Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger.

There are many reasons why older people may not get enough sleep at night. Feeling sick or being in pain can make it hard to sleep. Some medicines can keep you awake. No matter the reason, if you don’t get a good night’s sleep, the next day you may:

• Be irritable
• Have memory problems or be forgetful
• Feel depressed
• Have more falls or accidents

The rhythm and timing of the body clock change with age. Teens fall asleep later at night than younger children and adults. One reason for this is because melatonin is released and peaks later in the 24-hour cycle for teens. As a result, it's natural for many teens to prefer later bedtimes at night and sleep later in the morning than adults.

People also need more sleep early in life when they're growing and developing. For example, newborns may sleep more than 16 hours a day, and preschool-age children need to take naps.

Young children tend to sleep more in the early evening. Teens tend to sleep more in the morning. Also, older adults tend to go to bed earlier and wake up earlier.

The patterns and types of sleep also change as people mature. For example, newborn infants spend more time in REM (rapid eye movement) sleep. Dreaming typically occurs during REM sleep.

The amount of deep or slow-wave sleep (non-REM sleep) peaks in early childhood and then drops sharply after puberty. It continues to decline as people age.

Insomnia is the most common sleep problem in adults age 60 and older. People with this condition have trouble falling asleep and staying asleep. Insomnia can last for days, months, and even years. Having trouble sleeping can mean you:

• Take a long time to fall asleep
• Wake up many times in the night
• Wake up early and are unable to get back to sleep
• Wake up tired
• Feel very sleepy during the day

Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. This may make it harder to fall asleep and stay asleep.

Some older adults who have trouble sleeping may use over-the-counter sleep aids. Others may use prescription medicines to help them sleep. These medicines may help when used for a short time. But remember, medicines aren’t a cure for insomnia.

Developing healthy habits at bedtime may help you get a good night’s sleep.

People with sleep apnea have short pauses in breathing while they are asleep. These pauses may happen many times during the night. If not treated, sleep apnea can lead to other problems, such as high blood pressure, stroke, or memory loss.

You can have sleep apnea and not even know it. Feeling sleepy during the day and being told you are snoring loudly at night could be signs that you have sleep apnea.

If you think you have sleep apnea, see a doctor who can treat this sleep problem. You may need to learn to sleep in a position that keeps your airways open. Treatment using a continuous positive airway pressure (CPAP) device almost always helps people with sleep apnea. A dental device or surgery may also help.

Restless legs syndrome, periodic limb movement disorder, and rapid eye movement sleep behavior disorder are common in older adults. These movement disorders can rob you of needed sleep.

People with restless legs syndrome, or RLS, feel like there is tingling, crawling, or pins and needles in one or both legs. This feeling is worse at night. See your doctor for more information about medicines to treat RLS.

Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Medication, warm baths, exercise, and relaxation exercises can help.

Rapid eye movement, or REM, sleep behavior disorder is another condition that may make it harder to get a good night’s sleep. During normal REM sleep, your muscles cannot move, so your body stays still. But, if you have REM sleep behavior disorder, your muscles can move and your sleep is disrupted.

Alzheimer’s disease often changes a person’s sleeping habits. Some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night.

The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired for the challenges they face.

If you’re caring for someone with Alzheimer’s disease, take these steps to make him or her safer and help you sleep better at night:

• Make sure the floor is clear of objects.
• Lock up any medicines.
• Attach grab bars in the bathroom.
• Place a gate across the stairs.

Try to set up a safe and restful place to sleep. Make sure you have smoke alarms on each floor of your home. Before going to bed, lock all windows and doors that lead outside. Other ideas for a safe night’s sleep are:

• Keep a telephone with emergency phone numbers by your bed.
• Have a lamp within reach that is easy to turn on.
• Put a glass of water next to the bed in case you wake up thirsty.
• Don’t smoke, especially in bed.
• Remove area rugs so you won’t trip if you get out of bed during the night.

The years of the menopausal transition are often a time when there are other changes in a woman’s life. You may be caring for aging parents, supporting children as they move into adulthood, taking on more responsibilities at work, and reflecting on your own life journey. Add symptoms of menopause on top of all this, and you may find yourself having trouble sleeping at night.

Hot flashes, especially night sweats, and changes in mood — depression in particular — can contribute to poor sleep. Managing these issues may help to manage sleep symptoms as well.

Some women who have trouble sleeping may use over-the-counter sleep aids such as melatonin. Others use prescription medications to help them sleep, which may help when used for a short time. But these are not a cure for sleep disturbances, such as insomnia, and should not be used long term.

Not getting enough sleep can affect all areas of life. Lack of sleep can make you feel irritable or depressed, might cause you to be more forgetful than normal, and could lead to more falls or accidents. And research now suggests that waking from sleep itself may trigger hot flashes, rather than the other way around.

Developing healthy habits at bedtime can help you get a good night’s sleep.

Getting a good night’s sleep during the menopausal transition

To improve your sleep through the menopausal transition and beyond:

• Follow a regular sleep schedule. Go to sleep and get up at the same time each day.
• Avoid napping in the late afternoon or evening if you can. It may keep you awake at night.
• Develop a bedtime routine. Some people read a book, listen to soothing music, or soak in a warm bath.
• Try not to watch television or use your computer or mobile device in the bedroom. The light from these devices may make it difficult for you to fall asleep.
• Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
• Exercise at regular times each day but not close to bedtime.
• Avoid eating large meals close to bedtime.
• Stay away from caffeine (found in many coffees, teas, and chocolate) late in the day.
• Remember, alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Talk to your doctor if you are having trouble sleeping. If these changes to your bedtime routine don’t help as much as you’d like, you may want to consider cognitive behavioral therapy for insomnia. This problem-solving approach to therapy has been shown to help improve sleep in women with menopausal symptoms. Cognitive behavioral therapy can be found through a class or in one-on-one sessions. Be sure that your therapy is guided by a trained professional with experience working with women during their menopausal transition. Your doctor may be able to recommend a therapist in your area.

New findings reveal a connection between sleep and memory, and shed light on why forgetfulness is common in the elderly.

Our brains naturally deteriorate with age. Sleep quality — specifically the slow-wave activity that occurs during deep sleep — also decreases as we get older. Previous research found that slow waves are generated in a brain region called the medial prefrontal cortex (mPFC), which exhibits age-related deterioration.

A team of neuroscientists led by Drs. Bryce Mander and Matthew Walker at the University of California, Berkeley, set out to explore whether age-related changes in sleep and brain structure are linked to impaired memory. Their study included 18 healthy young adults (ages 18 to 25) and 15 healthy older adults (ages 61 to 81).

Before going to sleep, the subjects memorized and were tested on 120 word pairs. While they slept, their brain activity was measured using an electroencephalogram. After 8 hours of sleep, the subjects were tested on the same word pairs, this time while undergoing functional MRI (fMRI) scans to measure changes in brain activity. The study, funded by NIH’s National Institute on Aging (NIA), appeared online on January 27, 2013, in Nature Neuroscience.

Memory performance in older adults was significantly worse than in their younger counterparts. Older adults also had significantly less slow-wave activity. Brain structures differed between the age groups as well, with the most degeneration in the older group in the mPFC. Interestingly, reduced mPFC volume was associated with lower slow-wave activity, regardless of age.

To confirm that diminished memory retention in older adults was sleep-dependent, the researchers had participants perform the same word-pair memory task after an 8-hour period of wakefulness. Older adults still performed worse on the memory tasks than the younger group. However, while sleep improved memory retention for the younger group, this overnight sleep benefit was markedly impaired in the older adults.

Older adults, the fMRI scans revealed, relied more heavily on their hippocampus, a brain region crucial for memory formation, to perform memory tasks. Younger adults, on the other hand, relied more on the mPFC.

Taken together, these findings suggest that, as we age, changes in the mPFC reduce slow-wave activity during sleep, which contributes to a decline in establishing long-term memory. As slow-wave activity wanes, the brain must rely more heavily for memory tasks on the hippocampus, a structure designed for short-term memory storage.

“When we are young, we have deep sleep that helps the brain store and retain new facts and information,” says Walker. “But as we get older, the quality of our sleep deteriorates and prevents those memories from being saved by the brain at night.”

This study helps explain the relationship between brain deterioration, sleep disruption and memory loss as we get older. The findings may give researchers insight into designing new approaches for treatment.

— by Meghan Mott, Ph.D.

You may have heard about some tricks to help you fall asleep. You don’t really have to count sheep—you could try counting slowly to 100. Some people find that playing mental games makes them sleepy. For example, tell yourself it is 5 minutes before you have to get up, and you’re just trying to get a little bit more sleep.

Some people find that relaxing their bodies puts them to sleep. One way to do this is to imagine your toes are completely relaxed, then your feet, and then your ankles are completely relaxed. Work your way up the rest of your body, section by section. You may drift off to sleep before getting to the top of your head.

Use your bedroom only for sleeping. After turning off the light, give yourself about 20 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.

If you feel tired and unable to do your activities for more than 2 or 3 weeks, you may have a sleep problem. Talk with your doctor about changes you can make to get a better night’s sleep.

Being older doesn’t mean you have to be tired all the time. You can do many things to help you get a good night’s sleep. Here are some ideas:

• Follow a regular sleep schedule. Go to sleep and get up at the same time each day, even on weekends or when you are traveling.
• Avoid napping in the late afternoon or evening, if you can. Naps may keep you awake at night.
• Develop a bedtime routine. Take time to relax before bedtime each night. Some people read a book, listen to soothing music, or soak in a warm bath.
• Try not to watch television or use your computer, cell phone, or tablet in the bedroom. The light from these devices may make it difficult for you to fall asleep. And alarming or unsettling shows or movies, like horror movies, may keep you awake.
• Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
• Use low lighting in the evenings and as you prepare for bed.
• Exercise at regular times each day but not within 3 hours of your bedtime.
• Avoid eating large meals close to bedtime—they can keep you awake.
• Stay away from caffeine late in the day. Caffeine (found in coffee, tea, soda, and chocolate) can keep you awake.
• Remember—alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.