Sleep problems in later life
Long term causes of bad sleep
We talked to people aged 65 and over about their sleep. Many were not surprised that it was poor now and had expected their sleep to get worse as they got older. They may have seen a gradual decline in their sleep. Some also said it had been bad at other times in their lives, for various reasons, and that was still having an impact on them now. These reasons could include:
- Bereavement
- Being a carer
- Having had children
- Menopause
- Having worked shifts
- Past and present worries and stress
- A prior health problem
Bereavement
One very common reason for having poor sleep now was the death of a loved one. People talked about how they found their sleep had gotten worse once their partner had died, and remained poor, even though it may have been several years since the death of their partner.
Being a carer
Others had been a carer for a loved one who was terminally ill. They found that caring duties and the worry they felt for their loved one disrupted their sleep. Judy looked after her brother for two years before he went to live in a care home but her sleep was still bad because she felt guilty and worried about him.
Joyce finds that since her husband died, 5 years ago, her sleep has been quite fragmented, and she often watches television in the night.
Joyce finds that since her husband died, 5 years ago, her sleep has been quite fragmented, and she often watches television in the night.
SHOW TEXT VERSION
PRINT TRANSCRIPT
You see really. So I didn’t get a good night’s sleep. I did have some sleep but not a good night’s sleep. And I think this is what happens. If you go to bed and you are tired and like as I said, I can’t sleep during the day, I never have been able to sleep. I am not one that would lay and doze in a chair or anything. If I was really tired I would have to lay down and stretch out, but it is a thing I have never done and I have always tried to keep busy so that when I go to bed I am exhausted. But some nights, I might get six hours. And another night it might only be about three. It all depends how your mind works, but as I said before I do find that the television is a boon in the middle of the night. It saves you tossing about. You can put it on quietly and there is some quite interesting programmes on, especially the BBC news the world news. And I do find that interesting and I find before I know where I am I have dozed off and missed half of it you see, and then perhaps I might wake up about seven, come down and make a cup of tea and come back and usually my brother puts the paper in for me about quarter to eight and I go back with the paper. Sometimes I might doze off for another hour. But otherwise I get up and try and keep busy, but that is how I find, that since I lost my husband, that is how my sleep pattern is.
So was it different when your husband was alive?
Oh yes. I could always have a good night’s sleep. Never no bother, you know, always reckoned to have a good seven hours at least. Seven or eight.
What seven hours unbroken or…?
Yes usually yes.
Even though her sleep had improved a bit since her husband had died, Dessie still found herself waking up remembering what she had been through.
Even though her sleep had improved a bit since her husband had died, Dessie still found herself waking up remembering what she had been through.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well we had just moved house and we had got a new doctor and she did very kindly come and see me one afternoon and he said if you need me for anything he said, you know, I am only on the end of the phone.
Oh that is good.
Just give me a bell, and if I am not there my wife will be there and she can relay a message, just ring me. He said do you need anything at the moment and I said no not really because although I was waking up a lot then, I thought oh this will pass, you know, this too shall pass, you know, and get through, you get through the funeral, you get through the everything else that you have got to get through and after a few months I thought oh well my sleep isn’t coming back like I hoped it would.
Did it improve a bit?
It improved a little bit yes, but then of course the things that wake you up are when you have been through that you are thinking could I have done anything else. What about if I had done this or said that. And you just get those sort of thoughts as well that wake you up. And constant dreams, dreams of being there.
Robert describes how the 'stop and start' sleep pattern he had when he was caring for his terminally ill wife has continued after she died.
Robert describes how the 'stop and start' sleep pattern he had when he was caring for his terminally ill wife has continued after she died.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well I knew, I thought she was dying, and nobody had said dying, but gradually the body language of the consultants and the nurses you know, you put all this together and my own common sense I did know. But this, it still couldn’t help the problem of being awake in the worst case about six times a night when she was diabetic. When we got that under control she kept wanting to go to the toilet. And other times when she couldn’t sleep and she would want to get out of bed and so on. And that set my physical condition and I think my sleep mode until the end of April when she went and I went away for a holiday and then sleeping in my little caravan I had some good night’s sleep. But after getting refreshed as it were, I think the body was telling me you have got to have some sleep. Once I was obviously physically better, I reverted, I have reverted now to this stop and start sleeping. Previously as I could go to bed at ten o’clock, eleven o’clock and wake up at half past six or seven o’clock or when I wanted to, and have a solid night’s sleep. It is still an interrupted sleep pattern.
Judy cared for her brother, who had dementia, until her sleep was so disturbed the doctor suggested he be moved into a home.
Judy cared for her brother, who had dementia, until her sleep was so disturbed the doctor suggested he be moved into a home.
SHOW TEXT VERSION
PRINT TRANSCRIPT
So he was wondering around in the night here?
Oh gosh yes, absolutely, and then sometimes he wouldn’t get up in the morning, and he wouldn’t get up and have anything to eat, and as I say in the end, it got so stressful that the doctor said he has got to go, and that is what we did. But he was quite happy where he was, but he lasted a lot longer than we thought he would.
Were you working at the time as well?
No I gave up work to look after him. But, even when he was well I didn’t sleep that well.
Really, so even before he was poorly?
Yes, before he was ill, I was 64 when that happened, and I was going for retirement anyway, but I just to give up the job straight away and there was an awful lot to do as far as his place was concerned. When I look back on it, I don’t know how I did it, but I did it, and then we brought him up here which was so much easier for me, but he got worse, and you never know if you are doing the right thing or not.
Having children
Other women mentioned that disturbance in their sleep had started when their children were young and it had never been the same since.
The menopause
A few women thought that one of the possible reasons for their poor sleep was the onset of the menopause, and the symptoms that are associated with it.
Mary also wasn't sure whether it was the menopause that was the start of her sleeping problems, or having to be alert listening for her children.
Mary also wasn't sure whether it was the menopause that was the start of her sleeping problems, or having to be alert listening for her children.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Can you think back to when this type of sleep you have got now…?
I think it started with the menopause. Although I think it might have started when I had children. I mean I think once you have children you are much more alert to waking up. I don’t remember before having children having any problems with sleep at all. And then I remember waking up with the children but mostly it is since the menopause.
You have had more disturbed sleep you are saying. And what about getting to sleep. The time it takes you to get to sleep. When did you notice that?
When did that start? Probably in the last ten years I think. I haven’t really sort of analysed it.
So it was like a gradual onset?
It was a gradual onset yes and it is not because I have been particularly worrying about anything although of course we all know that once we start thinking about things that keeps us awake more than anything else. So I try very hard to shut up, shut off and forget anything that might be worrying me.
Although Juliet did have her sleep disturbed at night by pain, she also felt that hot flushes made her toss and turn at night.
Although Juliet did have her sleep disturbed at night by pain, she also felt that hot flushes made her toss and turn at night.
SHOW TEXT VERSION
PRINT TRANSCRIPT
I think it is not always the pain, I get, I often get very hot at night and I try and keep… and then I get cold. So you tuck the bedclothes at bit, you know, a bit like, you know, the old hot flushes, you know, you toss the bedclothes off and then you are cold. It is quite often with diabetes as well having to go to the lavatory. So it is not always the pain, but it is a lot of the time. I am conscious of it. And I am conscious of having quite a low level of sleep before I actually wake up. It is almost as if I take a long time to come round, you know.
Working shifts
A few people had worked in shifts in the past which they thought might have had an influence. Christopher said that because he had worked shifts he had “never had a regular pattern of sleep all my life”.
Worries
People also talked about how their sleep was affected by worry. Some of these were more recent worries, but several older people also talked about how worries in earlier life were still affecting how they sleep. This varied from worries about family and work, to health and financial issues.
Some older people often woke up in the night thinking about distressing past events and how they might have handled things differently. Others felt that the stress and worry of jobs they'd had before retirement continued to affect their sleep. This could carry on for years after retirement.
Val slept very badly when she was running a care company because of the worry and concerns for the people under her care, and this pattern of sleep continued, even though she has been retired for some time.
Val slept very badly when she was running a care company because of the worry and concerns for the people under her care, and this pattern of sleep continued, even though she has been retired for some time.
SHOW TEXT VERSION
PRINT TRANSCRIPT
What did you start waking up in the night or …just not being able to get to sleep or both?
Waking up. Being sick. I used to be sick. Every night.
Oh goodness. What wake up and feel sick and be sick. Is that the stress?
The stress. It was a very stressful situation and because of the responsibility. It is the responsibility isn’t it. You are responsible for so many vulnerable people and I took it personally. Where I might have got carers going out, but before I went to bed, I rang every one of them to make sure they are working, their car hasn’t broken down.
I think it started, obviously with children you have got to be up a bit… no I slept well. I always slept well.
So growing up you slept well and prior to having children you slept well?
It is the care company I think. That is when it started. And that was because the, as I said before I needed to know that everything was in place before I went to bed, and I am wondering if that… although I am not doing it now, I don’t have to do it now, I am wondering if it is a habit, but I don’t know.
Prior health conditions
For many others though, health problems that had started in earlier life were an additional reason for poor sleep in later life. Significant health issues, such as heart problems, diabetes, rheumatoid arthritis and prostate problems can disturb sleep at the time they are diagnosed. But they can continue to disturb sleep after diagnosis throughout treatment and even when they had recovered.
Sometimes the an injury can cause sleep problems for years afterwards.
John noticed a change in his sleep pattern at the time of his heart surgery 15 years ago, and this has continued.
John noticed a change in his sleep pattern at the time of his heart surgery 15 years ago, and this has continued.
SHOW TEXT VERSION
PRINT TRANSCRIPT
You have talked about your sleep changing as you have got older. Can you think back to what point you noticed it to change to start to deteriorate?
I suppose about yes, I think after my heart surgery funnily enough. That was one of the points…
You were sleeping okay up until that point?
Strangely, yes. You would have thought with a heart problem I wouldn't, I think I was. Yes, I mean to the best of my knowledge and my memory, I think I was having a regular seven hours. And it is in the last fifteen years, twelve, fifteen years that things have deteriorated a bit. I say deteriorated. I don’t feel any particularly bad, you know, this is what, if I felt really wretched I would go to the doctors but I do know I get less sleep. My friends they seem to get a bit more sleep then I do. And they are all about my age.
An injury to his shoulder several years before continued to cause Peter pain and on some nights and he has to get up and take painkillers so that he can get back to sleep.
An injury to his shoulder several years before continued to cause Peter pain and on some nights and he has to get up and take painkillers so that he can get back to sleep.
SHOW TEXT VERSION
PRINT TRANSCRIPT
An average night’s sleep I will go to bed at about eleven. Hopefully get to sleep fairly soon, within ten minutes, quarter of an hour. Could be a problem if I don’t, if I don’t get to sleep fairly soon. A few years ago, well quite a few years ago, I injured my left shoulder. I fell in the shower after running a road race at the YMCA in [Town]. And broke the ball and socket joint on the left side. Well I have to lay on the left side, if I lay on the right side the hanging sort of arm aches badly, but sometimes laying on the left side starts to ache and if I don’t get to sleep, can keep me awake. Under which situation I need to get up and take a painkiller, stay up for anything from half an hour to an hour, watching night time television which is pretty dreadful even though we have got digital. But a normal night I will sleep through generally reasonably well until six something, six thirtyish. Stay in bed till ten past eight, turn on the radio at eight, just before eight for the news and get up at ten past eight. That is typical.
Mary realised she had never slept very well, and that this may be because of having bad asthma as a child.
Mary realised she had never slept very well, and that this may be because of having bad asthma as a child.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well… no, there wasn’t a strict routine at all but I had very bad asthma as a child. So probably I didn’t sleep very well. I have never thought about it actually until you mentioned it this moment but no I got a lot of asthma. I was off school a lot.
Because the treatment then wasn’t so good?
Oh Ephedrine they gave you. They boiled kettles and things. And my Father would spend a lot of time helping me. At night actually. I remember that now. I hadn’t thought. I may have never slept very well.
Although actually when I was about fifteen my asthma sort of stopped until it came back when I was about forty. So I did have some time. But then I had the children so may be there wasn’t, may be in my twenties I slept well.
Last reviewed November 2020.
Last updated November 2020.
Next review November 2023.
Copyright © 2024 University of Oxford. All rights reserved.