Quick answer
Sleep naturally becomes lighter with age, but persistent sleeplessness usually has a cause worth finding: needing the bathroom at night, pain, sleep apnea, restless legs, low mood or worry, dementia, long daytime naps, or medications. Be cautious with over-the-counter “PM” sleep aids, which are generally not recommended for older adults. What helps most is a steady routine, daylight and activity during the day, a calm evening, and a doctor’s review of medications and health problems.
Your mom is up at 3 a.m. again, wandering the kitchen. Or Dad says he “hasn’t slept properly in months,” then dozes off in his chair every afternoon. Poor sleep is one of the most common complaints in later life, and it affects everything: mood, memory, balance and the risk of falls. It also wears out caregivers.
The good news is that poor sleep in older adults usually has identifiable causes, and many of them can be improved.
What’s Normal, and What Isn’t
As we age, sleep tends to become lighter, with more brief awakenings, and many people get sleepy earlier in the evening and wake earlier in the morning. That’s normal. What isn’t normal is feeling exhausted every day, struggling to stay awake in the daytime, loud snoring with pauses in breathing, or being up for hours every night. Those deserve a closer look.
Common Causes of Poor Sleep in Older Adults
Needing the bathroom at night. Waking to urinate (nocturia) is one of the most common reasons. Causes include an enlarged prostate, an overactive bladder, poorly controlled diabetes, heart problems, drinking a lot in the evening, and water pills taken later in the day.
Pain. Arthritis, back pain and other chronic pain often get worse at night.
Sleep apnea. Loud snoring, gasping or choking at night, and daytime sleepiness can be signs of obstructive sleep apnea, which is common and treatable.
Restless legs. An uncomfortable urge to move the legs in the evening or at night can make falling asleep hard.
Low mood, anxiety and loneliness. Worry and depression commonly disturb sleep, especially early-morning waking.
Dementia. Dementia can disrupt the body clock, leading to night-time waking, wandering and late-day confusion. See our article on sundowning.
Habits: long or late daytime naps, little daylight or activity, caffeine in the afternoon, alcohol in the evening (which disrupts sleep later in the night), and screens or TV in bed.
A Pharmacist’s Note on Medications and Sleep
Medications are a frequently overlooked cause of poor sleep:
- Water pills (diuretics) taken in the evening can cause night-time bathroom trips.
- Steroids, some decongestants, and certain antidepressants can make it harder to sleep.
- Caffeine hides in some pain relievers and in tea, coffee, cola and chocolate.
Be cautious with over-the-counter sleep aids. Many “PM” and “nighttime” products contain sedating antihistamines (such as diphenhydramine or doxylamine). In older adults, these can cause next-day grogginess, confusion, constipation, difficulty urinating, and a higher risk of falls, and they’re generally not recommended for older adults. Prescription sleeping pills carry similar risks. Before your parent takes any sleep aid, including melatonin or herbal products, talk to the doctor or pharmacist. Never stop a prescribed medicine without advice.
When to Talk to the Doctor
- Loud snoring, gasping or pauses in breathing during sleep
- Falling asleep during the day, while reading, watching TV or, worse, driving
- Getting up many times a night to urinate
- Pain that keeps them awake
- Low mood, worry, or new confusion
- Falls at night. See Elderly Parent Falling at Night?
Ask for a medication review. For long-term insomnia, doctors often recommend cognitive behavioral therapy for insomnia (CBT-I), a structured, drug-free program that’s usually considered the first-line treatment for chronic insomnia.
What Helps: Practical Steps
Keep a steady schedule. Going to bed and getting up at the same time every day, including weekends, helps reset the body clock.
Get daylight and activity during the day. Morning light and a daily walk or gentle exercise help people sleep better at night.
Limit naps. If your parent naps, keep it short (around 20–30 minutes) and early in the afternoon.
Watch evening drinks. Reduce caffeine after lunch, limit alcohol, and cut back on fluids in the two hours before bed, while making sure they drink enough earlier in the day.
Create a calm wind-down routine. A warm drink (caffeine-free), quiet music, reading or a bath, the same way each night.
Make the bedroom comfortable: cool, quiet and dark, with a comfortable mattress and pillows.
Make night-time waking safe. If your parent does get up, motion-sensor night lights, non-slip slippers by the bed, and a bedside commode for frequent bathroom trips can prevent falls. For a parent with dementia who wanders at night, a bed exit alarm can alert you.
If they can’t sleep, get up. Lying awake for a long time can make sleeplessness worse. Getting up for a quiet, dim-light activity until sleepy, then returning to bed, is often recommended.
Look After Your Own Sleep, Too
When a parent is up at night, caregivers lose sleep too, and exhaustion builds quickly. If you’re getting up repeatedly, share nights with family, or ask about respite care through your local Area Agency on Aging (Eldercare Locator: 1-800-677-1116). Our guide to caregiver burnout may help.
Frequently Asked Questions
Why is my elderly parent not sleeping at night?
Common reasons include needing to urinate, pain, sleep apnea, restless legs, low mood or anxiety, dementia, long daytime naps, and medications such as evening water pills. A doctor’s review can identify treatable causes.
Are over-the-counter sleep aids safe for the elderly?
Many contain sedating antihistamines like diphenhydramine or doxylamine, which can cause confusion, next-day drowsiness and falls in older adults. They’re generally not recommended for older people. Ask the doctor or pharmacist before using any sleep aid.
How much sleep does an elderly person need?
Most older adults still need around 7–8 hours, although sleep tends to be lighter and earlier than when they were younger.
What helps an elderly person sleep better naturally?
A regular sleep schedule, daylight and activity during the day, short early naps only, less caffeine and alcohol, a calm bedtime routine, and a comfortable, dark bedroom.
This article provides general information and is not medical advice. Talk to your loved one’s doctor about sleep problems and before starting or stopping any medication or sleep aid.