Ask the Expert – Amy Natt – May 2026
I turned 73 this year and I am increasingly noticing that I am having difficulty sleeping. I often find myself lying awake at 3am and then I am groggy and have low energy the next day. I used to be a great sleeper, what can I do to deal with this insomnia?
Insomnia is something that impacts many older adults and should not be ignored or dismissed as a normal part of the aging process. As a person ages, they require the same 8 hours of sleep as younger adults, sometimes more. Approximately 50% of older adults report having sleep issues and this age group is more likely to report insomnia than younger adults. Sleeping patterns may change over time, but quality sleep is of equal importance.
Some of the reasons an older adult might experience sleep difficulties include but are not limited to: Chronic pain, stress, medications, chronic obstructive pulmonary disease, sleep apnea, depression, anxiety, onset or progression of medical issues, mobility loss and inactivity, limited social interactions, grief, and caregiving.
A lack of sleep can have a much bigger impact on your day-to-day functioning, beyond feeling tired. Many people see a decrease in functioning, weight loss (or gain), memory loss, poor judgment, medication errors, missed appointments, increased falls, increased anxiety, irritability and even depression.
A starting point is to understand the different types of insomnia. This can help you in describing what you are experiencing. According to the Sleep Foundation, insomnia can be short-term (brief period of time) or chronic (long-term pattern). Each can have different and specific causes. Some people experience difficulty falling asleep. This is sleep onset insomnia. Others have an inability to stay asleep through the night. This is sleep maintenance insomnia. Late insomnia is when a person wakes up too early and is unable to fall back to sleep. There is also mixed insomnia, which can be a combination of the above.
There are many different causes and treatments for insomnia. In extreme cases, it may be diagnosed as a sleep disorder. It is important to report and discuss this with your primary care physician. In preparation, you can keep a sleep diary to help identify patterns. Here are some things you might include in your daily notes:
- What time did you get into bed?
- How long did it take you to fall asleep?
- How many times did you wake up?
- How long did you stay awake each time?
- What time did you wake up for good?
- Did you feel tired the next day?
- How many times did you nap during the day? How long was each nap?
- How many alcoholic or caffeinated drinks did you have?
- Which over the counter and prescription medications do you take?
- Did you exercise? At what time?
- What time did you last use an electronic device/TV prior to going to bed?
- Describe your sleep environment.
This information will help your medical team determine what diagnostic tools would be appropriate to fully evaluate your specific concerns. For example, they may order a full sleep study, make medication changes, suggest a wearable sleep tracker, or refer you for insomnia-specific cognitive behavioral therapy.
The good news is that there are several recommended and effective treatments for a variety of insomnia and other sleep disorders that can help you increase the quality of sleep you are getting. This will help improve your overall health and wellbeing. We all deserve a good nights sleep, so addressing the issue now is a great step in the right direction.