I’ve been writing about what sleep looks like at every age. Last week, we covered sleep in young adulthood, right up to the start of middle age.
If young adulthood gave some of us a hall pass when it comes to paying attention to sleep and investing time and energy in cultivating sleep habits, well ... middle-age is when that free ride typically ends. In order to sleep well and reap the benefits and protections of high-quality rest, we’ve got to pay attention to sleep on a daily basis. It helps to know what to expect from sleep during these years.
What sleep is like in your mid-40s and 50s
Tell me if this sounds familiar. You slept like a log in your 20s, and pretty well in your 30s, maybe even into your early 40s. Then, somewhere in your later 40s or 50s, sleep started to get wonky.
You go to bed exhausted, but still have trouble falling asleep. You wake at least once or twice a night—sometimes to go to the bathroom, sometimes just because. Often, you don’t sleep all the way to dawn, waking way ahead of your alarm, wishing you could grab that extra 45 minutes or hour of rest. Welcome to sleep in middle age.
These years are some of the most challenging for sleep. So many of my patients (and readers) fall into this age range. Given all that’s happening during this stage of life, it’s hardly a surprise that sleep is particularly complicated.
Many of us during these years are in the throes of parenting and doing our best to give our all to work at the same time. We’re helping look after aging parents at the same time we’re figuring out how we’ll pay for kids’ college and fund our own retirement. These are just a handful of reasons why chronic stress and worry are huge problems for sleep during middle age.
At the same time, there’s plenty happening biologically that also makes sleep more challenging. For both men and women, the hormones that promote healthy sleep are on the decline. At the same time, sleep-disrupting hormones—including cortisol and others—are often spiking, thanks to stress and an ongoing lack of sleep.
For women, these years typically include both perimenopause and menopause, which bring significant challenges for sleep. More than half of perimenopausal women—56 percent— sleep less than seven hours a night , on average. That’s a big jump from the third of pre-menopausal women who are sleeping less than seven hours nightly. Nearly one-quarter—24.8 percent—of perimenopausal women say they have trouble falling asleep four or more times in a week.
Even more common than trouble falling asleep? Difficulty staying asleep. Among women in perimenopause, about 31 percent say they have trouble staying asleep at least four nights a week. Half of the perimenopausal women—49.9 percent—wake in the morning feeling tired, rather than rested, four or more days weekly.
To learn all about how menopause affects sleep and health, and natural strategies for protecting your sleep in menopause, check out my series of articles on menopause and sleep.
Men face their own hormonal changes in middle age, including a natural reduction in testosterone, which can have an adverse effect on sleep quality . In turn, short sleep suppresses the production of testosterone, which contributes to more sleep and sleep-related health issues , including obstructive sleep apnea and sexual dysfunction.
Sleep architecture continues to change, as we spend less time in deep sleep (and to a subtler degree, less time in REM sleep). During these years, more of our sleep time is spent in the lighter, less restorative stages of non-REM sleep.
During these years, I see sleeplessness take a particular toll on weight gain and metabolic health in both men and women. The combination of biological changes underway and crowded, stressful daily schedules isn’t friendly to sleep or to regular exercise, which can be a real difference-maker for sleep and weight at any age, and especially during these years.
You’ve heard me talk many times about the connection between poor sleep and weight gain. I’m about to do it again. If you don’t get enough sleep to meet your individual needs, you will gain weight. This really interesting 2017 review of sleep-metabolism research found that running a sleep debt leads to the consumption of an average of 285 additional calories a day.
Hormones have a lot to do with this. When you’re sleep-deprived, cortisol levels are high, and serotonin levels are low, and your body starts to crave starchy, sugary, and fatty foods to help boost serotonin and calm stress. At the same time, lack of sleep increases the hunger hormone, ghrelin, and suppresses the satiety hormone, leptin, which signals when we’ve eaten enough.
What to watch for: Support the daily habits and choices that boost sleep—and avoid the ones that hurt it. A healthy diet, regular exercise, and attention to mindfulness and stress management can make the difference in sleeping well during some of the busiest, most challenging years of our lives.
My big takeaway for people of every age? Make the investment in your sleep now. It’s never too late to make improvements in your sleep that will benefit your health and performance. And the attention you give to healthy sleep today will pay off years, and decades, down the road.
Michael J. Breus, Ph.D., DABSM
The Sleep Doctor™