Aging and sleep: Making changes for brain health

As a neuropsychologist, my research interests have focused on the link between sleep and cognitive health. As I have gotten older, I have personally come to appreciate the restorative power of a good night’s sleep for thinking, memory, and functioning at my best.

Sleep affects our overall health, including our hormones and immune system. Neurobiological processes that occur during sleep have a profound impact on brain health, and as a result, they influence mood, energy level, and cognitive fitness. Numerous studies have shown that structural and physiological changes that occur in the brain during sleep affect capacity for new learning, as well as the strength of memories formed during the day. Sleep promotes the consolidation of experiences and ideas; it plays a pivotal role in memory, and has been shown to enhance attention, problem solving, and creativity.

Specific sleep stages are associated with different types of learning

Over the course of each night sleep unfolds in five different cycles which alternate throughout the night. These include rapid eye movement (REM) and non-REM stages. REM is the stage when dreaming occurs. This stage of sleep is associated with active eye movements and body paralysis, which assures that a sleeping person is protected from acting out the dream. During REM there is increased activity in limbic structures involved in memory and emotional regulation, whereas there is less activity in frontal brain systems involved in analytic thinking. Fragments of events and memories experienced during the day may be combined in novel and often bizarre ways during REM-based dreaming. REM plays a pivotal role in memory and other cognitive functions. Other sleep stages are also associated with memory. For instance, stage 2 (slow wave) sleep promotes motor skill learning needed for activities such as playing an instrument or keyboarding.

Changing circadian rhythms and sleep disturbances are common

When we get older, we tend to feel sleepy earlier in the evening. This may result in waking up early in the morning as our sleeping hours shift. Older people have less REM and less slow wave sleep. Less slow wave sleep may impede memory consolidation in older adults. In addition to changes in sleep cycles, older people are increasingly vulnerable to sleep disturbances that cause poor sleep and low brain oxygen such as sleep apnea, a medical condition characterized by loud snoring, breathing pauses during sleep, and daytime fatigue. Research has shown that sleep apnea increases amyloid, a protein associated with Alzheimer’s disease. Poor sleep increases amyloid deposition and in turn, amyloid deposition compromises the quality of sleep. In fact, people with Alzheimer’s disease are prone to sleep problems, including insomnia at night and excessive sleeping during the day.

Aging well means prioritizing sleep

We know that a good night’s sleep is good for our brain, especially as we get older. But how do we do this? As a first step you should use a sleep diary to keep track of your sleep schedule for at least two weeks. This will provide objective information regarding the consistency of your sleep routine as well as the association between sleep and your level of alertness during the day.

Recommendations from sleep experts such as Dr. Suzanne Bertisch provide a road map for improving sleep hygiene. The following tips are highlighted:

Consistency matters. Train your body to sleep well by going to bed and getting up around the same time each day (even on weekends).

Only sleep when you are sleepy. Do not spend too much time awake in bed.

Pay attention to your sleep environment. Your bed should be comfortable. The room should be sufficiently dark and quiet. Some people use eye masks to block light. Some use white noise filters or ear plugs when there is noise in or near the bedroom. The temperature of your bedroom should be cool. A cool room with warm blankets is optimal for a good night’s sleep.

Reserve your bed for sleep (and sex). Avoid television, reading, or work activities while in bed.

Avoid (or limit) naps. You need to be tired at bedtime. If you need a daytime nap, do this before 3 PM and for less than one hour.

Avoid stimulants (coffee, cola, chocolate, and cigarettes) for four to six hours before going to bed.

Limit alcohol intake for four to six hours before going to bed. Alcohol disrupts REM and slow wave sleep, which are important for memory.

Avoid electronic devices with LED screens for at least an hour prior to bedtime. The blue light that comes from these screens interferes with the brain’s natural sleep rhythms, and may trick your brain into thinking that it is daytime.

Use rituals. Some people enjoy a hot bath one to two hours before sleep. Others use stretching or mindfulness practices in preparation for sleep.

If you do wake during the night, don’t remain in bed struggling to fall back to sleep. Get up and do something that may increase sleepiness (like reading) for about 20 minutes, and then return to bed and try to initiate sleep.

Sleep is an important aspect of cognitive health, but it is not whole story. Further information regarding brain fitness can be obtained by reading our Special Health Report A Guide to Cognitive Fitness.

Related Information: A Guide to Cognitive Fitness


  1. Susie Fowls

    I struggled with sleep apnea for about 3 years before finding a competent sleep clinic. Addressing the sleep apnea with a good medical doctor changed my sleep life! I sleep between 7 and 8 hours almost every night without waking up. My nights AND days are so much better! Heaven!

  2. Brenda

    I once got up and looked for the most boring book in my library. I chose Ancient Education and Today. It was fascinating, and I stayed awake for hours, but I didn’t mind because I was enjoying myself. So maybe it doesn’t matter much if we don’t sleep every now and then, as long as we find something that we enjoy.

  3. Helene

    Insomnia runs in our family. I am 83 years old and am prescribed Trazadone, Gabapentin and Clonazepam. Even with these meds I am lucky if I get 6 hours of sleep. Have been tested for sleep apnea – none. I go to bed same time each evening after a cup of Chamomile tea, yet wake up tired and am fatigued all day long.
    I am not sedentary, walk 2 – 3 miles daily. Is there help for me???

    • Rethel

      If you are able try swimming or walking In the pool for at least 20 minutes in an evening or late afternoon time period. This always helped my ADDHD son when he was a teen and it helped me a great deal when working a stressful job. Try for 3-4 x a week.

  4. Kathy

    Where can we get an incandescent bulb?

  5. Carole Albores

    I have been using a sleep meditation with very soft music, and it seems help. Also I am wondering …about the value of “sleep aid”.
    doxylamine succinate 25mg.???

  6. john paul

    More than a year, I sleep about 7 hours at night and 3 in the afternoon.
    Recently I am awaked after 7 hour nigh sleep for about 3 more hours.
    Otherwise Im OK

  7. Jay Liu

    good article for sleep. But as you getting older, it is hard to get good sleep regardsless

  8. LeAnn Bjelle

    I live in California with legal cannibus. I frequently take a small amount before bed and I sleep well. I wonder though if I am getting good quality of sleep?

  9. Diana Smith

    How many hours of sleep are required for a person with enlarged heart?

  10. Weena

    My dr husband tried to convince me about so-called “sleep hygiene” regarding my desire to read in bed (my pre-sleep ritual) and wanted me to read elsewhere. Fact is, I have been reading myself to sleep since I was very young (and then, my parents read bedtime stories out loud to help get us kids to sleep). For me the association between reading and sleeping is absolute. If I wake up at night, I read a little (still in bed!) and conk out easily. (It seems to be the specific combination of reading AND being horizontal and warm, with low lights, so if I’m sitting in a chair during the day to read, no, I do not fall asleep!)
    But medical advice is to get up, go read elsewhere and “only sleep in bed.” Leaving the cozy bed to go read somewhere else, at hubs’s request, ruined my nights. The walking to and from a reading chair woke me up thoroughly.
    Now I’m back reading in bed, fading into sleep, and the rare occasion I awake at night, a little in-bed reading (yes, with an LED, sorry, but very dim, and hubs does not wake up) helps me ease right back into dreamland.
    Habits are as important as “sleep hygiene,” if not more so!

    • R. W. A.

      I have a lifetime of sleep issues but now that I’m retired and seldom have to worry about rising early really early I find most of the time I can get enough sleep if I do what Weena says…turn on a light and read for a while. It seems to interrupt the mind’s insistence of going over and over useless stuff. I also have no desire to move into another, probably cold, less comfortable area. I usually become sleepy, turn off the light and fall asleep again. It’s a relief from years of sleepless torture.

  11. Barbary Baer

    I have found that listening to certain podcasts, where the voice pitches are fairly even, is a great help.

  12. Cliff Gallant

    I read somewhere once that lying in bed after waking up in the morning costs you some of the benefit of the time spent sleeping – I think it was that for every five minutes you lie in bed awake you lose the benefit of twenty minutes of sleep. I think the science of it is that when you’re lying down the brain secrets chemicals to make you sleep, and since you don’t go back to sleep, those chemicals stay in the brain and have the effect of dragging you down throughout the day.

  13. Anthony Ruggiero

    I’ve been working nights for over forty years. I find that with me, it isn’t the shift you work that affects mental functioning so much as the hours of quality sleep you receive.
    Great article, very informative!

  14. Diane Ruedy

    Great article and tips on improving sleep! Most of us are unaware of the effects of the sleep deprived brain in correlation to the physical body.

  15. Angela Najla Hessabi

    As I am reading this article, I am getting very sad because I am doing everything Dr. Suzanne Bertisch suggested. However, I still suffering from insomnia for over a year. I am a middle age between the age of 50-56 and in menopause. I am very much scared for my brain healthy of this sleeplessness and want to solve it. My doctor’s suggestion is sleep pills, which I refuse to take because of so much side effects. I have tried a lot of over the counter sleep aids as well as natural products like teas and milk with ginger and turmeric before going to bed. However, nothing has helped. So, as of the past 2 nights, I am taking a Benydral pill with an over the counter sleep pill called Remfresh, and I have slept for 6 hrs. I don’t know if I should keep doing this or this has more side effects than sleeping pills? Please help me! I greatly appreciate any response! Best Regards,

    • Elizabeth Fischer

      Have you tried Melatonin? I take 2 each night; Trader Joe’s Chewable peppermint flavor, 3 mg. Have you tried Ibuprofen? That can help, too. I used to be somewhat dependent on Benadryl; then read there’s some speculation that there may be a link with it and the development of Alzheimer’s, which scared the heck out of me. Do your own research about its safety. Good luck!

    • Trizah Kihiko

      I am an online student with Futurelearn where I have learnt about food as Medicine.
      I am over 65 years.and I sleep like a child unlike before when I could sleep like 4 hours or less. From there I concluded that there are things that make the body sleep well.

    • Victoria

      My doctor prescribed non-addictive Trazadone for sleep. It is an early antidepressant that had such a strong soporific effect that it was useless as an antidepressant. My prescription is below the antidepressant effectiveness level, but it works beautifully to help me sleep through the night. I use it to regulate my sleep cycle when it has slipped too late. Without trazodone, I sometimes was awake all night and sleeping most of the day.

    • Jim DeLong

      Hi Angela. I had similar experience. I do yoga, get moderate exercise and eat more vegetables, tree nuts and beans ; and avoid anything made with dairy, sugar or grains. Sometimes I get up at midnight and stretch muscles and do light exercises for about 10 minutes.
      Of course everyone is different. I read book Eat Right for Your Type (blood type) and subsequent books by same author. There are very specific recommendations therein that really seemed to help me.

    • Kenneth Sandale

      Benadryl is pretty bad stuff:

    • Judy

      Acute kidney injury (AKI) can be caused by diphenhydramine (Benadryl, McNeil). We do not usually think of this drug as a major source of renal impairment, but it can cause problems in some predisposed patients, including elderly populations. It can also trigger heart palpitations. I suggest you try exercising early in the day and a light snack like milk and crackers before bed. Good luck.

    • Janet

      Have you thought about CBD or mild Cannabis? Talk to your Doctor about alternative treatments. Also YouTube is a great resource for 528 sleep frequencies. Meditations for sleep.
      Magnesium helps, soaking in Epsom salts.

      I hope something helps you..

    • Mahesh kumar Sivanathan

      Do everyday some cardio excercise for 25 minutes without a break.that’s the best way improve you sleep.

    • Rose Clarke, Confront Your Issues

      It’s time to talk to a therapist and work through whatever underlying problems are keeping you awake. I came to terms with a lot of things that were plaguing me under the surface. No formal therapy but I had difficult dialogue with siblings about their lack of support with our parents care – and a lot more about the gender bias and internalized sexism in my family. Now it’s off of me after a number of years. I pray and I sleep like a gem. My soul has been lifted and my heart is happier.

    • Bob

      Circadian Rhythyms and sleep patterns are linked and are set by the light source entering through your eyes as indicated in this Harvard Article

      A person can set the rhythm by getting adequate sunlight or as in some nursing homes changing the lighting and you can research this online. Also if you are a little restless it could be due to magnesium deficiency and I have heard of people taking it before bed to help sleeplessness and restless leg syndrome. Magnesium sources you can find online but the best form is a pico-ionic liquid form which absorbs better and I have heard good testimonies on its usage so do some research and find what works for you.

  16. Colin Stone, Relaxation Therapist

    If you do wake up and decide to read for awhile to get back to sleep, do so with dim ‘warm’ (yellow/orange) light from an incandescent bulb, not an LED or compact fluorescent. And avoid reading anything intense or overly-interesting. I once bought an old book on birds, from the 1800s, that was just perfect for putting me to sleep!

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