circadian rhythm, which has been shown to actually make it all harder," agrees Sadighi.
3. They skip the wind-down routine
Nighttime routines should help you to relax and prepare you for bed, but not all activities that help you relax should be part of yours.
