Identifying the underlying problem is the first step toward a good night’s rest.
Smartphones, caffeine, jet lag. Sometimes it’s easy to figure out why you’re staring at the ceiling at 2 a.m.
But what if you’ve banned devices from the bedroom, sworn off caffeine after noon, and keep to a regular sleep schedule? Other factors may be keeping your eyes wide open. A common one: age. Certain sleep disruptors tend to hit later in life.
Here are five reasons you might be up at night—and what to do about each.
1. You’re a Late-Life Insomniac
Slept like a baby your whole life but suddenly struggling to doze off post-retirement? You’re hardly alone. “Insomnia is the most common sleep problem in adults ages 60 and older,” says Damon Raskin, M.D., a sleep expert in California.
The condition is thought to impact older adults more because of the sleep-disrupting physical and mental concerns—say, GI issues or depression—associated with aging. If you have it, you’ll not only have trouble falling asleep, but you struggle to stay asleep, says Dr. Raskin.
See your doctor if you’re worried. “Treatment of late-life insomnia can involve psychological strategies, prescription medicines, or both,” he says.
2. You Have Undiagnosed Sleep Apnea
Sleep apnea—when you experience short pauses in breathing while you slumber—is a common sleep disorder, particularly as we grow older.
And it’s dangerous. “If untreated, sleep apnea can lead to high blood pressure, stroke, or memory loss,” Dr. Raskin says. It’s more difficult to diagnose older patients, he adds, because sometimes it comes with no symptoms. Look out for snoring, waking up with a headache, or feeling sleepy throughout the day—even after a full night’s sleep.
Women in particular should pay attention. “More women develop sleep apnea later in life,” says Michael Breus, Ph.D., a clinical psychologist and fellow of the American Academy of Sleep Medicine. “Prior to menopause, we see a two-to-one ratio of men to women. After, it goes one to one.”
Treatments vary. Losing weight or changing sleeping position can work for some. Others have to wear a CPAP mask, which forces air into the lungs to keep your breathing normal. If you have any symptoms of sleep apnea, see your doctor.
3. Your Body Is Short on Melatonin
As you age, your body creates less of the sleep hormone melatonin, Breus says. Foods like strawberries, cherries, walnuts, and tomatoes contain melatonin, and they can help. But if your body is truly not producing enough, your best bet might be a supplement.
Some research suggests that very low doses (up to 0.5 mg) each night can help ease sleep woes. As always, check with your doctor before starting any supplement.
4. Your Meds Are Messing with You
Doctors don’t always explain all the ways a drug might impact your life, besides treating the condition it’s prescribed for. As it turns out, many common drugs—respiratory meds, decongestants, beta-blockers, and some antidepressants—can disrupt sleep, Breus says.
Before starting a new prescription or over-the-counter med, ask your physician or pharmacist about any sleep-disrupting side effects. If you are currently on a prescription medication and have trouble sleeping, continue taking the medicine as directed, but let your doctor know about the side effects.
5. Your Sleep Architecture Is Changing
Sleeping half the day as an infant or not being able to wake up for class in high school is normal. Our sleep needs evolve as we get older.
“As people age, their ‘sleep architecture’ changes,” Dr. Raskin says. “They tend to go to sleep earlier and wake up earlier.” These changes mean a decrease in deep, restorative sleep and an increase in light, transitory sleep, he says. (Read: You’ll wake up more easily throughout the night.)
Aim for seven to eight hours of sleep per night. In its first-ever age-specific guidelines, that’s the amount the National Sleep Foundation recommends for adults ages 65 and older.