Sleep and Age: How Our Rest Changes Across the Lifespan

Sleep is one of our most fundamental needs, yet the way we sleep transforms dramatically from infancy to old age. Understanding these changes can help us appreciate why a newborn’s sleep patterns differ so vastly from a teenager’s, and why our elderly relatives might wake before dawn.

The Early Years: Infancy and Childhood

Newborns live in a world where sleep dominates. They spend 14 to 17 hours sleeping each day, cycling between sleep and wakefulness every few hours as they feed and grow. Their sleep architecture differs from adults, with about 50% spent in REM (rapid eye movement) sleep compared to the 20-25% adults experience. This abundant REM sleep appears crucial for the explosive brain development happening in those early months.

As infants become toddlers, sleep gradually consolidates into longer nighttime stretches, though naps remain important through the preschool years. By age five, most children need 10 to 13 hours of sleep, and their sleep cycles begin to more closely resemble adult patterns. These years establish sleep habits and circadian rhythms that can influence health for decades to come.

School-age children generally need 9 to 11 hours of sleep, though many don’t get it. The demands of school, activities, and screen time increasingly encroach on sleep time. Yet this is a period when sleep directly impacts learning, memory consolidation, and emotional regulation. Children who sleep well tend to perform better academically and socially.

The Teenage Shift: Adolescence

Adolescence brings one of the most dramatic changes in sleep biology. During puberty, the circadian rhythm shifts later by as much as two hours. This isn’t laziness—it’s biology. Teenagers naturally feel alert later at night and struggle to wake early in the morning. Melatonin, the hormone that promotes sleepiness, is released later in the evening for teens than for children or adults.

This biological shift collides painfully with early school start times in many countries. Teenagers need 8 to 10 hours of sleep, but many get far less. The consequences extend beyond daytime drowsiness to increased risks of depression, anxiety, poor academic performance, and even car accidents among young drivers.

Adulthood: The Busy Years

Young and middle-aged adults need 7 to 9 hours of sleep, though many chronically fall short. The pressures of careers, relationships, parenting, and social obligations create a perfect storm for sleep deprivation. Adults in their 20s through 50s often sacrifice sleep to meet competing demands, not realizing that chronic sleep debt accumulates and affects health, cognitive function, and emotional wellbeing.

During these years, sleep quality begins to subtly decline. Adults spend less time in deep, restorative slow-wave sleep and may wake more frequently during the night. Women often experience sleep disruptions during pregnancy and menopause due to hormonal changes. For many adults, this is when sleep disorders like insomnia or sleep apnea first emerge.

The Golden Years: Older Adulthood

Aging brings further changes to sleep architecture and patterns. The aging population experiences normal aging-related changes in sleep, including alterations in circadian rhythms, sleep duration, and increased prevalence of sleep issues. Older adults often find themselves waking earlier, feeling sleepy earlier in the evening, and spending more time awake during the night. In fact, older adults tend to go to bed earlier and wake up earlier than younger adults. They experience less deep sleep and more fragmented sleep, and sleep tends to be shorter and lighter in older adults, with more frequent awakenings during the night. However, it is a common misconception that older adults require less sleep than younger individuals. In reality, older adults need about the same amount of sleep as all adults—seven to nine hours each night.

Sleep architecture changes with age: the amount of deep sleep older adults get declines, dropping to 10–15% of total sleep time, and a gradual decrease in total sleep time occurs, sometimes by about 30 minutes per decade after middle age. As we age, our bodies produce less melatonin, which helps promote sleep by coordinating circadian rhythms, making older adults more likely to wake up from small disturbances due to reduced melatonin production. The suprachiasmatic nucleus in the brain, which regulates our circadian rhythm, deteriorates with age, weakening the sleep-wake signal. The body’s internal clock becomes less robust, and its deterioration can disrupt sleep-wake cycles, leading to more disrupted sleep. Disrupted sleep is common in older adults due to health conditions, medications, and changes in the body’s internal clock.

Medications and health conditions play a significant role: older adults are more likely to take medications and have medical conditions that affect sleep, and sleep issues may also be related to the side effects of medications, with almost 40% of adults over the age of 65 taking five or more medications. If sleep medication is considered, it is important to consult a doctor before use, as some medications may lead to dependency or lose effectiveness over time.

Sleep disorders are more prevalent in older age. Insomnia is the most common sleep problem in adults age 60 and older, and many older adults experience chronic sleep issues, with estimates ranging from 40% to 70%. Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the most effective first-line treatment for chronic insomnia. Restless Legs Syndrome (RLS) is characterized by an uncontrollable urge to move the legs, often worsening at night, and can make it difficult to fall asleep or lead to highly fragmented sleep. REM sleep behavior disorder involves acting out dreams due to loss of normal muscle paralysis during REM sleep, and managing it requires a safe sleep environment and medical treatment; melatonin supplements are a safe and effective option to help manage this disorder.

Sleep apnea is another common disorder, causing you to stop breathing for a few seconds repeatedly during sleep, and is linked to higher amyloid protein, which is a risk factor for Alzheimer’s disease. Alzheimer’s disease itself can cause sleep disturbances, wandering, and altered nighttime behaviors, making sleep management crucial for both patients and caregivers. Reduced deep sleep can contribute to cognitive decline by impeding memory consolidation and increasing amyloid protein deposition.

Poor sleep quality in older age is associated with increased risk of falls, accidents, and chronic diseases like high blood pressure, diabetes, stroke, and heart disease—a common health condition in older adults that can negatively impact sleep. Research shows that poor sleep increases the risk of various health conditions in older adults, including depression and anxiety. Poor sleep can also exacerbate chronic pain and worsen conditions like arthritis, making it harder to sleep.

Healthy habits, such as good sleep hygiene, consistent routines, and behavioral strategies, are important for managing insomnia and supporting aging well. If sleep issues persist despite good sleep hygiene, consulting a sleep specialist is recommended for expert diagnosis and treatment.

Brain activity is monitored during sleep studies to understand sleep disorders and normal sleep architecture, including the identification of light sleep—the initial, less deep stage of sleep where individuals are easily awakened. Many older adults report feeling tired upon waking, as reduced deep and REM sleep can lead to waking up exhausted or sluggish. Achieving a good night’s sleep is vital for overall health and daily functioning in older adults.

It is important to remember that changes in sleep patterns are a normal part of getting older and not necessarily a sign of a problem. Sleep duration declines with age and is affected by lifestyle and health factors. While older adults often experience less sleep or poorer sleep quality, they do not actually need less sleep. Aging leads to a decrease in sleep duration and quality, but older adults require the same amount of sleep as younger adults.

Supporting Sleep at Every Stage

Recognizing that sleep needs and patterns change across the lifespan can help us approach sleep more wisely. Parents can build healthy sleep routines for children rather than fighting against biological needs. Society might reconsider school start times to align with teenage biology. Adults can prioritize sleep as essential to health rather than an optional luxury. And older adults can seek help for sleep problems rather than accepting poor sleep as normal.

Regardless of age, certain principles support healthy sleep: consistent sleep schedules, dark and quiet sleep environments, regular physical activity, limited caffeine and alcohol, and minimal screen time before bed. But the most important insight may be this: sleep isn’t one-size-fits-all across a lifetime. Understanding where you are in your sleep journey can help you get the rest you need at every age.​​​​​​​​​​​​​​​​

Introduction

Sleep is a vital component of human life, playing a crucial role in maintaining both mental and physical health. As people age, their sleep patterns and needs evolve, often leading to changes in sleep quality and duration. For many older adults, poor sleep quality becomes a common concern, influenced by factors such as sleep disorders, medication side effects, and shifts in daily routines. These changes can have a significant impact on overall well-being and quality of life. Understanding how sleep habits and sleep hygiene affect sleep at every stage of life is essential for promoting healthy aging and addressing sleep-related challenges. By recognizing the importance of quality sleep and adapting to the natural changes that occur as people age, individuals can support their mental and physical health and enjoy better sleep throughout their lives.

Sleep Cycles and Rhythm

Our sleep is governed by the body’s internal clock, known as the circadian rhythm, which is regulated by the suprachiasmatic nucleus in the brain. This internal clock responds to light and darkness, helping to synchronize our sleep-wake cycle. As people age, the circadian rhythm naturally shifts, often resulting in earlier bedtimes and wake-up times for older adults. Younger adults typically experience more deep sleep and spend a greater proportion of the night in rapid eye movement (REM) sleep, which is associated with active dreaming and memory consolidation. In contrast, older adults tend to have lighter sleep, with more frequent awakenings and less time spent in deep, restorative sleep stages. According to the National Sleep Foundation, adults should aim for 7 to 9 hours of sleep each night, but sleep disturbances such as sleep apnea, restless legs syndrome, and periodic limb movement disorder can affect sleep quality, especially as people age. These disruptions can make it harder to fall asleep, stay asleep, and achieve the restful night needed for optimal health.

Infancy and Childhood: Building the Foundation

The early years of life are crucial for establishing healthy sleep habits and building the foundation for lifelong sleep quality. During infancy, babies typically sleep between 16 and 20 hours a day, with their sleep architecture and sleep-wake cycles still developing. As children grow into toddlers, their need for sleep gradually decreases to about 12 to 15 hours, but maintaining a regular sleep schedule and consistent bedtime routine remains essential. Creating a sleep-conducive environment and encouraging good sleep habits during childhood can help improve sleep quality and reduce the risk of developing sleep disorders later in life. Research shows that children who follow a regular sleep schedule and have a calming bedtime routine are more likely to experience better sleep, which supports healthy growth, brain development, and emotional well-being.

Adolescence: The Shifting Clock

Adolescence is marked by significant changes in sleep patterns, largely driven by shifts in the body’s internal clock. During this stage, teenagers naturally experience a delay in their circadian rhythm, leading to later bedtimes and a tendency to sleep in. This biological shift can make it challenging for teens to get enough sleep, especially with early school start times and busy schedules. As a result, many adolescents struggle with poor sleep quality and insufficient hours of sleep, which can impact their mental health, academic performance, and overall well-being. To support healthy sleep during adolescence, it’s important to establish good sleep habits, such as maintaining a consistent sleep schedule, limiting caffeine and screen time before bed, and creating a relaxing sleep environment. The American Academy of Sleep Medicine recommends that teenagers aim for 8 to 10 hours of sleep each night to support their physical and mental health during this critical period of growth and development.

Adulthood: Balancing Sleep and Life

For adults, balancing the demands of work, family, and social life can make it difficult to prioritize sleep. However, maintaining good sleep quality is essential for both physical and mental health. Adults should aim for 7 to 9 hours of sleep each night and establish a consistent sleep schedule to support a healthy sleep cycle. Developing a bedtime routine—such as reading, taking a warm bath, or practicing relaxation techniques—can help signal the body that it’s time to wind down and fall asleep. Avoiding stimulants like caffeine and nicotine, as well as limiting electronics before bed, can further improve sleep quality. Creating a comfortable sleep environment by keeping the bedroom cool, dark, and quiet also promotes better sleep. By adopting healthy sleep habits, adults can reduce their risk of sleep disorders such as sleep apnea and restless legs syndrome, and support their overall well-being. Prioritizing quality sleep is a key component of better health and a more balanced life.