What Causes Insomnia? 7 Reasons Women Over 65 Can't Sleep

Insomnia—trouble falling asleep, staying asleep, or waking too early—is common as we age. If you're a woman over 65 and finding sleep harder to come by, you're not alone. Understanding what causes insomnia is the first step toward better rest and better health.

Below are seven well-supported reasons insomnia is more common later in life, explained in clear, everyday language. These causes are drawn from well-established medical knowledge used by doctors and sleep specialists worldwide. While this information is meant to be reassuring and practical, it's also important not to ignore symptoms that may signal a serious issue. If something feels concerning, please speak to a doctor.

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1. Natural Changes in Sleep as We Age

As we get older, the body's internal clock (circadian rhythm) changes. This affects when we feel sleepy and how deeply we sleep.

Common age-related sleep changes include:

• Feeling sleepy earlier in the evening
• Waking up earlier in the morning
• Lighter sleep with more frequent awakenings
• Less deep, restorative sleep

These shifts are normal, but they can still be frustrating. Even when total sleep time looks "okay" on paper, lighter sleep can leave you feeling tired during the day. This is one of the most common explanations doctors give when patients ask what causes insomnia later in life.

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2. Hormonal Changes After Menopause

Hormones play a major role in sleep, and menopause brings long-lasting changes. Even many years after menopause, lower estrogen and progesterone levels can continue to affect sleep quality.

Hormonal changes may cause:

• Night sweats or feeling overheated
• More frequent nighttime awakenings
• Increased sensitivity to stress

These symptoms may come and go, which can make insomnia feel unpredictable. While hormone changes are not dangerous on their own, ongoing sleep disruption deserves attention—especially if it affects your mood, memory, or daily function.

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3. Chronic Health Conditions

Many women over 65 live with one or more long-term health conditions, and these can directly interfere with sleep.

Common examples include:

• Arthritis or joint pain that makes it hard to get comfortable
• Heart or lung conditions that affect breathing at night
• Acid reflux that worsens when lying down
• Neurological conditions that disrupt sleep-wake cycles

Pain or physical discomfort is a frequent answer to the question what causes insomnia, and it's one that should never be brushed aside. Poor sleep can worsen chronic illness—and chronic illness can worsen sleep—creating a difficult cycle.

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4. Medications and Their Side Effects

Many prescription and over-the-counter medications can interfere with sleep, especially when taken later in the day.

Medications that may contribute to insomnia include:

• Some blood pressure medicines
• Steroids and certain inhalers
• Antidepressants or stimulants
• Decongestants and caffeine-containing products

Even medications meant to help sleep can sometimes reduce sleep quality if used long-term. Never stop or change a medication on your own, but if sleep problems began after starting a new medicine, it's wise to speak to a doctor about possible alternatives.

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5. Anxiety, Worry, or Depression

Emotional health strongly affects sleep at any age. In older adulthood, insomnia is often linked to ongoing worry, loneliness, or depression—even when these feelings aren't obvious.

You might notice:

• Racing thoughts at bedtime
• Waking up and worrying about health, family, or finances
• Feeling low energy or loss of interest during the day

Mental health concerns are medical concerns. Persistent insomnia alongside changes in mood or thinking should be taken seriously. Help is available, and addressing emotional well-being often leads to meaningful improvements in sleep.

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6. Sleep Disorders That Become More Common With Age

Some sleep disorders are more likely to appear or worsen later in life and are often mistaken for "just aging."

Examples include:

• Sleep apnea, which causes breathing to stop briefly during sleep
• Restless legs syndrome, an uncomfortable urge to move the legs at night
• Periodic limb movements, causing repeated jerking motions during sleep

These conditions can severely disrupt sleep without you fully realizing it. Loud snoring, gasping for air, or extreme daytime sleepiness are important warning signs. If present, it's essential to speak to a doctor, as some sleep disorders can increase the risk of heart disease or accidents if untreated.

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7. Lifestyle and Environmental Factors

Daily habits and surroundings matter more than many people realize, especially with age.

Common contributors include:

• Napping too long during the day
• Limited daylight exposure or physical activity
• Irregular sleep schedules
• Too much caffeine or alcohol
• Noise, light, or an uncomfortable mattress

These factors are often overlooked when asking what causes insomnia, yet they are among the easiest to improve. Small, consistent changes—like keeping a regular bedtime or getting morning sunlight—can have a meaningful impact over time.

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When to Take Insomnia Seriously

Occasional sleepless nights are normal. However, insomnia may need medical attention if it:

• Happens most nights for several weeks
• Causes daytime sleepiness or trouble concentrating
• Affects mood, balance, or memory
• Comes with chest pain, breathing problems, or severe depression

Anything that feels life-threatening or rapidly worsening should be discussed with a healthcare professional right away.

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A Helpful Next Step

If you're struggling with sleepless nights and want to better understand what might be behind your symptoms, you can use a free AI-powered symptom checker for insomnia to help identify possible causes and guide your conversation with a healthcare provider.

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The Bottom Line

So, what causes insomnia in women over 65? Most often, it's not just one thing. Aging, hormones, health conditions, medications, emotional well-being, sleep disorders, and daily habits all play a role. The good news is that many of these causes are manageable once they're clearly identified.

Quality sleep is not a luxury—it's a foundation of good health at every age. If insomnia is affecting your life, don't ignore it. Talk with a healthcare professional about your symptoms, especially if anything feels serious or unusual. Better sleep is often possible, even later in life.