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Several factors are believed to be responsible for the difficulties that older people encounter when trying to sleep. These include:

• Physical changes. Various aging-related changes in the body may contribute to sleep problems. For example, older people may produce and secrete lower amounts of melatonin, a hormone that is involved in regulating the sleeping and waking cycle. Lower production levels of growth hormone (which promotes deep sleep) and changes in body temperature cycle may also impact the sleep quality of an older person.
  
  
• Increased sensitivity to noise. As people age, they may become more sensitive to environmental noise that disrupts sleep.
  
  
• Emotional and physical illness or conditions. Patients with health problems tend to report poorer sleep than healthy individuals. In addition, people who experience physical pain frequently have difficulty falling asleep and have a poorer sleep quality. Sleep disorders can precipitate or exacerbate many medical conditions including diabetes and cardiac disease and mental disorders including depressive and anxiety disorders.
  
  
• Use of certain medicines. Older people are more likely than younger people to take medications regularly. Some of these medications are known to interfere with sleep, including asthma medications, blood pressure drugs, corticosteroids, cardiovascular drugs, decongestants and gastrointestinal drugs.

Alzheimer’s disease often affects the sleep patterns of older people with the illness. Some patients with Alzheimer’s may sleep excessively, whereas others do not sleep enough. Alzheimer’s patients often awaken frequently at night and may be found wandering around or yelling in the middle of the night.

Other conditions that may cause sleeping problems in older adults include:

• Sedentary lifestyle
  
  
• Arthritis
  
  
• Asthma
  
  
• Cancer
  
  
• Chronic heartburn
  
  
• Emotional disorders (e.g., depression)
  
  
• Enlarged prostate
  
  
• Gastroesophageal reflux disease (GERD)
  
  
• Heart problems (e.g., heart failure)
  
  
• Incontinence
  
  
• Lung disease (e.g., chronic obstructive pulmonary disease)
  
  
• Menopause
  
  
• Osteoporosis
  
  
• Neurological disorders (e.g., Parkinson’s disease, dementia)