Sleep habits that hold up in midlife

How much sleep you need

The CDC recommends 7 or more hours a night for adults up to 60, 7 to 9 hours from 61 to 64, and 7 to 8 hours from 65 onward. Needs do not fall much with age, but sleep often becomes lighter and more broken, which is why habits matter more in midlife.

Habits with the strongest support

• Keep the same bedtime and wake time every day, including weekends
• Make the bedroom cool, quiet, dark and used mainly for sleep
• Turn off screens at least 30 minutes before bed
• Stop caffeine by early afternoon; its effects can last many hours
• Avoid large meals and alcohol close to bedtime
• Get daylight in the morning and stay physically active during the day
• If you cannot sleep after about 20 minutes, get up and do something quiet in dim light until sleepy
• Keep naps short, around 20 to 30 minutes, and early in the afternoon

Alcohol: the sleep thief

Alcohol can make you fall asleep faster, but it fragments sleep later in the night and can worsen snoring and sleep apnea. Many people who wake at 3 a.m. find this improves noticeably when they stop drinking in the evening. The CDC notes that drinking less is better for health than drinking more.

Menopause and sleep

Night sweats, hot flashes, anxiety and the need to urinate at night commonly disrupt sleep during the menopause transition. A cool bedroom, breathable bedding and layered sleepwear help. For women with bothersome hot flashes and night sweats, hormone therapy is the most effective treatment and often improves sleep as a result; non-hormonal options exist as well. These are worth discussing with a clinician rather than simply enduring.

Insomnia: CBT-I comes first

When trouble sleeping lasts for months, the American College of Physicians recommends cognitive behavioral therapy for insomnia as the initial treatment for adults. CBT-I combines a consistent sleep schedule, limiting time in bed to time asleep, changing unhelpful thoughts about sleep and relaxation techniques. It is available through trained clinicians and validated digital programs.

Sleeping pills can help in the short term for some people, but they carry risks, especially for older adults, including next-day drowsiness and falls.

Sleep apnea: easy to miss

Obstructive sleep apnea causes repeated pauses in breathing during sleep. Signs include loud snoring, gasping or choking at night and daytime sleepiness. Risk rises with weight gain, male sex, family history and, for women, after menopause. Sleep apnea is diagnosed with a sleep study and is treatable. Untreated, it worsens fatigue, blood pressure and heart risk.

A wind-down routine that works

A predictable routine in the hour before bed tells your brain that sleep is coming. Dim the lights, put the phone on a charger outside the bedroom if you can, and choose something calming such as reading, stretching or a warm shower. Write tomorrow's to-do list earlier in the evening so it is not running through your head at midnight.

If worry keeps you awake, setting aside 10 minutes in the early evening to write down concerns and possible next steps can help. In bed, slow breathing or a body-scan exercise can ease the transition to sleep.

Shift work, travel and irregular schedules

Irregular schedules make consistent sleep harder but not impossible. Anchor your wake time as much as you can, use bright light when you need to be alert and darkness when you need to sleep, and protect a block of sleep even on busy travel days. For crossing time zones, timed light exposure and, in some cases, low-dose melatonin can help your body clock adjust.

When to see a clinician

• Insomnia most nights for three months or more
• Loud snoring, witnessed breathing pauses or gasping
• Falling asleep while driving or in meetings
• Restless, uncomfortable legs in the evening
• Night sweats that are severe or not explained by menopause
• Low mood or anxiety that keeps you awake

What about sleep supplements?

Melatonin is most useful for shifting the body clock, such as with jet lag, and less effective for general insomnia. The CDC Yellow Book notes that FDA does not regulate melatonin as a drug, so actual content can differ from the label. Other sleep supplements have limited evidence. Discuss them with a clinician if you take other medicines.