65+ How to improve sleep hygiene

Improving Sleep Hygiene in Adults 65+

Good sleep is vital for physical health, mental clarity, and overall quality of life—especially after age 65. Changes in sleep patterns, medications, chronic conditions, and lifestyle shifts can make it harder to fall asleep and stay asleep. Focusing on sleep hygiene—the habits and environment that support restful sleep—can help you get the rest you need.

Why Sleep Hygiene Matters after 65
• Sleep architecture changes with age
• Increased risk of insomnia and daytime fatigue
• Links between poor sleep and falls, mood disorders, memory loss

Research Highlights
• Lichstein et al. (1994) found that stimulus control and consistent sleep routines improved sleep in older adults.
• Reid et al. (2010) showed that regular aerobic exercise boosted self-reported sleep quality and daytime function.
• Edinger et al. (2021) confirmed that behavioral treatments—like cognitive restructuring and relaxation training—are effective for chronic insomnia.

Core Components of Good Sleep Hygiene

1. Consistent Sleep–Wake Schedule
   • Go to bed and wake up at the same time every day, even on weekends.
   • A stable circadian rhythm helps you fall asleep faster and enjoy deeper sleep.

2. Stimulus Control
   • Use the bed only for sleep and intimacy.
   • If you can’t fall asleep within 20 minutes, leave the bedroom and do a quiet activity (reading, knitting) until you feel sleepy.
   • Return to bed only when you’re ready to sleep.

3. Bedroom Environment
   • Keep the room cool (60–67°F or 15–19°C), dark, and quiet.
   • Consider blackout curtains, white-noise machines, or earplugs.
   • Invest in a comfortable mattress and pillows suited to your preferred sleep position.

4. Pre-Sleep Routine
   • Wind down for 30–60 minutes before bed with relaxing activities.
   • Avoid screens (phone, TV, tablet) at least an hour before bedtime; the blue light can suppress melatonin.
   • Try reading, gentle stretching, or listening to calming music.

5. Limit Stimulants and Heavy Meals
   • Cut off caffeine (coffee, tea, soda, chocolate) by early afternoon.
   • Avoid nicotine, which is stimulating and can fragment sleep.
   • Finish big meals at least 2–3 hours before bedtime to prevent indigestion.

6. Moderate Evening Alcohol
   • While alcohol may help you fall asleep initially, it disrupts sleep stages and leads to nighttime awakenings.
   • If you drink, limit yourself to one standard drink and finish at least 3 hours before bed.

7. Daytime Activity and Exposure to Natural Light
   • Aim for at least 30 minutes of moderate aerobic exercise (walking, swimming, cycling) on most days. Research shows this improves sleep quality and daytime energy.
   • Get morning sunlight exposure—sit by a sunny window or take a brief walk outside. Natural light helps regulate your internal clock.

8. Manage Naps Wisely
   • Short naps (20–30 minutes) can boost alertness without ruining nighttime sleep.
   • Avoid late-afternoon naps that push bedtime later.

Behavioral Strategies for Chronic Insomnia
According to Edinger et al. (2021), combining sleep hygiene with cognitive and behavioral techniques offers the best results for persistent insomnia. Consider:

• Sleep Restriction
– Limit time in bed to the actual amount of sleep you typically get (e.g., if you sleep 6 hours, spend only 6–6.5 hours in bed).
– Gradually increase time in bed as sleep efficiency improves.

• Cognitive Restructuring
– Identify and challenge unhelpful thoughts (“I’ll never sleep well again,” “I’ll be useless tomorrow”).
– Replace them with realistic, calming statements (“I might not sleep perfectly, but I can rest my mind,” “Even short sleep helps my body recover”).

• Relaxation Training
– Practice progressive muscle relaxation, deep breathing, or guided imagery.
– Use apps or recordings that guide you through these exercises.

• Mindfulness and Meditation
– Daily mindfulness practice can reduce hyperarousal and intrusive thoughts that keep you awake.
– Even 10 minutes a day can make a difference.

When to Seek Professional Help
Most sleep problems respond to improved sleep hygiene and behavioral strategies. However, talk to your doctor if you experience:
• Loud, chronic snoring or gasping for air (signs of sleep apnea)
• Restless legs or leg jerking at night
• Unexplained daytime sleepiness interfering with daily activities
• Symptoms of depression or anxiety affecting sleep
• Pain or discomfort that prevents you from sleeping

You might also consider doing a free, online symptom check for to better understand your sleep issues and whether you need further evaluation.

Tips for Implementing Changes
• Start small—pick one or two habits to change each week.
• Keep a sleep diary to track your bedtime, wake time, naps, exercise, and how rested you feel.
• Involve a partner or family member for support and accountability.
• Celebrate small wins (falling asleep faster, fewer awakenings).

Common Challenges and Solutions
Challenge: “I can’t stop worrying when I get into bed.”
Solution: Set aside 15 minutes of “worry time” in the early evening. Write down concerns and possible solutions, then close the notebook before bedtime.

Challenge: “My medication schedule disrupts my sleep.”
Solution: Review your prescription times with your doctor or pharmacist. They may adjust dosing schedules or suggest alternatives with fewer sleep-related side effects.

Challenge: “My partner has a different sleep schedule.”
Solution: Coordinate as much as possible—share evening routines or designate overlapping quiet time. Use separate bedding or white-noise machines if necessary.

Maintaining Progress
• Revisit your sleep diary monthly to spot patterns.
• Refresh your bedtime routine with new relaxing activities (a different book, new music, or aromatherapy).
• Keep sleep hygiene top of mind—small lapses are normal; refocus on good habits promptly.

Safety and Special Considerations
• If you have mobility issues, choose gentle exercise like chair yoga or water aerobics.
• Discuss any major lifestyle changes—especially exercise or dietary adjustments—with your doctor.
• If you’re taking multiple medications, ask about interactions that could affect sleep.

Final Thoughts
Improving sleep hygiene takes time and patience, but the payoff is well worth it: better mood, sharper memory, improved balance, and a higher quality of life. Begin with small, manageable steps, build consistency, and consider behavioral strategies if insomnia persists. Above all, speak to a doctor about any symptoms that could be life threatening or serious. Good sleep is within reach—prioritize your habits and create a restful environment to enjoy the restorative rest you deserve.