Over 65? Experts share how to fix the 3 common sleep issues
If you’re over the age of 65, getting enough sleep is a great way to improve your health and wellbeing.
Investing in the right sleep products, from the best mattress to one of the best sleep trackers, can ensure you’re sleeping comfortable, looking out for sleep disorders such as sleep apnea, and even preventing bugbears such as lower back pain.
The 3 biggest sleep problems facing over 65s
1. Sleep duration
Many older adults may feel like they’re not getting enough sleep, and this dip in sleep duration can decrease your sleep score.
“After age 60-65 total, sleep time decreases on average by about 30–60 minutes,” says Mike Wakeman, researcher, pharmacist and founder of Evera Nutrition. “This is because the brain produces less of the sleep hormone melatonin, which causes shifts in the circadian rhythm making you feel sleepy earlier and wake up earlier.”
While Wakeman says lifestyle factors such as decreased physical activity and medication use can also cause shorter sleep duration in adults, he asserts that a shorter sleep time is a perfectly normal “natural phenomenon”.
Board-certified sleep psychologist and Mattress Firm sleep advisor Dr. Jade Wu agrees. “We naturally need a bit less sleep as we age because we’re no longer growing or processing as much new information, so slightly shorter nights can be normal,” she explains.
While sleep changes as we age, most adults need to get at least seven hours of sleep, and people over 65 need this amount of sleep, too.
GP Dr Deborah Lee, a sleep expert from Dr Fox Online Pharmacy, warns that older adults still need to track how long they sleep, which can be tricky as many older adults may supplement shorter sleep at night with naps during the day.
“Most adults will still require around six-eight hours over a 24-period, whether that’s through daytime napping or one long snooze,” says the health expert currently working with The Wooden Bed Company
2. Sleep stages
However, while the sequence of sleep cycles remain the same, older adults experience less deep sleep.
“One of the most consistent changes with aging is a reduction in slow wave sleep, which is the deepest, most restorative stage of sleep,” says Dr Lee.
“By age 70, deep sleep may be reduced by 50–70% compared to young adulthood,” explains Wakeman. “This happens because of reduced growth hormone secretion, brain structural changes, reduced physical intensity during the day and lower GABA activity, the brain’s ‘calming agent’ that improves sleep depth.”
3. Fragmented sleep
However, if you wake up frequently and struggle to fall back to sleep, these nighttime awakenings could lower your sleep score. Older adults tend to experience more fragmented sleep and this is linked to the previous point: people over 65 get less deep sleep and more light sleep.
“There are biological changes in the brain going on that reduce deep sleep, meaning sleep becomes a lot easier to disrupt and a lot lighter,” explains Dr Lee. “You may find yourself waking up a lot easier than you were previously.”
Dr Wu says that easily-disrupted lighter sleep can be compounded by health issues associated with aging, such as arthritis pain.
“More nighttime awakenings, which can be normal, but menopause, chronic conditions, medications, or sleep apnea can make fragmentation worse,” says the sleep advisor.
Another condition that is common in older adults is nocturia, the term for waking up more than once to use the bathroom.
“Reduced bladder capacity can play a part,” says Wakeman. “Fragmented sleep is often a result of increased bathroom trips.”
3 fixes for sleep problems facing over 65s
1. How to fix your sleep duration
As mentioned above, shorter sleep after 65 is completely normal, so all three experts recommend that instead of trying to ‘fix’ your sleep time, you should optimize your sleep by maintaining consistent sleep and wake schedules.
“A lot of people over the age of 65 feel they’re not sleeping enough, whereas in fact, they’re getting a shorter sleep at night, but making up for it with naps in the day,” explains Dr Lee.
To combat the negative effects of a long daytime nap on a good night’s sleep, Dr Lee suggests keeping naps short.
“If daytime naps are needed, take them but keep them around 20-30 minutes, don’t spend hours napping in the day,”she advises.
However, the three experts unanimously agree that the best way to remedy sleep quantity is to stay physically and socially active during the daylight.
“Strengthen your circadian rhythm by getting morning sunlight for 15 to 30 minutes, establishing a consistent wake time and avoiding bright light at night,” says researcher Wakeman.
“Resistance training three to four times a week along with daily walking will help build sleep pressure,” he adds.
2. How to fix your sleep architecture
“Deep sleep can’t be ‘forced’, but regular physical activity, consistent schedules, and addressing untreated sleep disorders can help protect the quality of the sleep you do get,” advises Dr Wu.
“Strength training, in particular, is helpful for earning deep sleep,” the board-certified sleep doctor adds.
Dr Lee says that, while you can’t “reverse” these neurological changes, you can influence them with lifestyle changes.
“Regular physical activity, particularly resistance training and aerobic exercise, has been shown to increase slow wave sleep,” she suggests.
“Of course, avoiding the likes of alcohol and caffeine are both really important, as alcohol can fragment REM sleep, and caffeine can keep you awake for longer,” she continues.
The GP also says that keeping an eye on overall health and wellbeing can also increase deep sleep.
“Good cardiovascular health also supports better sleep structure, while conditions such as hypertension and diabetes can affect sleep quality, so managing overall health is indirectly a way of protecting sleep stages,” she explains.
3. How to fix fragmented sleep
In terms of nocturia, Wakeman suggests considering the timing of your last drink. “Stopping fluids two to three hours before bed and limiting evening alcohol reduce nighttime toilet trips,” he says.
Dr Lee suggests practicing good sleep hygiene habits can help increase deep sleep.
“Keeping the bedroom cool, dark and quiet is essential,” she advises. “Cognitive behavioral therapy for insomnia has also been proven to be effective particularly in older adults, so it’s worth taking a look at this if you feel as though insomnia is starting to affect your day-to-day life.”
The 3 things to remember when tracking your sleep score
If you’re using a sleep tracker to monitor your sleep, it’s important to remember these trackers can be tricky to navigate, and sometimes users may become worried about their sleep data.
So, I asked sleep experts what adults over 65 should remember when using a sleep tracker. Here are their top three tips.
1. Don’t obsess
For some users, sleep tracking can lead to orthosomnia, a term for when you feel stressed about achieving the perfect sleep.
This condition can arise in those who may perceive they’re not getting enough sleep, a perception which Dr Lee says is common among older adults.
“As we age, the total time that we’re asleep typically reduces, but the perception of sleep also changes,” says the health expert.
Dr Wu agrees, and says that, while a sleep tracker can be a useful tool, you shouldn’t obsess over its sleep scores.
“People over 65 should remember that lighter, slightly shorter, and more interrupted sleep can be normal, so chasing perfect tracker scores can create unnecessary anxiety,” says the sleep doctor.
2. Focus on how you feel during the day
Dr Wu suggests that, instead of limiting your attention on sleep data, you should also concentrate on your mood when you’re awake.
“Focus less on nightly numbers and more on how you feel during the day,” she advises. “And treat significant insomnia, unusual nighttime behaviors, loud snoring, or excessive daytime sleepiness as signals to seek medical guidance.”
3. Use your sleep tracker when seeking medical guidance
If you do decide to seek medical advice for any sleep issues, you can use your sleep data to illustrate any concerns to a healthcare professional.
“Sleep trackers can be useful for spotting patterns,” says Dr Lee. “They can help you if you need to explain to a medical expert how little sleep you’ve been getting, and any common times you seem to be waking up.”
However, she says the most important thing to remember is prioritizing comfort and overall wellbeing rather than chasing the “textbook sleep architecture”.
“If someone feels persistently exhausted, is waking gasping for air, or experiencing significant insomnia, that warrants medical assessment,” she advises. “But small changes in duration or stage distribution are a normal part of aging, not necessarily a sign that something is wrong.”
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