By Small Hours · Last reviewed
Sleep does change as we age, with lighter, more broken sleep on average. But those changes are modest, and ongoing insomnia is a treatable problem rather than something you simply have to accept. [1][2][3]
What the research says
The largest pooling of sleep recordings, 65 studies of 3,577 healthy people aged 5 to 102, shows that sleep does shift across adult life: total sleep, sleep efficiency (the share of time in bed spent asleep), deep sleep and REM sleep all fell with age, while falling asleep took longer and more of the night was spent awake. After 60, only sleep efficiency kept falling. [1] The same paper carries a caution: how carefully people had been screened for mental disorders, illness, drug or alcohol use, sleep apnoea and other sleep disorders changed the size of those effects a great deal, shrinking or even hiding some of them. [1] A 2017 review agrees that older adults sleep less well on average, and notes an unsettled debate about whether they need less sleep or simply cannot produce the sleep they still need. [2] In plain terms, some change with age is expected, and the more carefully a study screened its participants, the smaller that change tended to look.
The studies behind this
- Lifespan meta-analysis (Ohayon, 2004): 65 studies covering 3,577 healthy people aged 5 to 102. In adults, total sleep time, sleep efficiency (the share of time in bed spent asleep), deep sleep and REM sleep all fell with age, while the time to fall asleep and time awake during the night rose. A few nights in the free sleep efficiency calculator will show you yours. Only sleep efficiency kept falling after age 60. [1]
- A caution from the same paper: the size of these changes depended on how carefully participants were screened for mental disorders, organic diseases, drug or alcohol use, sleep apnoea and other sleep disorders. The authors report that screening quality greatly modified the effect sizes, diminishing or even masking age associations for some measures. [1]
- Review (Mander, 2017): older adults on average do not sleep as well as younger adults. Whether older adults simply need less sleep, or are unable to generate the sleep they still need, is still debated. [2]
What is normal, and what is not?
Averages describe groups. A lighter sleeper at 70 is not the same as someone with insomnia disorder, which means persistent trouble sleeping together with daytime problems. [2][3] Brief wakings in the night are part of that average, and we cover when waking at night is normal. For women, the years around menopause bring their own sleep changes, covered in CBT-I for menopause. The research above does not tell you your own normal. If poor sleep is wearing on your days, mood or memory, that is worth treating regardless of age.
Does CBT-I work for older adults?
Cognitive behavioural therapy for insomnia, or CBT-I, is a structured program that changes the habits and thinking patterns keeping insomnia going. Two trials in older adults:
- Digital CBT-I (Ritterband, 2025): 311 people aged 55 to 95. A tailored internet program (with or without added support) improved insomnia severity after treatment and at 6 and 12 months, compared with online patient education. Falling asleep, time awake at night, sleep efficiency and fatigue also improved on most measures. [3]
- Mood protection (Irwin, 2022): 291 adults aged 60 and over with insomnia took part in a 2-month CBT-I program or sleep education. Over follow-up of up to 3 years, major depression developed in 12.2% of the CBT-I group and 25.9% of the education group (hazard ratio 0.51, which means roughly half the risk at any point in time). [4]
Why sleeping pills carry extra risk after 60
- Meta-analysis (Glass, 2005, Toronto): 24 trials in 2,417 people aged 60 and over. Sedatives raised total sleep time by about 25 minutes and improved sleep quality slightly. But adverse thinking and memory events were about 4.8 times more common and daytime fatigue about 3.8 times more common than with placebo. The authors concluded that the benefits may not justify the risks, particularly for people at risk of falls and cognitive problems. [5]
- Canadian deprescribing guideline (Pottie, 2018): for adults 65 and older taking benzodiazepine-type medicines for insomnia, it recommends that slow tapering be offered, regardless of how long they have been taken. It states these medicines are associated with harms, and that their benefits may be short-term. Tapering raised the rate of stopping without serious harms. [6]
- Beers Criteria (2023): the American Geriatrics Society keeps a list of medicines that are typically best avoided by people 65 and over in most circumstances. It is designed to support, not replace, shared decisions between a clinician and a patient. [7]
If you take a sleep medicine, do not stop it suddenly on your own. Talk to your doctor or pharmacist about a plan; we describe what the research says about coming off sleeping pills.
Where the evidence is thin
- The lifespan meta-analysis covers studies up to 2003, and the results shift with how participants were screened. [1]
- Both CBT-I trials are single studies. The Irwin trial was at one site, its CBT-I group had more people drop out of follow-up, and most participants were White, so it may not apply to everyone. [4] The digital trial enrolled volunteers in a research study, who may differ from people seeking help on their own. [3]
- The sedative meta-analysis is from 2005 and looked at short-term use. [5]
- The Beers list is designed for the United States, and the authors note there may be extra considerations in other countries. [7]
Where does this leave you?
Age changes sleep a little. It does not remove your ability to improve it. Small Hours turns a nightly sleep diary into a plan built around your own sleep. You can sign up at trysmallhours.com.
When should you talk to a doctor?
- Sleep trouble lasting months, or new changes in your sleep.
- Loud snoring, breathing pauses or falling asleep during the day.
- Memory changes, low mood, or falls.
- Before changing or stopping any sleep medicine.
General education, not medical advice.
References
- Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004;27(7):1255-1273. Source for reference 1 (opens in a new tab)
- Mander BA, Winer JR, Walker MP. Sleep and human aging. Neuron. 2017;94(1):19-36. Source for reference 2 (opens in a new tab)
- Ritterband LM, Shaffer KM, Thorndike FP, Chow PI, Gonder-Frederick L, Ingersoll KS, Cohn WF, Frederick C, et al. A randomized controlled trial of a digital cognitive behavioral therapy for insomnia for older adults. NPJ Digit Med. 2025;8(1):458. Source for reference 3 (opens in a new tab)
- Irwin MR, Carrillo C, Sadeghi N, Bjurstrom MF, Breen EC, Olmstead R. Prevention of incident and recurrent major depression in older adults with insomnia: a randomized clinical trial. JAMA Psychiatry. 2022;79(1):33-41. Source for reference 4 (opens in a new tab)
- Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ. 2005;331(7526):1169. Source for reference 5 (opens in a new tab)
- Pottie K, Thompson W, Davies S, Grenier J, Sadowski CA, Welch V, Holbrook A, Boyd C, et al. Deprescribing benzodiazepine receptor agonists: evidence-based clinical practice guideline. Can Fam Physician. 2018;64(5):339-351. Source for reference 6 (opens in a new tab)
- 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. Source for reference 7 (opens in a new tab)
This article is general education, not medical advice. It cannot diagnose anything or replace a conversation with your doctor. Read how we choose and check sources on the how we write page.