Did you sleep?

 

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A good night’s sleep gets harder as we age, but that doesn’t mean we’re doomed to being sleep-deprived zombies after 40.

Typically starting in midlife, we wake up more often, have trouble falling back to sleep, and rise for the day too early. About 55% of Americans ages 40 to 49 and about 58% of those ages 50 to 64 have “low general sleep health,” which includes not sleeping the recommended seven to nine hours a night, not feeling well-rested and having trouble falling or staying asleep, according to 2023 survey data from the National Sleep Foundation, a nonprofit group.

There are many reasons why many sleep troubles hit in middle age, including stress, medical conditions and normal biological changes. Here’s what happens to sleep as we age—and how we can improve our shut-eye.

Your ‘sleep architecture’ changes

Starting in our 20s, the amount of deep sleep we get during the night starts to decline, says Philip Gehrman, professor of psychology at the University of Pennsylvania’s Perelman School of Medicine. By our 40s and 50s, we can really start to notice it, he says. 

This deep sleep, which is especially restorative rest, is particularly important for repairing muscle and bone and strengthening our immune systems, says Dr. Joanna Fong-Isariyawongse, associate professor in the department of neurology at the University of Pittsburgh School of Medicine, who treats sleep disorders. 

What may be driving the reduction in deep sleep, at least in part, is that the number of neurons in the brain that promote sleep and wakefulness declines as we age, Fong-Isariyawongse says. 

What to do: We can’t reverse these natural age-related sleep changes, but we can double down on good sleep practices, says Fong-Isariyawongse. Maintain a regular sleep-wake schedule, be physically active during the day, avoid caffeine at least eight hours before bedtime and keep the bedroom cool, dark and quiet, she says. 

Have a relaxing wind-down routine—and avoid screens—before bed. If you wake in the middle of the night, don’t look at the clock or your phone. If you have trouble going back to sleep, get out of bed and do something soothing like listening to music or reading until you’re sleepy again. 

Sleep disorders become more common

Sleep apnea, a disorder where people repeatedly stop breathing during sleep, becomes more common in your 40s and 50s, particularly in men, says Dr. Douglas Kirsch, medical director of sleep medicine for Atrium Health in Charlotte, N.C. The rates among women tend to rise after menopause, he notes. 

Part of the reason sleep apnea rates increase is that we tend to gain weight in middle age and extra flesh in the neck can compress the airway. 

In addition, age-related sagging doesn’t just affect our faces and arms. “All of our tissues get a little floppier,” Kirsch says. That includes the tissue in our throats—which makes our airway more prone to collapsing, causing sleep apnea. 

Midlife is also a prime time for insomnia, when people have trouble falling asleep or staying asleep. Insomnia is often fueled by stress. While stress can affect us at any age, midlife can be particularly difficult with many people juggling kids, aging parents and peak work responsibilities, says Dr. Greg Mahr, staff psychiatrist at Henry Ford Health in Detroit.  

What to do: Sleep apnea can be treated with oral appliances and CPAP machines that use air pressure to keep the airway open. Milder cases of sleep apnea can sometimes be resolved with weight loss or changing sleeping positions, says Dr. Fariha Abbasi-Feinberg, medical director of sleep medicine at Millennium Physician Group in Fort Myers, Fla. 

For insomnia, exercise can help with stress relief, notes Kirsch. Expressing some of your worries by writing in a journal, praying or talking to a friend can also help promote sleep, says Abbasi-Feinberg.