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Sleep problems in later life

Describing current sleep

When we talked to people about their sleep, as well as asking them what a good night’s sleep was, we also asked them to describe what a typical or normal night’s sleep was for them at the moment. Whilst most people had a set routine, including a particular time to go to bed and to get up, a few chose not to have a routine, either because, like Richard, they never had a routine, or because they didn’t want to reach retirement and still live their lives by the clock. Those who worked part time usually had a variable routine according to whether it was their day for working or not.

 

Richard leads a very active social life and finds the idea of having set sleep routines boring.

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Age at interview: 67
Sex: Male
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Yes. 92. I stopped full time work.
 
92. Did you notice a change in your sleep when you stopped full time work?
 
No.
 
It just carried on?
 
Hm.
 
Did you maintain your daily routine going to bed at a certain time and then getting up?
 
I have never done that!
 
Oh haven’t you?
 
I think that is boring.
 
What did you do then?
 
I don’t know. I never have set times to go to sleep or…
 
So what makes you go to bed now? What’s your …oh I need to go to bed?
 
Just feel a bit tired and think it is about time to go to bed. But it could be any time. Early hours of the morning!
 
So sometimes you are awake until the early hours of the morning?
 
I lead an active social life. Let’s put it that way.
 
So you are out?
 
I am out yes.
 

Mike varies his bedtime and wake up time according to whether he is working the next day, but may...

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Age at interview: 66
Sex: Male
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What I usually start by asking people is just really to give me a description of what a typical night’s sleep is for you. So you might need to do that twice. One if you’re working and one for when you’re not working?
 
Okay yes. I mean I suppose even when I’m not working I’m not into any very fixed pattern. I mean if I’m working because I’m one of these people that takes a long time, I don’t like rushing around in the morning, I like to have time to move slowly and so I often get up 5.15, 5.30. So that means I probably go to bed somewhere around 9.30 give or take a quarter of an hour and then as I say I get up about 5.15, 5.30, so that I can get out the house about 7 o’clock. So that would be normally what I do then. If I’m not working and its just an ordinary day, Mondays and Tuesdays, my wife usually works and I usually get up reasonably early before her, so I’m driven a little bit by if it’s the day I’m not working, but she is, its driven a little bit by getting up and getting started. So that she can tie in with that. On days when neither of us are working I would say probably I get up between 7 and 7.30 having gone to bed between ten and eleven the previous night. But there isn’t any time table at all really. If I am watching something interesting in the television, if I’m playing on the computer or anything like that then I wouldn’t say well I’m going to stop now because its bed time.
 
So you have a, it’s the timing, that really vary. So you think if you are up earlier because of work you adjust your bedtime is that what you are doing?
 
Yes. I try to. I mean on odd occasions, I can’t remember one off the top of my head, but on odd occasions perhaps there is some reason why I can’t get to bed early and if so you just sort of shrug your shoulders and get on with it really. But in an ideal world if I’m going to work with an early start the following day, I mean the test centre opens at 8, I usually try and get in there quarter, to half hour an early to get ready. If I’m going to do that I would normally try and go to bed around 9.30 the night before.
 
So you do make sure you get to bed earlier?
 
I try to yes, yes, because again, I mean I’ve often been an early starter at work. I worked for Thames Water for donkeys years and I was on the operational side, albeit in the office, so then I used to try and get to work by about half seven, so I was sort of in a bit of a mindset, well I’m used to getting up fairly early, but I mean even ten years ago I could go to bed at half eleven and get up at 5.30, 6.00 without it being an issue, but I think times starting to catch up with me a bit now. 
Most people had some form of difficulty with their sleep, ranging from taking a long time to get to sleep, waking up a lot in the night, waking up early in the morning, and a combination of any or all of these.

Taking time to get to sleep
The time it took for people to go to sleep ranged from almost immediately to over an hour, with one or two people finding it takes more than two hours to get sleep on some nights. When people had been out late in the evening socialising they found it harder to switch off and to unwind for sleep. To help them get to sleep, people said they tried lots of different tactics, such as going to bed at a later time, avoiding drinking coffee, or alcohol before bed, or making sure they don’t sleep during the daytime (see 'Strategies for good sleep').
 
Margaret believes her problem getting to sleep may be caused by the fact that she dozes off in front of the television at night, and then by the time she has woken up again, got washed and dressed ready for bed, she is wide awake again.
 

Fred may be very tired when he gets into bed initially, but after about 5 minutes he is wide...

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Age at interview: 67
Sex: Male
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So what I usually say to people is can you give me a sort of a snapshot of what a normal night’s sleep for you, your pattern at the moment, how you sleep now?
 
How I sleep now. Well we basically go up at the same sort of time. Round about elevenish. We never used to go to sleep till… sorry we would never go later then say ten o’clock half past ten when I was working. But because of this problem about not being able to sleep, I said well it would be probably be better if I go later when I would be more tired. So we tried that and it didn’t make any difference. I mean I could be sitting down here and I would sit and do the crossword, if there wasn’t much on the television, I used to do Sodoku puzzles as well and then I would go out for a last cigarette, and go upstairs, into bed and by that time I am really feeling tired. I can get into bed and just for some reason I will lay there and initially the first five minutes, lovely, snuggle down like you do, and then all of a sudden, something just seems to wake me up and then I just turn over this side, turn the other side, lay on my back, I can’t sleep on me back or me left hand. I always go to sleep on the right hand side, on my right. And when that doesn’t work, I start to get frustrated then. And, well this is no good, just laying here I am not getting anywhere. Then I come downstairs in the garden, have a cigarette, about twenty minutes or something like that, then pop upstairs again and eventually I would go off.
 

But it just takes such a long time and then I possibly go to toilet, about say 2 o’clock, because it is only about a year I had prostate operation because I had a bladder problem you know, and that’s made a hell of improvement. It really has, from the point of view of not getting up during the night. But once I do wake up, then it’s a job to get back to sleep again. It is so frustrating at times you know, but if I do something really strenuous like I said to you earlier, we went down to [county] yesterday, it was fine. I was sitting watching television and [my wife] said to me, you going to sleep, I was sat there with my eyes shut. We were watching a documentary on National Geographic. And I said yes I do feel a bit tired. I went up to bed no trouble at all. I had my last cigarette out the back, upstairs, into bed and I should think I was asleep within five minutes. No trouble at all.

So it is very frustrating because I know sometimes, or most nights I do feel tired, when I am down here, but as soon as I get up them stairs into bed, and we have got a need a new bed, but I am not blaming the bed because the bed is lovely and comfortable. It really is comfortable, but for some reason, I just seem to wake up when I get into bed. I just can’t explain the reason why. I try the counting sheep type of thing which, I try to think of fishing …I enjoy fishing and golf and thinking of things like that, but it just doesn’t seem to help. And a couple of times I have gone back upstairs after I have had a cigarette, and then I come back down again and I have even come down and made a cup of tea and sat in the garden. Had a cup of tea and its probably half past two, three o’clock in the morning. Have a cigarette and then gone back up again.

 

Val takes a long time to fall asleep, wakes up a lot in the night, and early in the morning, but...

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Age at interview: 65
Sex: Female
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Do you want to tell me about your sleep pattern in general?
 
Yes. I go to bed, I was going to bed to about 9 o’clock because I was so tired, because I am awake half past 5 every morning. During the night I am awake a few times, and I put the radio on, and I find by putting the radio on that voice puts me back to sleep again and then it could be an hour, an hour and a half and I am awake again and that is the pattern mainly with my sleep. So about half past five six o’clock I get up and it is a long day. 9 o’clock I am in bed, but I lie there until one o’clock, two, and I just cannot get to sleep and yet when I am out here I am tired. Recently I have started to going to bed about 11, 12 o’clock. But it still doesn’t make any difference.
 
So do you take the same time to get to sleep even when you go to bed at 9 or at 11, it still takes you an hour or so to get to sleep?
 
By going later I do get to sleep. I don’t lie awake then as long. I also found that I am on the computer at night and that helps me to sleep better. But I still wake up in the night.
Waking up a lot in the night
Most people woke up in the night, at least once, and for some people several times, either to go to the toilet, because of pain, or some other reasons (see 'Health, illness and pain'). Carol told us she could easily be up six times in the night to go to the toilet. A few people just had the occasional night where they woke up a lot during the night.
 

Juliet hasn’t had a full night’s sleep since her diagnosis with rheumatoid arthritis 12 years ago...

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Age at interview: 69
Sex: Female
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A good night’s sleep would be one where I never woke up literally from start to finish, which I certainly enjoyed in my youth, when I literally went to bed and slept eight hours or whatever and go up feeling really good.
 
Yes and what do you get now then?
 
I get now pretty interrupted sleep but I do deal with that because there is only one way, is to deal with it. But I mean obviously as you get older you are up spending pennies in the night. I mean I expect that anyway, but I do get quite a lot of pain from my rheumatoid arthritis. And so I wake up with it. I probably wake up about three or four times in the night. Not always, not always, but I never have a night when I don’t have at least if not two breaks and when I wake up, I probably go to the loo, come back again and I won’t lie there in the dark, well I put the television on, or I read a book or if I really feel like it I will get up and have a go on the computer and then I get myself tired again and then I will go back to bed, and this does have the result sometimes that may be we get up quite late in the morning, because if I do drop off, but you know, that is the way it is now.
 
And how long do you think has it been like that?
 
I haven’t had a direct night’s sleep that I could count on really since I was diagnosed with the rheumatoid because you get the pain and you get it all the time. It is difficult to remember right back to the first time when I was diagnosed, but I was always conscious of having at least one interruption and that has got more and more interruptions as time has gone on.
 
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Anne falls off to sleep okay, but then will wake up in the middle of the night.

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Age at interview: 73
Sex: Female
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What I do is start by asking people just to give me a snapshot as it were, a kind of description of what a typical night’s sleep is for you at the moment. If you could just sort of tell me how your sleep is?
 
Okay more often than not I get very sleepy. I do the Telegraph crossword that is how I wind down. In bed, you know, when I’m ready to go to bed. And if I can get sleepy when I’m doing it then I do go to sleep quite quickly, but I will then wake up again. Usually in the middle of the night, and I know instantly if I’m going to be able to go back to sleep again. Sometimes I’ll get up and go to the bathroom in order to go back and get sleepy quickly.
 
But if I wake up after 4 o’clock in the morning or about 4 which I often do. No chance of going back to sleep again then. If I’ve slept till five, that’s a good night and that’s a normal night. It's very rare that I would be asleep beyond five and because we don’t want to get up at that hour, I try to doze off again. I usually succeed in dozing off about ten minutes before my husband makes the tea. So I’m in the middle of a dream when he brings the tea in.
 
And what time is that?
 
No later than six. But these lighter mornings if it’s been quite bright, we usually have the tea about quarter to six.
 
So you have your tea in bed?
 
Yes. 
 
Waking early in the morning
Whilst most people complained of having difficulty getting to sleep and waking up in the night, a few people did experience waking very early and not being able to get back to sleep. Anne told us that if she woke at 4 am she didn’t expect to be able to get back to sleep at all and will eventually get up. But those who did wake up early usually didn’t find it was a problem and dealt with it in a variety of ways, either by getting up straight away and getting on with things they needed to do, or taking a cup of tea back to bed, or just dozing in bed and waiting until it was bit later.
 

Daniel typically wakes up at about 5 am now he is older, but will doze in bed until about 8 am.

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Age at interview: 78
Sex: Male
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What I usually do is start by saying to somebody can you just describe for me what a typical night’s sleep is for you, so starting say from when you plan to go to bed to when you get up?
 
Okay, so when you say a typical night, it does vary. I am glad to say at the moment most nights are quite reasonable. I go to bed at say half past ten to eleven o’clock and I find I can go to sleep fairly easily just at the moment. And a typical night’s sleep is I am conscious that I wake up in the night a number of times but then I must go asleep again, so I can’t actually say when, but I am conscious that I don’t sleep right through. I virtually, every morning wake up at 5 a.m. These days I never seem to sleep after 5 o’clock, but I don’t get up. And I sort of lie in bed dozing till say 8 o’clock when we do get up. So that’s normal, but there are other times that are not so normal.
Some people experienced a combination of several different kinds of sleeping difficulties, but were more disturbed by one kind than another.
 
The News and sleep routines
Nearly all of the people we spoke to told us they had a great interest in what was happening in the world and often had the news on either their radios or televisions throughout the day, with some people telling us that if they wake up in the night they may watch the television news, or listen to the World Service News on the radio. Several people also would not go to bed until after one of the news programmes at night, usually the 10 o’clock news or Newsnight, although some found it difficult to stay awake for all of the news. Others would wake up in the morning and doze in bed listening to the morning news. Peter wakes at about 6 to 6.30 am every morning and will stay in bed until after the 8 o’clock news on the radio.
 

Margaret doesn’t normally watch television, but likes to be in bed in time to watch Newsnight.

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Age at interview: 72
Sex: Female
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So the first thing I usually say to people is if you could just describe for me now what a typical night’s sleep is?
 
Well I usually, I’m in bed by 10 o’clock in the evening mostly to listen to the news, or have the television news because you know, my life’s so busy I don’t really have much time for that and I really don’t enjoy television that much. It’s not something, I’d rather read than use the television.
 
I go to bed and I’m always asleep by the time Newsnight stops. But then and I believe I sleep quite deeply although I’m not sure because you don’t really know what you are like when you’re sleeping. But then I can wake up at 2 o’clock in the morning, lively as a cricket, ready you know, to go and face the world again. And that can be a bit daunting because I can then get strapped into thinking about the family, and the history of the family, and my Mum and all this sort of thing. It gets very emotional, it’s the wrong thing to do. So I’ve managed to move on from that and now I read. I’ve got an incredibly boring book. An extremely boring book, which is very good. It’s all about the medieval history of England and it’s just a series of lists of things that happened in the country with barons and knights and stuff. So within ten minutes flat I’m out.
 
However, and that works quite well, but then come 4 o’clock in the morning by then I need a wee and damn me it starts all over again. So that’s basically, and then of course come six or seven o’clock I’m lively as a cricket again. So that’s basically the way I sleep.
 
So you are in bed between sort of ten, half past ten?
 
Well certainly ten on the dot I like to be in bed to listen to the news so I’m right there.
Not everyone felt they had problems sleeping. Some had had periods of bad sleep during their lives and were sleeping better now. Others felt that although they were aware they weren’t sleeping very much, they were quite happy with the amount they slept because they felt fine in the morning and could easily get on with what they needed to do during the day.
 

Christopher has never had a problem with his sleep, and still considers that he sleeps well, even...

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Age at interview: 68
Sex: Male
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What I usually ask people to do for me to begin with is just give me a snapshot of what a typical night’s sleep for you at the moment is?
 
Well I generally go to bed about 11 o’clock to 12 o’clock and I sleep pretty well through unless I have to get up for a wee or something. And sometimes I have trouble getting back to sleep after that or it seems I do, but then if I’m not going to work, I sleep through till 8 o’clock. If I go to work I have to set the alarm for half past six and that’s a general pattern. I usually sleep quite well to be honest.
 
And have you always slept well?
 
Yes. I have never really had a real problem sleeping.
 
So you go to bed round about eleven until about eight. That’s about nine hours?
 
I don’t sleep straight away when I go to bed. I usually read for half an hour. A good half an hour.
 
And in the night if you’re awake at all are you awake for any length of period?
 
It seems a long time but I’m sure it’s not. It sometimes seems may be half of an hour to an hour to trying to get back to sleep again. But that is not a general thing, sometimes, in the last week or so I have just gone back to sleep straight away.
 
Do you know what’s waking you up in the night?
 
Usually I have to go for a wee or otherwise apart from that no I don’t. But in general terms I seem to wake up once a night, sometimes twice a night.

 Last reviewed October 2018.

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