How Sleep Changes As We Age
Table of Contents
The amount of sleep we need changes as we age. (1) Both sleep duration and quality tend to decline as we grow older, leveling off in the ninth decade. While infants typically need the most rest, older adults need the least, and sleep may be fragmented in later life, as well.
Getting a good night’s sleep becomes more difficult beginning in adulthood. Why do sleep needs shift from seventeen hours each night in infancy to seven or less in old age? Physical and mental developments and fluctuations in the body’s natural rhythm cause the architecture of sleep to change over time.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
Why Sleep Changes As We Age
A healthy sleep-wake cycle regulates individualized bed and wake times, causing feelings of sleepiness at night and alertness in the morning. The cycle is sensitive to environmental and physiological changes, and recalibrates in response to fluctuations in body chemicals, lifestyle choices, and health conditions. (2)
The sleep-wake cycle may change with age as the body produces less of the sleep-promoting hormone melatonin. (3) Decreasing levels of growth hormone can lead to a decline in deeper sleep. (4) Lifestyle habits more common in adults like drinking alcohol or caffeine can also affect sleep quantity.
Infants experience long periods of sleep that may total seventeen hours a day. Extended sleep periods in infancy allow for sustained release of human growth hormone, which stimulates muscle and bone growth. (5)
Most babies, children, and adolescents need more rest than adults to support physical and psychological development in such areas as:
- Gross and fine motor skills
- Social interaction
- Intimacy and motivation
FAQQ: What are the signs that a baby isn't sleeping enough? A: Common signs of infant sleep deprivation include a lack of interest in people and the environment, yawning, crankiness, pulling at the ears, and fluttering the eyelids
During the aging process, the body and brain go through fewer physiological changes and sleep often becomes less restorative. Possible reasons include decreased release of melatonin and less time spent in deep N3 sleep. The following changes in sleep patterns may also occur with age:
- Taking longer to fall asleep
- Experiencing less deep sleep
- Waking up three or four times a night
- Frequent trips to the bathroom
- Less restful sleep
- Falling asleep in the early evening and waking up in the early morning
Age And Sleep Stage Variations
Typical sleep consists of four stages: N1, N2, N3, and REM sleep. (6) During N1, N2, and N3, breathing and heart rate slow, blood pressure declines, and the sleeper is relatively still. By contrast, REM sleep closely resembles being awake. The eyes move rapidly and brain waves are similar to those that occur in the waking brain.
Babies spend the majority of sleep time in the deep, slow-wave sleep of N3. Slow-wave sleep gradually decreases throughout childhood, while REM sleep increases. Further declines in slow-wave sleep in adulthood and old age may result in lighter, more fragmented rest with frequent awakenings.
General Sleep Recommendations By Age
The National Sleep Foundation recently created sleep range recommendations based on age: (7)
- Newborns (0-3 months): 14-17 hours
- Infants (4-11 months): 12-15 hours
- Toddlers (1-2 years): 11-14 hours
- Preschoolers (3-5): 10-13 hours
- School-age children (6-13): 9-11 hours
- Teenagers (14-17): 8-10 hours
- Younger adults (18-25): 7-9 hours
- Adults (26-64): 7-9 hours
- Older adults (65+): 7-8 hours
Sleep debtSleep debt is the accumulated amount of sleep loss from insufficient sleep.
Newborns (14-17 hours)
Healthy newborns typically spend most of the 24-hour day asleep. Rest is usually sporadic until they establish a regular circadian rhythm that produces melatonin at the same time each night. A newborn baby may sleep eight to 12 hours at night and accumulate the additional hours through naps.
Infants (12-15 hours)
After three to four months, infants begin to develop a sleep pattern that becomes consolidated into longer periods. As infants reach their first birthday, they typically sleep through the night and take multiple daytime naps.
Toddlers (11-14 hours)
Toddlers nap less often and their sleep becomes more consolidated at night. The toddler stage may be a time of temporary or persistent sleep difficulties, including bedtime resistance, nighttime awakenings, difficulty falling back to sleep, and nightmares. (8) Many experts advise a consistent bedtime routine to help prevent sleep problems, and early intervention with a child sleep specialist should they develop.
Preschoolers (10-13 hours)
When kids reach pre-school age, napping continues to decline. The risk of sleep problems may increase. These issues often include resisting bedtime, asking to sleep with parents, wanting to continue a fun activity, and waking up frequently at night. Nighttime fears, sleepwalking, and sleep terrors can also occur.
School-Age Children (9-11 hours)
By the age of six or seven, many children stop taking naps. Sleep typically happens in a single consolidated block at night. Kids in this age group spend a lot of their sleep in slow-wave sleep, or deep and restorative rest, meaning they are usually very alert and energetic during the day.
Teenagers (8-10 hours)
Adolescents may experience a sleep phase delay due to natural circadian rhythm changes. (9) This shift causes teens to feel alert later at night and makes it difficult to fall asleep. Because most school start times are much earlier than a teenager’s preferred wake time, many students do not get enough rest. Some might develop a circadian rhythm disorder called delayed sleep phase syndrome (DSPS).
Younger Adults (7-9 hours)
As people enter their early twenties, they spend more of their time in lighter sleep stages and less time in deep, refreshing sleep. (10) As a result, young adults often feel less rested after waking up and may experience daylight sleepiness.
Adults (7-9 hours)
Adults need 7-9 hours of sleep per night. Genetic factors and individual chronotype help determine how much rest is needed within this range. However, 1 in 3 American adults doesn’t get enough sleep. Lifestyle factors such as alcohol and caffeine consumption, work and school demands, parenting, stress, and jet lag may contribute to this sleep deficit.
Older Adults (7-8 hours)
The elderly often experience sleep problems such as less restorative sleep, difficulty falling asleep, and frequent awakenings throughout the night. Various causes contribute to potential sleep problems later in life, such as:
- Decreased melatonin production. The brain’s pineal gland produces melatonin, a natural, sleep-promoting hormone. Studies show that night-time levels of melatonin in older adults are a quarter or less of those in younger people, which makes it harder to fall and stay asleep at night (11)
- Chronic medical problems. Sleep problems can also be associated with certain health conditions. (12) These conditions include heart and lung problems, urinary issues that lead to multiple bathroom trips, painful conditions like arthritis, or side effects from certain medications
- Advanced sleep phase syndrome. A significant percentage of the elderly live with advanced sleep phase syndrome (ASPS), a circadian rhythm disorder that causes earlier than typical bed and wake times. For example, some older people may develop a pattern of falling asleep as early as 6 pm and waking up at 3 am or even earlier
Last Word From Sleepopolis
As we age, the body goes through physiological changes that are closely tied to quantity and quality of sleep. Infants and young children need greater amounts of deep and restorative sleep due to rapid physical, cognitive, and emotional growth.
Major growth developments decline as people grow older, leading to lighter sleep of shorter duration. Lifestyle choices such as work schedules, parenting, and alcohol consumption may also contribute to changes in sleep patterns. The prevalence of sleep disorders and chronic illness also increases with age. Understanding these changes in sleep duration can lead to less anxious and more restful sleep—and better health and well-being.
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- Takahashi Y, Kipnis DM, et al. Growth hormone secretion during sleep. Journal of Clinical Investigation, Sept 1968
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- Hirshkowitz M, Whiton K, et al. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health, Dec 2015
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- Van Cauter E, Leproult R, et al. Age-Related Changes in Slow Wave Sleep and REM Sleep and Relationship With Growth Hormone and Cortisol Levels in Healthy Men. Clinical Investigation, Aug 2000
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- Rodriguez J, Dzierzewski J, et al. Sleep Problems in the Elderly. Medical Clinics of North America, Dec 2014