How much sleep is normal in elderly?

Most adults over 60 need 7–8 hours of sleep in 24 hours. Sleep becomes lighter, with more frequent awakenings. It is normal to sleep earlier, wake earlier, and wake 1–2 times at night briefly. It becomes a problem when total sleep is less than 5–6 hours regularly, daytime functioning is affected (irritability, memory issues, fatigue), or there are repeated falls, confusion, or mood changes.

Why do seniors wake up repeatedly or feel unrefreshed?

Seniors often wake up repeatedly or feel unrefreshed due to frequent urination (prostate issues, diabetes, diuretics), pain (arthritis, neuropathy), breathing problems (snoring, sleep apnea, COPD), anxiety or depression, restless legs syndrome, or disturbances from light, noise, or temperature. Even if total sleep time looks adequate, fragmented sleep makes it non-refreshing.

Why are seniors sleepy during the day but restless at night?

This is very common among seniors. Causes include circadian rhythm shifts (body clock advances with age), excess daytime napping, low daylight exposure, early dementia, depression, and poor sleep quality at night. In some older adults, especially those with cognitive decline, the sleep-wake cycle becomes reversed, known as “day–night reversal.”

How do medical illnesses affect sleep?

Many chronic diseases disturb sleep. For example, diabetes can cause night urination and low sugar episodes, heart failure can lead to breathlessness when lying down, COPD/asthma can cause night coughing/wheezing, arthritis can cause pain on turning, urinary issues can lead to repeated awakenings, and thyroid problems can cause insomnia. Sleep disturbance is often a symptom of underlying disease worsening.

 

Can regular medicines disturb sleep?

Yes, regular medicines can disturb sleep. Common culprits include diuretics (water tablets) which cause night urination, steroids which cause insomnia, some antidepressants, thyroxine (if dose is high), beta blockers, and certain Parkinson’s drugs. The timing of medication matters, and sometimes adjusting the timing can solve the issue.

When is snoring serious (Sleep Apnea)?

Snoring becomes concerning if it involves loud snoring with breathing pauses, gasping/choking at night, morning headache, excess daytime sleepiness, resistant hypertension, or diabetes with obesity. Untreated sleep apnea increases the risk of stroke, heart attack, memory decline, and falls. A sleep study may be required.

Can poor sleep worsen memory and mood?

Strong scientific evidence indicates that chronic poor sleep can worsen memory, increase anxiety and depression, trigger night-time confusion (delirium), increase Alzheimer’s progression risk, and increase fall risk. Deep sleep helps with “brain cleaning” (removal of toxic proteins like beta-amyloid).

Are sleeping pills safe?

Sleeping pills are usually not ideal long-term due to risks in the elderly such as falls, fractures, memory worsening, confusion, and dependence. Safer long-term strategies include sleep hygiene, regular sunlight exposure, daytime physical activity, Cognitive Behavioural Therapy, treating underlying medical causes, and melatonin in selected cases. Sleeping pills should be used short term and supervised.

When should families seek medical evaluation?

Families should seek medical evaluation if there is sleep less than 5 hours regularly, loud snoring with choking, night confusion or wandering, sudden sleep pattern change, excess daytime sleepiness, recurrent falls, depression or mood change, memory worsening, night urination more than 3–4 times, or caregiver burnout due to sleep disturbance. Sleep problems are often treatable but ignored for years.

Final Takeaway

In the elderly, sleep disturbance is not just ageing. It is often a signal of medical illness, medication side effects, mood disorders, sleep apnea, or early cognitive decline. Proper evaluation can improve memory, mood, blood pressure control, diabetes control, fall prevention, and overall quality of life.

 

 

Dr Manicka Saravanan,

Dr M.S. Clinic, Adambakkam.

For appointments

9600925266