Why Sleep Can Be a Struggle in Later Life

Like many other aspects of aging, sleep patterns may change over time. That doesn’t mean struggling to fall asleep or stay asleep should be accepted as an inevitable part of getting older. While various factors may influence a senior’s ability to sleep, treatment may be available by addressing both biological and psychological factors. Anxiety, isolation, or other mental health concerns may contribute to sleep problems, and addressing them may help you sleep more easily at night no matter your age. 

Biological shifts in how we sleep

As we get older, how we sleep can change. Deep, slow-wave sleep, which is the most restorative type, naturally declines. Many seniors may also notice that the “advanced sleep phase" (when they feel sleepy) hits them earlier in the evening, and they end up waking up earlier in the morning. 

Even with these shifts, your body’s need for seven to nine hours doesn’t change, and waking up more often at night can make sleep feel less satisfying.

For older adults noticing changes in sleep patterns, how do you tell what’s normal and what’s not? Occasional restlessness or earlier wake times can be expected. But consistent difficulty falling asleep, waking frequently and struggling to return to sleep, or feeling unrefreshed day after day may be signs of a sleep disorder like insomnia or sleep apnea. Both of these conditions can benefit from clinical attention.

When your mind keeps your body awake

Many seniors settle into bed after an exhausting day, just to find that they can’t quiet their brains. Anxiety or simply stress can cause you to stay up ruminating, which can make you even more exhausted as you fight to go to sleep. Anxiety can also create a loop where poor sleep worsens worry, and worry further disrupts sleep.

Another culprit could be depression, which may shows up differently in later life. While it may be common to expect that someone with depression would sleep a lot, seniors with depression may wake up too early and struggle to fall back asleep. 

Untreated mental health conditions, including those related to trauma, can all interfere with sleep. That makes insomnia a symptom, not an isolated problem. When your sleep is off, it’s often your mind signaling that something deeper needs attention.

Lifestyle factors that disrupt sleep

Beyond biology and mental health, daily habits can quietly undermine your ability to sleep. 

If life after retirement means decreased activity and spending more time indoors, seniors may find that their circadian rhythm is off. Without social interactions and natural sunlight, the day may drag and you may feel restless at night.

Medications can also play a role in disrupted sleep. Many older adults take multiple prescriptions (a situation known as polypharmacy), and even when each medication is necessary, their combined effects can disrupt sleep cycles.

Some common habits can also contribute to worse sleep:

• Daytime napping, especially long or late naps
• Drinking caffeine later in the day
• Alcohol in the evening, which can fragment sleep
• Limited physical activity
• Screen use close to bedtime

Individually, these behaviors may seem minor, but they can have a major impact how well you sleep. This is especially true if you regularly engage in more than one of them.

Tips for improving your sleep as an older adult

Improving sleep doesn’t require rigid rules or losing independence. Small, consistent adjustments can make a meaningful difference:

• Keep a regular sleep and wake time, even on weekends
• Get natural light exposure early in the day
• Stay physically active in ways that feel manageable
• Create a calming wind-down routine in the evening
• Use the bed only for sleep (and intimacy), not for TV or worrying
• Limit naps to under 30 minutes, taken earlier in the day

The goal for sleep shouldn’t be perfection. Instead, it should be making adjustments to support your body’s natural sleep rhythms.

How therapy helps seniors sleep better

One of the most effective treatments for chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). Rather than relying on medication, CBT-I helps retrain the brain to associate the bed with rest, not frustration or wakefulness.

Talk therapy can also address the underlying thoughts that often surface at night. Whether it’s unresolved stress, grief, anxiety, or life transitions, working through these thoughts during the day can quiet the mind when it’s time to sleep.

Therapy offers something sleep aids can’t: it can treat the root cause, not just the symptoms. Various mindfulness-based therapies, or trauma-informed care can also support better sleep in later life, especially when a mental health condition such as anxiety or depression is present.

How Sailor Health helps remove the barriers to better rest

When sleep problems in later life are tied to anxiety, stress, loneliness, grief, or major life changes, better rest often starts with support for what’s happening during the day. Therapy can help you understand what may be interfering with sleep, build practical coping strategies, and feel less alone in the process.

But reaching out for help can feel overwhelming, especially when you’re already tired. Sailor Health makes that support easier to access from home, with therapy by video or phone call, including landlines. That means no waiting rooms, no driving, and no need to navigate transportation just to get care.

Our therapists are experienced older adults themselves, with a real understanding of the mental health challenges that can come with later life and how symptoms may show up differently with age. We’ll match you with a therapist who fits your needs and preferences, and you may be able to begin therapy as soon as 24 hours after signing up.

Sailor Health accepts Medicare, and most of our Medicare patients have a $0 copay. If sleep has become harder with age, support may be easier to reach than you think. Reach out when you’re ready, and we’ll help you take the first step.

Seniors & sleep FAQ

Is it true that people need less sleep as they get older?

No. Sleep needs remain largely the same (7–9 hours), even if sleep becomes lighter or more fragmented.

Why do I wake up so much earlier now than I did ten years ago?

This is often due to an “advanced sleep phase,” a natural shift in circadian rhythm that makes you feel sleepy earlier and wake earlier.

How can I tell the difference between “normal” aging and a sleep disorder?

 If sleep issues are persistent, affect daytime functioning, or cause distress, it’s worth speaking with a healthcare provider.

Can anxiety cause physical restlessness only at night?

Yes. Anxiety can seem to kick up at night when all of the distractions fade. This can leave you mentally and physically restless.

Does Medicare cover treatment for chronic insomnia?

Medicare generally covers therapy services, including treatments like CBT-I when provided by qualified professionals.

Is it okay to take a nap during the day if I didn’t sleep well at night?

It depends. Short power naps can help, but long or late naps may make it harder to sleep at night. 

What’s the relationship between loneliness and sleep quality in seniors?

Loneliness can increase stress and reduce feelings of safety, both of which can disrupt sleep patterns.

Why do I feel tired all day but wide awake as soon as I lie down?

This can happen when your body and mind are out of sync. Irregular routines and anxiety can cause this.

Can talking to a therapist actually help me get better sleep?

Yes. Therapy can address the underlying emotional and cognitive patterns that interfere with sleep, leading to more lasting improvement than medication alone.

References

1. Alhajaji, R., Jahrami, H., Pandi-Perumal, S. R., & BaHammam, A. S. (2026). Sleep health in the older adults: Architecture, circadian changes, and common sleep disorders. Ageing Research Reviews. Advance online publication. https://doi.org/10.1016/j.arr.2026.103101  
2. Sadighi, T., Dudley, A., Churaman, B., & Downes, L. (2025). Restful nights: Strategies for managing sleep disorders in older adults. The Journal for Nurse Practitioners, 21(4), Article 105305. https://doi.org/10.1016/j.nurpra.2024.105305