If you’re middle-aged — broadly, anywhere between about 40 and 65 — you’ve probably noticed that you don’t sleep as well as you used to. Recognizing the various contributing factors can help you safeguard your sleep during this stage of life.
Midlife sleep needs and realities
Although the amount of sleep you need stabilizes after age 18 (with adults generally requiring seven to nine hours a night), the nature of that sleep continues to change. You’ll still cycle through the various stages of sleep each night, but the amount spent in each stage gradually shifts. Compared to younger adults, you’ll spend less time in Stage 3 (deep sleep) — a gradual change that begins in adolescence and continues into old age. The gradual decrease in deep sleep is offset by increases in transition and light sleep.
Spending more time in light sleep also means it’s easier to be awakened, which, in turn, means that you’ll spend more time getting back to sleep, which can lead to less sleep overall.
Physical changes
Perimenopause and menopause
For women, both perimenopause and menopause can wreak havoc on sleep starting in their 40s. Hot flashes, driven by hormonal changes, can begin during perimenopause (the timeframe that leads up to menopause) and can last for several years afterward. Women who experience hot flashes may wake up sweating and can feel physically uncomfortable — both because of the sensation of heat and because of clamminess — and may also struggle to fall back asleep.
Obstructive sleep apnea
Up until midlife, women tend to be at lower risk for obstructive sleep apnea, a sleep disorder in which blockages in the airway cause temporary pauses in breathing. Those pauses can result in gasping, snoring, and multiple awakenings throughout the night. After menopause, however, obstructive sleep apnea rates for men and women tend to even out, with the increase for women driven primarily by hormonal changes, including potential weight gain and muscle tone changes.
Weight gain
Both men and women are prone to weight gain as they age. In addition to increasing the risk for obstructive sleep apnea, this excess weight can make snoring more likely, which can be disruptive to one’s bed partner, notes Wendy Troxel, Ph.D., a senior behavioral scientist at the RAND Corporation and author of “Sharing the Covers: Every Couple’s Guide to Better Sleep.”
Sleep-partner issues
By this point in your life, you may have been sharing your bed with a partner for many years. This can be a source of comfort, but it can also be disruptive to your sleep, Troxel says. Part of this is due to the changes in sleep architecture that come with age, she adds: “When we’re in the lighter stages of sleep, we’re more easily awakened, even by some sort of minor disruption from our partners.”
The combination of more time spent in light sleep, coupled with increased potential sleep disruptors from bed partners, such as snoring, means a greater likelihood of being roused from sleep.
“We might just become more aware of our partners’ movements or other sources of disruption,” Troxel says. As people enter middle age, “There are just more factors at play that can interfere with each individual and therefore make the shared sleep experience even more challenging.”
Slower recovery
In middle age, people tend to bounce back more slowly than they once did, whether from physical issues or sleep deprivation.
More aches and pains
Increased stiffness, as well as muscle and joint pains, become more common with age. It also takes longer to heal from injuries than it once did. As these various aches and pains creep in, they may end up disrupting sleep. “Back pain, neck pain, shoulder pain, knee pain — all of these things that are associated with aging can also compromise sleep,” Troxel says. Then there are the effects of medications, either for these physical ailments or for other age-related issues: As you increase the number of medications you take, there’s an increased potential for sleep-related side effects, Troxel points out.
The effects of alcohol
Although alcohol is a sleep disruptor at any age, the effects can be more pronounced in midlife than in young adulthood. Among the concerns: Alcohol is metabolized more slowly as we age, and the potential for an interaction with a medication is greater (given the increased likelihood of taking more medications). Plus, the likelihood of waking is exacerbated, given that you’re spending more time in light sleep and thus are more likely to be awakened during the night. Alcohol also increases the need for overnight bathroom visits — already more common as we age.
Jet lag and other sleep disruptors
Other common sleep disruptors, such as travel, may take longer to recover from than they once did. “We tend to experience jet lag more profoundly as we age,” Troxel says. “People often find that the impact on daytime functioning is much more significant.”
Stress and life changes
Certain sleep disruptors, such as new parenthood, are less likely, but other life shifts may affect your ability to fall or stay asleep. Even though middle-of-the-night newborn wakings and childhood nightmares may be a thing of the past, parents may now lie awake worrying about paying for college or retirement or find themselves unmoored by becoming empty-nesters.
“It’s important to think about the confluence of life changes and stressors that happen at midlife,” Troxel points out. “There can be lots of different life transitions that are happening both in the home and in the workplace.”
Relationships with longtime partners may be undergoing changes due to various midlife transitions, and the resulting stress may further impact sleep. “Midlife is a time when couples who have been together for a long time are sort of entering a new chapter,” Troxel says. “As with any new chapter or transition in a couple’s life, that can also create stress.”
Addressing midlife sleep changes
Despite all this, Troxel says, “It’s not inevitable that as we age, we have to accept poor sleep.”
Instead, take the time to identify the various factors that may be eroding your sleep so you can address them. This may mean lifestyle changes, such as addressing weight gain or alcohol intake, or simply recognizing that certain activities like travel now require more recovery time. It may mean addressing sleep disorders such as obstructive sleep apnea that may have developed. Some couples may even consider separate sleeping arrangements if one partner is regularly being kept awake by the other’s snoring or restlessness.
Although addressing sleep hygiene and any underlying disorders may suffice, those with chronic insomnia (defined as having trouble falling or staying asleep at least three times a week for at least three months) should also consider cognitive behavioral therapy for insomnia (CBT-I), which incorporates both cognitive and behavioral techniques and is considered the most effective first-line treatment for insomnia.
All of this may take a bit more work than it did when you were younger, but the result — a good night’s sleep in middle age and beyond — will be well worth it.
