Sleep problems in the elderly: causes and how to help

Good sleep matters at any age, but it becomes even more important as we get older. It keeps the body and mind working properly. Research links poor sleep to a higher risk of falls, low mood and worsening health.

Many older people find their sleep changes over time. Some of this is a normal part of ageing. But regular, disrupted sleep can also signal an underlying sleep disorder. It's worth taking seriously rather than putting down to "just getting older".

This guide explains why sleep changes with age, the different problems that can disrupt it, and practical ways to help your loved one sleep better. We also look at when to see a GP, and how a live-in carer can support a better night's sleep.

Why sleep changes as we get older

Sleep patterns naturally shift with age. The brain's internal clock, called the circadian rhythm, sits in a small area of the hypothalamus known as the suprachiasmatic nucleus. It controls when we feel sleepy and when we feel alert.

As we age, this internal clock becomes less precise. Many older people also get less daylight exposure than they realise, sometimes as little as an hour a day. People living with Alzheimer's disease may get even less. Daylight helps keep the body clock on track, so too little of it can lead to early waking and daytime tiredness.

Hormones change too. The body produces less melatonin as we age, the hormone that responds to darkness and helps trigger sleep. This is one reason sleep can become lighter and more easily disrupted in later life.

Sleep problems are especially common for people living with dementia, and they can make caring for a loved one at home more demanding. None of this means poor sleep is something to simply accept. If sleep problems happen regularly, they're worth looking into properly.

Types of sleep problems in older people

A few different conditions can disrupt sleep in later life, and they're not all the same. Each one needs different treatment, so speak to a GP rather than trying to work it out alone. Some of the more common ones include:

Insomnia

Insomnia means regularly struggling to fall asleep, stay asleep, or both. It's one of the most common sleep complaints in older adults. It can have many causes, from pain and medication side effects to needing the toilet in the night, anxiety or depression.

The good news is that insomnia often improves with the right support. Better sleep habits can help, and so can cognitive behavioural therapy for insomnia. A GP can work out what's behind it and suggest next steps. The NHS has more information on insomnia and how you can treat it.

Restless legs syndrome

Restless legs syndrome causes an uncomfortable, hard-to-ignore urge to move the legs, usually worse in the evening or at night. The NHS has more information on restless legs syndrome and how it's treated.

Sleep apnoea

Sleep apnoea causes breathing to repeatedly stop and start during sleep, often with loud snoring or gasping. It's more common in older adults, and it can leave someone feeling exhausted during the day, even after a full night in bed.

Advanced sleep phase

Some older people feel sleepy very early in the evening and wake in the early hours. This is a shift in the body clock rather than a sign of insomnia, and it becomes more common with age. A GP can help tell the difference.

REM sleep behaviour disorder

Normally the body stays still while we dream. With REM sleep behaviour disorder, it doesn't. A person can shout, kick or punch as they act out a dream, and they can hurt themselves or someone beside them. It mostly affects older adults. Doctors sometimes link it to conditions such as Parkinson's disease or Lewy body dementia.

Sundowning

Some people with dementia become more confused, agitated or restless in the late afternoon and evening. This is called sundowning, and it often disrupts sleep too. Our guide to sundowning in dementia explains what it is and how to manage it.

If your loved one has a mix of these symptoms, or you're not sure what's causing their sleep problems, a GP is the right place to start.

Signs it could be a sleep disorder

It's worth speaking to a GP if your loved one regularly experiences:

• Difficulty falling or staying asleep
• Feeling drowsy or low on energy during the day
• Discomfort or an urge to move their legs at night
• Trouble concentrating or focusing
• Unusual movements or behaviour during sleep, such as kicking, calling out, or acting out dreams
• Difficulty breathing when they wake up

Practical ways to help your loved one sleep better

Keep a consistent routine

Help your loved one go to bed and wake up at the same time each day. A steady routine keeps the body clock on track. Most older adults need around seven to eight hours, though some sleep a little less. Encourage them to avoid lying down during the day, since daytime rest can make it harder to fall asleep at night.

Try a sleep diary

Keep a simple record of your loved one's bedtimes, wake times and any broken sleep. It can help you spot patterns. Bupa has a free sleep diary template you can download and use.

Wind down before bed

A relaxing bedtime routine helps signal to the brain that it's time to sleep. Reading, a warm bath, gentle stretching or a short period of meditation can all help. Encourage your loved one to avoid screens for an hour before bed, since blue light from phones and TVs can make the brain think it's still daytime.

Get the timing of naps right

A short nap can help with alertness later in the day. Help your loved one keep naps to 20 to 30 minutes. Longer naps let the body fall into deeper sleep, which can make it harder to fall asleep again that night.

Watch food and drink in the evening

A heavy meal late at night can make it harder to fall asleep. A lighter dinner, eaten at least three hours before bed, tends to work better. Caffeine after lunch can also disrupt sleep, and alcohol in the evening, even in small amounts, can affect sleep quality later in the night.

For ideas on what to cook and how to keep meal times regular, see our guide to cooking and meal preparation for the elderly.

Make the bedroom sleep-friendly

A dark, quiet, comfortable room supports better sleep. Blackout blinds, curtains or an eye mask can help if the room gets too much light, and earplugs can help with noise. If total darkness feels unsettling, a dim night light or a landing light can help. This matters most if your loved one needs to get up at night. Loose, comfortable nightwear matters too, particularly for someone with dementia who may not be able to say if their clothes feel uncomfortable.

Get moving during the day

Regular activity during the day makes it easier to feel tired at bedtime. Even a short daily walk helps, and getting outside adds the benefit of natural daylight, which supports melatonin production. If mobility is limited, gentle seated exercise or a short walk with a companionship carer can still make a difference. Mentally stimulating activities help too, such as puzzles or crosswords.

Don't force it

If your loved one is still awake after 20 minutes in bed, encourage them to get up and do something relaxing rather than lying there trying to fall asleep. If they're unsteady, check they have a light on and someone nearby. Going back to bed once they feel sleepy again tends to work better than forcing it.

When to see a GP

Booking an appointment with a GP can help identify what's behind ongoing sleep problems. The cause could be a specific sleep disorder, an underlying health condition, or something like anxiety, depression or stress. They may refer your loved one to a specialist, or suggest cognitive behavioural therapy (CBT), which helps change the thoughts and habits that get in the way of good sleep.

Sleeping pills are rarely the first option for older adults, because of the risk of side effects and dependence. If a GP does prescribe them, it's usually only for a short period, alongside other treatment.

How a live-in carer supports a better night's sleep

A good night's sleep matters for everyone, and a live-in carer can make nights feel safer and more settled for your loved one, and for you. Here's how:

• A comforting, secure presence overnight. An overnight live-in carer can help reduce the risk of falls, and support a loved one getting in and out of bed safely if they need it in the night. This is often especially valuable after a hospital stay or surgery, such as a hip replacement, when mobility is more limited. Our guide to overnight care explains the different ways this support can work.
• A calmer, more settled night. Medication and health conditions can disrupt sleep-wake cycles. A carer can offer reassurance, a warm drink or company during a wakeful night, and help keep the bedroom at a comfortable temperature.
• A consistent bedtime routine. A carer can help with the small things that add up to a good night's sleep: a regular bedtime, help with evening medication, and a calm, familiar routine that reduces anxiety about the night ahead. If it's your own sleep that's suffering from caring for a loved one, our guide to help caregivers overcome sleep problems covers ways to protect your own rest too. For someone with dementia, our guide to how live-in care can help with sleep shares simple strategies for building that routine.

Elaine's story: keeping her mum safe at home, day and night

Elaine's mum, Dorothy, lives with dementia. Before live-in care, she fell out of bed and spent the night on the floor, which led to another stay in hospital.

A care home placement afterwards left Dorothy unsettled and in tears. Elaine started looking for another way to keep her mum safe at home, and found live-in care through Elder.

"After the first night she was settled and happy in her own home," Elaine says.

For families worried about what happens overnight, Elaine's story shows how the right support can bring real peace of mind.

Read Elaine's full story

Support if sleepless nights are affecting your family

Every family's experience of this is different, and it's normal to feel worn down when a loved one isn't sleeping. Broken nights can leave you tired, worried and on edge. That's a common reaction, not a sign you're doing anything wrong. Your loved one may also feel anxious about the night, or not want to talk about it.

If you're wondering whether your parent needs more support at night or day to day, our care advisors are happy to talk through your options, whatever stage you're at.