Daytime sleepiness in older adults

Overview

Daytime sleepiness is when an older adult feels unusually tired or drowsy during the day, even after a full night's sleep. It is not a normal part of aging and may be a sign of an underlying health issue.

Yes, daytime sleepiness affects many older adults. Studies suggest that about 20% to 30% of older adults experience significant daytime sleepiness.

It primarily affects adults aged 65 and older. Those with chronic health conditions, who take multiple medications, or have sleep disorders are more likely to experience it.

Symptoms

Common symptoms

• Feeling drowsy or falling asleep during quiet activities like reading or watching TV
• Taking long or frequent naps during the day
• Having trouble staying awake during conversations or meals
• Feeling tired even after what you think is a full night's sleep
• Needing more effort to stay alert and focused

Symptoms in older adults

• Increased confusion or forgetfulness
• Unsteady walking or falls
• Lack of interest in social activities or hobbies
• Irritability or mood changes
• Difficulty doing everyday tasks like cooking or shopping

Causes

Main causes

• Sleep apnea (pauses in breathing during sleep)
• Restless legs syndrome (uncomfortable leg sensations that disrupt sleep)
• Side effects from medications, such as blood pressure pills or antihistamines
• Depression or anxiety
• Chronic pain or discomfort at night
• Poor sleep habits like irregular bedtime or too much caffeine
• Medical conditions like diabetes, heart disease, or thyroid problems

Risk factors

• Being over age 65
• Being overweight or obese
• Taking many different medications (polypharmacy)
• Having a chronic illness like heart failure or Parkinson's disease
• Living alone or being less socially active
• Not getting enough natural light during the day

When to see a doctor

See a doctor urgently if:

• If you or a loved one has sudden, severe daytime sleepiness along with confusion or difficulty speaking
• If daytime sleepiness leads to a fall or accident

Book a routine appointment if:

• If you feel tired every day for more than 2 weeks
• If sleepiness is affecting your ability to do daily activities safely
• If you snore loudly or have pauses in breathing during sleep

Diagnosis

Your doctor will start by asking about your sleep habits, medications, and overall health. They may ask you to keep a sleep diary for a week or two. Based on your answers, they may recommend further tests.

Tests that may be done

• Sleep diary (write down when you sleep, nap, and feel sleepy)
• Blood tests to check for anemia, thyroid problems, or other issues
• Sleep study (polysomnogram) – you spend a night in a sleep lab or use a home device to record breathing, heart rate, and brain activity
• Questionnaires to measure your sleepiness level

What to expect at your appointment

A diagnosis may take time. Your doctor may refer you to a sleep specialist. The process is designed to find the underlying cause so you can get the right treatment. Be prepared to answer questions about your sleep environment, alcohol use, and emotional health.

Treatment

Treatment depends on the cause. The goal is to improve nighttime sleep so you feel more alert during the day. This may involve changes to sleep habits, adjusting medicines, or treating a sleep disorder like sleep apnea.

Self-care at home

• Go to bed and wake up at the same time every day, even on weekends
• Spend time outdoors in natural light during the morning
• Avoid caffeine, alcohol, and heavy meals within 3 hours of bedtime
• Limit daytime naps to 20-30 minutes, and avoid napping late in the day
• Keep your bedroom cool, dark, and quiet

Medical treatments

If a sleep disorder like sleep apnea is found, treatment may include a device that helps keep your airway open during sleep (called continuous positive airway pressure or CPAP). If a medication is causing sleepiness, your doctor might adjust the dose or switch to a different one. For restless legs syndrome or depression, specific therapies like cognitive behavioral therapy or light therapy may be recommended. Never change or stop a medicine on your own; talk to your doctor first.

When is surgery considered?

Surgery is rarely needed for daytime sleepiness. It may be considered only if there is a physical blockage in the airway that cannot be treated with other methods, but this is not common.

Living with this condition

Living with daytime sleepiness can be challenging, but small changes can help. Plan your most important tasks for times when you feel most alert. Take short, planned naps if needed. Stay socially connected – loneliness can worsen sleepiness.

Lifestyle tips

• Get regular exercise, like walking or gentle stretching, during the day
• Expose yourself to bright light every morning for at least 30 minutes
• Avoid sitting still for long periods – get up and move every hour
• Talk to family or friends about how you feel

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Avoid large, heavy meals before bed. Being active during the day promotes better sleep at night, but avoid vigorous exercise too close to bedtime.

Mental health and emotional wellbeing

Daytime sleepiness can make you feel frustrated, isolated, or depressed. It can also affect memory and concentration. It's important to address emotional well-being. If you feel down or anxious, talk to your doctor – therapy or counseling may help.

Prevention

Not all causes can be prevented, but you can reduce your risk by maintaining a healthy sleep schedule, staying active socially and physically, and managing health conditions like diabetes or high blood pressure. Review your medicines regularly with your doctor.

Screening programmes

If you have risk factors like obesity or snoring, your doctor may screen you for sleep apnea with a simple questionnaire or a home sleep test. Early detection can prevent daytime sleepiness from getting worse.

Complications

If left untreated

• Increased risk of falls and accidents
• Worsening of other health conditions like heart disease or dementia
• Poor quality of life, including loss of independence
• Depression and social isolation
• Cognitive decline (trouble with memory and thinking)

Long-term outlook

With the right diagnosis and treatment, most people see improvement in their daytime sleepiness. It may take a few weeks to find what works best, but many causes are reversible. Even when the sleepiness is linked to a chronic condition, managing it can greatly improve your daily energy and overall well-being. Staying hopeful and working with your healthcare team is key.

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