Understanding Sleep in Older Adults: Patterns and Changes

Sleep Architecture Changes with Age

Older adults need 7–8 hours, but sleep becomes more fragmented:

• ↓ Slow‑wave sleep (N3), ↓ REM.
• ↑ Stage N1/N2, ↑ wake after sleep onset (WASO).
• Advanced sleep phase – earlier bedtime/wake time.
• Increased daytime napping.

Contributing Factors

Circadian

Reduced melatonin amplitude, weaker light entrainment.

Medical

Arthritis pain, nocturia (BPH, OAB), HF/COPD, GERD.

Psychiatric

Depression, anxiety, grief.

Medications

Diuretics, β‑blockers, SSRIs, corticosteroids, sedatives.

Lifestyle

Reduced activity, social isolation, irregular schedules.

Management

• CBT‑I (first‑line for chronic insomnia).
• Bright morning light, regular rise time.
• Review medications; minimize anticholinergics/sedatives.
• Treat comorbid conditions (pain, apnea, RLS).
• Limit naps to <30 min before 3 PM.