Why Your Parent Can’t Sleep Anymore — The Truth About Aging, Insomnia, and What Actually Helps

By Patrick Mapile, Founder of CarePali Home Care — West Los Angeles

The National Sleep Foundation reports that more than half of adults over 65 experience at least one sleep complaint, with chronic insomnia affecting approximately 30 to 48 percent of older adults — roughly double the rate in younger populations. Yet a study published in the Journal of Clinical Sleep Medicine found that fewer than half of older adults with significant sleep problems ever discuss them with their physician, often because they believe poor sleep is simply an inevitable part of aging. The research says otherwise. While sleep architecture does change with age, chronic sleep disruption is not normal, it is treatable, and leaving it unaddressed has cascading consequences for health, cognition, and safety.

How Sleep Changes With Age — and What Is Actually Normal

The biology of sleep shifts measurably over the lifespan. Research published in Neuron found that deep sleep (slow-wave sleep) decreases by approximately 2 percent per decade after age 30, and by age 70, many people experience 60 to 70 percent less deep sleep than they had in young adulthood. The circadian rhythm advances with age — a phenomenon researchers call "phase advance" — causing older adults to feel sleepy earlier in the evening and wake earlier in the morning. The Journal of Biological Rhythms reports that the suprachiasmatic nucleus, the brain's master clock, loses approximately 40 percent of its neurons by age 80, weakening the circadian signal.

These changes are normal and manageable. What is not normal is persistent difficulty falling asleep, frequent awakenings with inability to return to sleep, non-restorative sleep that leaves a person feeling unrefreshed, or daytime sleepiness that impairs functioning. The American Academy of Sleep Medicine distinguishes between age-related sleep changes and clinical insomnia, noting that the latter requires evaluation and treatment rather than acceptance.

The Health Consequences of Chronic Poor Sleep

The medical toll of untreated sleep problems in older adults is well documented. A meta-analysis published in Sleep Medicine Reviews found that insomnia in older adults is independently associated with a 36 percent increased risk of cognitive decline and a significantly elevated risk of developing dementia. Research from the University of California Berkeley found that disrupted sleep allows the buildup of beta-amyloid plaques — the protein associated with Alzheimer's disease — creating what researchers describe as a self-reinforcing cycle between poor sleep and neurodegeneration.

Fall risk is another critical concern. The Journal of the American Geriatrics Society found that older adults with insomnia are 1.5 times more likely to fall than those who sleep well, with nighttime bathroom trips being the highest-risk activity. Depression and poor sleep are deeply intertwined — research in JAMA Psychiatry found that treating insomnia in older adults reduces depression symptoms by 50 percent in many cases, suggesting that sleep disruption is often a driver of depression rather than merely a symptom.

Common Causes Beyond "Just Getting Old"

Research identifies several treatable conditions that frequently disrupt sleep in older adults. Sleep apnea affects an estimated 20 to 56 percent of adults over 65 according to the American Academy of Sleep Medicine, yet remains dramatically underdiagnosed in this population. Restless legs syndrome affects up to 35 percent of older adults and is highly treatable. Medications are a major and often overlooked culprit — the Journal of Clinical Sleep Medicine reports that beta-blockers, diuretics, corticosteroids, some antidepressants, and decongestants can all significantly disrupt sleep.

Pain is perhaps the most common sleep disruptor. The National Sleep Foundation found that chronic pain — from arthritis, neuropathy, or other conditions — accounts for sleep disruption in over 50 percent of older adults with insomnia complaints. Nocturia (frequent nighttime urination), which affects up to 80 percent of adults over 70 according to the International Continence Society, interrupts sleep an average of 2 to 3 times per night and is itself associated with increased fall risk and reduced quality of life.

What the Research Says Actually Helps

Cognitive Behavioral Therapy for Insomnia, known as CBT-I, is considered the gold standard treatment. The American College of Physicians recommends CBT-I as the first-line treatment for chronic insomnia in adults of all ages, and a meta-analysis in the Annals of Internal Medicine found it effective in 70 to 80 percent of patients, with benefits that persist long after treatment ends — unlike sleep medications, which lose effectiveness over time and carry significant risks in older adults.

The AGS Beers Criteria classifies most common sleep medications — including benzodiazepines, antihistamines like diphenhydramine (Benadryl), and Z-drugs like zolpidem (Ambien) — as potentially inappropriate for older adults due to increased risk of falls, cognitive impairment, and delirium. Research in the BMJ found that these medications increase hip fracture risk by 95 percent in older adults. Evidence-based alternatives include sleep hygiene optimization, light therapy to strengthen circadian rhythm, regular physical activity (which the Journal of Sleep Research found improves sleep quality by 65 percent in sedentary older adults), and treatment of underlying conditions.

West Los Angeles Resources

UCLA's Sleep Disorders Center is one of the nation's leading programs for diagnosing and treating sleep conditions in older adults. The UCLA Longevity Center incorporates sleep assessment into its comprehensive aging evaluations. Several behavioral health providers in West LA offer CBT-I, and the VA Greater Los Angeles Healthcare System provides sleep medicine services for veterans.

At CarePali, our home care aides play an important role in supporting healthy sleep for our clients. From maintaining consistent evening routines and ensuring a safe, comfortable sleep environment to observing sleep patterns and communicating concerns to families and healthcare providers, we help address the daily factors that influence sleep quality. If your parent is not sleeping well and you are concerned about what it means, the answer is rarely "it's just old age." We are here to help figure out what is going on and connect you with the right resources.