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.”
It’s 2:17 a.m. You’re exhausted, but wide awake. Your mind races. A sudden wave of heat rises through your body. You finally drift off—only to wake again an hour later. By morning, you feel depleted, foggy, and irritable. And yet, when you mention it to a provider, you’re told it’s “just stress” or “part of getting older.” Instead, you may simply be experiencing insomnia.
Up to two-thirds of people occasionally experience symptoms of insomnia, according to the National Sleep Foundation. But insomnia is more than just a few nights of poor sleep. It is a common sleep disorder characterized by difficulty falling asleep, staying asleep, or achieving restorative sleep—even when there is adequate time and an environment conducive to rest.
While insomnia can be triggered by trauma, stress, life transitions, or medications, researchers are increasingly examining another powerful and often overlooked contributor: menopause.
Sleep disturbances, including insomnia, are common during and after the menopause transition.
According to the World Health Organization, menopause marks the end of menstrual cycles, typically occurring between ages 45 and 55 as oestrogen levels decline. It is associated with symptoms such as hot flashes, mood changes, and sleep disruption, while also increasing long-term risks for conditions like osteoporosis and heart disease. These changes often occur during midlife—a period generally spanning ages 35 to 65—when many women are already managing significant personal and professional responsibilities.
Woman In Bed With Menopausal Insomnia. getty
1. Midlife Is A Significant Risk Factor For Insomnia
As people age, the body’s internal clock (circadian rhythm) may become less resilient to stress and schedule changes. While sleep deprivation at any stage of life can be harmful, chronic insomnia during midlife carries additional emotional and physical consequences.
The National Institute on Aging notes that increased responsibilities during middle age—demanding careers, caring for aging parents, and supporting children—significantly contribute to sleep disruption. Heightened stress and emotional arousal during this period often make it harder to fall or stay asleep.
Menopause can compound these challenges. Hot flashes and other vasomotor symptoms frequently interrupt sleep, and studies suggest that women report higher levels of caregiving-related sleep problems compared to men. A 2026 review published in Menopause found that sleep disturbances remain highly prevalent during postmenopausal years—even among women without significant vasomotor symptoms—and can substantially affect quality of life.
Given these overlapping stressors, tailored treatment strategies are essential. Approaches may include cognitive behavioural therapy, mindfulness practices, yoga, acupuncture or acupressure, dietary improvements, and short-term pharmacologic support when appropriate. Addressing both physiological and psychological contributors is key to improving sleep outcomes.
2. Hormonal Changes May Contribute To Insomnia
Healthy sleep habits—such as maintaining good sleep hygiene and keeping a cool bedroom environment—are important during menopause. However, insomnia is a clinical sleep disorder, not simply “poor sleep,” and often requires targeted treatment.
Menopausal insomnia is influenced by hormonal changes, including increased cortisol and reduced levels of progesterone and melatonin—hormones that play essential roles in regulating body temperature, mood, and sleep cycles. For example, declining oestrogen can trigger night sweats and hot flashes while also contributing to increased anxiety, depression, and irritability. Together, these shifts make it more difficult to relax and fall asleep.
Managing menopausal insomnia requires targeted and effective strategies, one of the most evidence-based being cognitive behavioural therapy for insomnia (CBT-I).
Cognitive Behavioural Therapy for Insomnia (CBT-I) is widely recognized as a first-line, non-pharmacological treatment. A recent study published in Women’s Health Nursing concluded that CBT-I significantly improves sleep quality and reduces insomnia severity in menopausal women. Importantly, its effectiveness was consistent regardless of delivery method (in-person or remote), follow-up duration, or initial insomnia severity.
Because insomnia is so common during midlife and menopause, integrating CBT-I into routine clinical care could greatly benefit patients. Expanding standardized training programs and clinical protocols would help make this evidence-based therapy more widely accessible.
3. Negative Beliefs About Hot Flashes May Worsen Insomnia
While severe hot flashes are known to disrupt sleep, emerging research suggests that beliefs about hot flashes may also play an important role.
A recent study in Menopause examined whether hot flash beliefs were independently associated with insomnia severity. The findings indicated that negative beliefs about hot flashes may heighten physiological arousal and interfere with sleep—regardless of the actual intensity of the symptoms.
In other words, how women interpret and mentally respond to hot flashes may influence the degree of sleep disturbance they experience. This supports a broader mind–body framework, highlighting that cognitive and emotional factors can amplify physical symptoms.
Reframing menopause as a natural life transition rather than a personal failure or pathology may reduce distress and, in turn, improve sleep quality.
Moving Beyond Menopausal Insomnia
Treating insomnia becomes more complex when layered with menopausal symptoms. As research continues to evolve, women can take proactive steps by advocating for comprehensive care, asking informed questions, and seeking providers who approach health holistically rather than offering one-size-fits-all solutions.
While systemic change in women’s health care is still needed, self-advocacy remains powerful. Navigating menopausal insomnia with knowledge, support, and dignity is not only possible—it is essential for long-term well-being.
Growth hormone released during sleep is critical not only for childhood growth but also for adult metabolism. A new study reveals the complex brain circuits involved, offering fresh insights into health and fitness
As every bodybuilder knows, a deep, restful sleep boosts levels of growth hormone to build strong muscle and bone and burn fat. And as every teenager should know, they won’t reach their full height potential without adequate growth hormone from a full night’s sleep.
But why lack of sleep — in particular the early, deep phase called non-REM sleep — lowers levels of growth hormone has been a mystery.
In a study published in the current issue of the journal Cell, researchers from University of California, Berkeley, dissect the brain circuits in mice that control growth hormone release during sleep and report a novel feedback mechanism in the brain that keeps growth hormone levels finely balanced.
The findings provide a map for understanding how sleep and hormone regulation interact. The new feedback mechanism could open avenues for treating people with sleep disorders tied to metabolic conditions like diabetes, as well as degenerative diseases like Parkinson’s and Alzheimer’s.
“People know that growth hormone release is tightly related to sleep, but only through drawing blood and checking growth hormone levels during sleep,” said study first author Xinlu Ding, a postdoctoral fellow in UC Berkeley’s Department of Neuroscience and the Helen Wills Neuroscience Institute. “We’re actually directly recording neural activity in mice to see what’s going on. We are providing a basic circuit to work on in the future to develop different treatments.”
Because growth hormone regulates glucose and fat metabolism, insufficient sleep can also worsen risks for obesity, diabetes and cardiovascular disease.
The sleep-wake cycle
The neurons that orchestrate growth hormone release during the sleep-wake cycle — growth hormone releasing hormone (GHRH) neurons and two types of somatostatin neurons — are buried deep in the hypothalamus, an ancient brain hub conserved in all mammals. Once released, growth hormone increases the activity of neurons in the locus coeruleus, an area in the brainstem involved in arousal, attention, cognition and novelty seeking. Dysregulation of locus coeruleus neurons is implicated in numerous psychiatric and neurological disorders.
Researchers recorded brain activity in sleeping and awake mice while stimulating neurons in the brain’s hypothalamus.
Yang Dan lab/UC Berkeley
“Understanding the neural circuit for growth hormone release could eventually point toward new hormonal therapies to improve sleep quality or restore normal growth hormone balance,” said Daniel Silverman, a UC Berkeley postdoctoral fellow and study co-author. “There are some experimental gene therapies where you target a specific cell type. This circuit could be a novel handle to try to dial back the excitability of the locus coeruleus, which hasn’t been talked about before.”
The researchers, working in the lab of Yang Dan, a professor of neuroscience and of molecular and cell biology, explored the neuroendocrine circuit by inserting electrodes in the brains of mice and measuring changes in activity after stimulating neurons in the hypothalamus with light. Mice sleep for short periods — several minutes at a time — throughout the day and night, providing many opportunities to study growth hormone changes during sleep-wake cycles.
Using state-of-the-art circuit tracing, the team found that the two small-peptide hormones that control the release of growth hormone in the brain — GHRH, which promotes release, and somatostatin, which inhibits release — operate differently during REM and non-REM sleep. Somatostatin and GHRH surge during REM sleep to boost growth hormone, but somatostatin decreases and GHRH increases only moderately during non-REM sleep to boost growth hormone.
Released growth hormone regulates locus coeruleus activity, as a feedback mechanism to help create a homeostatic yin-yang effect. During sleep, growth hormone slowly accumulates to stimulate the locus coeruleus and promote wakefulness, the new study found. But when the locus coeruleus becomes overexcited, it paradoxically promotes sleepiness, as Silverman showed in a study published earlier this year.
“This suggests that sleep and growth hormone form a tightly balanced system: Too little sleep reduces growth hormone release, and too much growth hormone can in turn push the brain toward wakefulness,” Silverman said. “Sleep drives growth hormone release, and growth hormone feeds back to regulate wakefulness, and this balance is essential for growth, repair and metabolic health.”
Because growth hormone acts in part through the locus coeruleus, which governs overall brain arousal during wakefulness, a proper balance could have a broader impact on attention and thinking.
“Growth hormone not only helps you build your muscle and bones and reduce your fat tissue, but may also have cognitive benefits, promoting your overall arousal level when you wake up,” Ding said.
The work was funded by the Howard Hughes Medical Institute (HHMI), which until this year supported Dan as an HHMI investigator, and the Pivotal Life Sciences Chancellor’s Chair fund. Dan is the Pivotal Life Sciences Chancellor’s Chair in Neuroscience. Other co-authors of the paper are Peng Zhong, Bing Li, Chenyan Ma, Lihui Lu, Grace Jiang, Zhe Zhang, Xiaolin Huang, Xun Tu and Zhiyu Melissa Tian of UC Berkeley; and Fuu-Jiun Hwang and Jun Ding of Stanford University.
While insomnia is typically thought of as not being able to fall asleep or stay asleep, there is a lesser-known sleep disorder called late insomnia that can be just as frustrating.
“Late insomnia, or early morning awakening, is when you wake up much earlier than you want to and can’t fall back asleep, even though you’re still tired,” Dr. Angela Holliday-Bell, a physician and sleep specialist, told HuffPost.
While anyone can experience late insomnia, it becomes more likely with age, according to the journal ”Sleep Medicine Clinics.” Sleep doctors say there are a few reasons why late insomnia is more common with age, but the good news is that there is a lot you can do about it.
Why Late Insomnia Is More Common With Age
Late insomnia isn’t an official medical diagnosis, butDr. Meredith Broderick, a sleep neurologist andOzlo medical advisory board member, explained that it describes waking up spontaneously between 1.5 and 2 hours earlier than you plan to. She shared that this isn’t considered a problem if it happens occasionally, but if it occurs at least three times a week for at least three months, it’s considered late insomnia.
There are four major reasons why late insomnia happens and why older adults are most prone to experience it, according to sleep doctors.
1. Circadian rhythm naturally changes as we age
Dr. William Lu, a sleep doctor and the medical director at Dreem Health, told HuffPost that circadian rhythm changes as we age, which can contribute to late insomnia. “The body’s internal clock shifts with age, causing people to feel sleepy and wake earlier than they used to,” he said. Lu explained that older adults tend to spend less time in deep sleep and more time in lighter stages, making them more prone to waking up early.
Circadian rhythm changes as we age, which can contribute to late insomnia. DMP via Getty Images
2. Hormonal shifts
For women, perimenopause and menopause can contribute to sleep disorders, including late insomnia. “In perimenopause and menopause, hormonal shifts — especially declining oestrogen and progesterone — affect the brain’s sleep centre and circadian rhythm. These changes are not just due to hot flashes. These changes can trigger night wakings, especially when combined with elevated cortisol and a dysregulated circadian rhythm, said Dr. Romie Mushtaq, a neurologist, integrative medicine doctor and author of “The Busy Brain Cure.”
Holliday-Bell added to this, saying that lower oestrogen can also lead to lighter, more fragmented sleep. On top of that, she said that many menopausal women experience night sweats and hot flashes that wake them in the early morning hours and make it hard to fall back asleep.
3. Depression and anxiety
All of the sleep experts told HuffPost that late insomnia is a hallmark symptom of depression, which scientific research backs up. Lu explained that depression can lead to waking up in the early morning because it changes the circadian rhythm and leads to elevated morning cortisol levels.
“Anxiety and stress also contribute by keeping the brain in a hyper-alert state, making it difficult to fall back asleep,” he added.
4. Alcohol
Mushtaq told HuffPost that the most common reason for late insomnia that she sees (in adults of all ages) is alcohol use. While alcohol may help someone initially fall asleep, a wealth of scientific research shows that it’s associated with sleep disturbances. These sleep interruptions often happen during REM sleep, which occurs in the second half of the night, including the early morning hours.
How To Stop Experiencing Late Insomnia
The first step to overcoming late insomnia is identifying the reason why you are experiencing it, according to sleep experts. Often, this makes the next step pretty logical. For example, if you tend to unwind in the evening with an alcoholic drink, spend the next few weeks going without it and seeing if it makes a difference. If hot flashes are waking you up and you can’t fall back asleep, outfitting your bed with cooling sheets and lowering the temperature are good first steps to take.
Don’t know what the root cause is? Then it’s time to do some detective work. “Start by looking at your habits. Keep a consistent sleep and wake time, create a calming bedtime routine and avoid alcohol, caffeine and bright screens late in the day,” Holliday-Bell recommended. In other words, take a close look at your lifestyle and change anything that isn’t a good sleep hygiene habit.
If you think your mental health is contributing to your late insomnia, all of the sleep experts recommend seeing a therapist who can help you find healthy ways to manage your depression, anxiety or stress so that it doesn’t interfere with your sleep. They all say that asking your primary care provider to refer you to a sleep specialist can be beneficial, too. A sleep specialist can serve as your co-detective, helping you pinpoint the reason why you’re waking up so early and then troubleshooting accordingly.
Though late insomnia isn’t uncommon among older adults, Mushtaq emphasized that it isn’t normal. “Late insomnia isn’t just about aging; it’s often a signal that your stress response is out of sync. Healing starts with calming the brain at night and supporting the body’s natural rhythms. With the right tools, including targeted supplements, we can restore both sleep and sanity,” she said.
If you’re experiencing late insomnia, consider what your body is trying to communicate to you. It may be a self-care alarm bell going off, signalling that one part of your life needs a little extra attention. Once you take action, you’ll sleep more deeply — and longer.
