Medically reviewed by Michael MacIntyre, MD

• Natural changes in sleep cycles, stress, and medication side effects are among the reasons sleep can get worse in middle age.
• Not getting enough sleep increases your risk of chronic health conditions, cognitive issues, and other health issues.
• To improve your sleep quality, focus on setting up a healthy bedtime routine, exercising frequently, and following a healthy eating pattern.

For many people, midlife marks a period of change—but aside from larger career pivots or shifts in family dynamics, you might also notice that you don't sleep as well as you did when you were younger.

Aging and poor sleep are closely linked, which can have a serious impact on your brain health and the rest of your body. Everything from new medications to hormonal changes may be to blame, but there are some steps you can take to get better rest as you age.

Why Sleep Gets Worse as You Age

Starting in middle age, many people find it harder to fall asleep and stay asleep, leading to fewer hours slept each night.

Sleep is a complex process, and there are a number of factors that can impact why sleep may be more difficult in your 40s, 50s, and beyond.

1. Changing Sleep-Wake Cycles

As most people age, their sleep-wake cycles shift up—essentially, you're more likely to be a "morning" person as you reach midlife and beyond. This is caused by natural changes to your circadian rhythm, or your internal body clock, which starts to signal that it's time to wake up and go to bed earlier.

2. Changing Sleep Patterns

When you sleep, your brain and body cycle through periods of deeper and lighter sleep. In middle and older age, people don't get as many minutes of deep sleep, plus their bodies go through fewer of these sleep cycles.

Middle-aged people are also more likely to be light sleepers—they usually report more fragmented sleep and more time spent awake in the middle of the night, which worsens sleep quality.

3. Chronic Disease

When you reach midlife, your risk of chronic disease increases. Many of these conditions—including type 2 diabetes, heart failure, and neurological conditions such as Alzheimer's disease—are associated with poor sleep.

Chronic pain also becomes more common once people reach middle age. Sometimes, pain can interrupt people's sleep.

4. Medications

For people managing new conditions in midlife, medication side effects may mess with your sleep as well. This can happen with certain antidepressants and beta-blockers (used to treat heart conditions or anxiety), as well as cholesterol-lowering drugs called statins, in very rare cases.

5. Hormonal Shifts

As you age, you produce less melatonin, a hormone that regulates your sleep-wake cycle and helps you fall asleep.

Plus, midlife often brings about perimenopause and menopause for people assigned female at birth. These hormonal transitions cause hot flashes, night sweats, and other symptoms that disrupt sleep. In fact, it's estimated that up to 47% of people in perimenopause and 60% of people in menopause have a sleep disorder.

6. Sleep Disorders

As people age, especially once they reach the tail end of midlife or are officially considered older adults, sleep disorders become more common. Those include:

• Obstructive sleep apnea: This condition causes breathing problems during sleep that make it hard for the body to get enough oxygen. Globally, an estimated 936 million people ages 30–69 have obstructive sleep apnea.
• Insomnia: Affecting about 16% of the population worldwide, insomnia refers to chronic difficulties falling or staying asleep that affect day-to-day function.
• Restless legs syndrome: People with this condition experience an involuntary need to move their legs at night.

7. Lifestyle Changes

Sleep problems in middle-aged adults can also stem from the changes in daily life, such as:

• Less physical activity: As many people get older, they become less physically active and more sedentary. This raises the risk of insomnia and other sleep problems.
• Changes in schedule: Generally, having a consistent routine improves sleep. People in midlife may struggle to keep a consistent sleep schedule as they deal with parental responsibilities or unexpected changes in work schedule, such as helping a sick child in the middle of the night or staying late at the office.

8. Stress and Worry

Anxiety and stress are common causes of insomnia and sleep problems. In middle age, stressors, including problems at work, conflicts in relationships, or financial issues, may worsen your sleep.

Worry is another sleep killer. In a study of adults ages 40–60, worrying about adult children and aging parents significantly impacted sleep quality—and, getting a bad night's sleep was linked to more worrying about family members, too.

Health Impacts of Not Getting Enough Rest

Middle-aged adults—like all adults 18 to 60 years old—should get seven to nine hours of sleep per night. Not getting enough rest and trouble sleeping at night can have a wide range of impacts on health and wellbeing, including:

• Greater risk of cognitive decline, including difficulties with short term memory and attention, and neurological diseases such as Alzheimer's
• Worse mood and a greater prevalence of negative emotions
• Worsening anxiety, depression, or other mental health issues
• Increased chances of developing high blood pressure or type 2 diabetes
• Weakened immune system and a greater chance of infection

How To Improve Your Sleep

As you move into midlife and older age, certain lifestyle changes and habits may be able to help improve sleep issues, including:

• Establishing a consistent wake-up time and bedtime
• Ensuring your bedroom is quiet, cool, and dark
• Avoiding screens, large meals, and alcohol before bedtime
• Limiting caffeine intake to the morning or early afternoon
• Getting regular exercise
• Eating a well-balanced diet
• Practicing relaxation techniques to manage stress, like meditation or mindfulness
• Using the bed only for sleep or sexual activity

Since a lack of sleep can be detrimental to your health, it's important to get in touch with a doctor or sleep specialist if these lifestyle changes aren't improving your sleep, or if your lack of sleep is interrupting your day-to-day life.

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Kristina Dawson