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Sleep Problems in Older Adults: Causes, Sleep Hygiene and Medical Assessment
Why insomnia increases with age and why sleeping pills need caution: sleep hygiene tips and treatable causes such as sleep apnoea and restless legs.
"I can't sleep at night", "I wake at four and can't get back to sleep": sleep complaints are very common in older age. Sleep naturally changes with age, but insomnia that leaves people tired and drowsy during the day is not inevitable and often has a treatable cause.
Normal changes
Less deep sleep, more night waking, an earlier body clock and more daytime naps. If the person does not feel rested during the day, it should be assessed.
| Cause | Examples |
|---|---|
| Medical | Pain, heart failure, COPD, reflux, enlarged prostate |
| Sleep disorders | Sleep apnoea, restless legs |
| Emotional | Depression, anxiety, grief |
| Medicines | Diuretics taken in the evening, some BP and asthma drugs, steroids |
| Habits | Long naps, inactivity, evening caffeine, alcohol |
| Environment | Noise, light, temperature |
| Neurological | Dementia, Parkinson's |
Two conditions not to miss
Sleep apnoea: loud snoring, pauses in breathing noticed by a partner, morning headaches and daytime sleepiness. Untreated, it raises risks of hypertension, arrhythmias and stroke; a sleep study is needed and CPAP is often used.
Restless legs syndrome: evening tingling and an urge to move the legs, relieved by movement; linked to iron deficiency, kidney disease and some medicines, and treatable.
Caution with sleeping pills
They can cause daytime drowsiness, falls and hip fractures, confusion and dependence. Use only on medical advice, at the lowest dose for the shortest time. Some non-prescription "sleep" antihistamines carry similar risks.
Sleep hygiene
- Go to bed and get up at the same time every day.
- Limit naps to 30 minutes, early afternoon.
- Get morning daylight and light exercise.
- Avoid caffeine after midday.
- Light, early dinners.
- Less screen time before bed.
- A cool, dark, quiet bedroom.
- If you cannot sleep within 20–30 minutes, get up and return when sleepy.
- Reduce evening fluids without reducing the daily total.
The doctor reviews sleep patterns and medicines, treats pain, night urination and breathlessness, orders iron and thyroid tests if needed, and refers for a sleep study.
We assess sleep problems during home doctor visits across Yalova and help with CPAP devices, with appointments in Bursa, Istanbul and Kocaeli–Gebze.
