Sleep in older adults changes naturally: deep sleep decreases, nighttime awakenings increase, and the circadian rhythm shifts earlier (early bird pattern). Many seniors experience sleep complaints, but these are often due to comorbidities (e.g., nocturia, pain, sleep apnea) or medications rather than aging alone. Sleep apnea is common and underdiagnosed in this age group. Evidence supports non-drug interventions like sleep hygiene, regular physical activity, and bright light exposure (human-moderate). Melatonin may offer short-term benefit, but long-term safety data are limited. Caution: Sedative-hypnotics (benzodiazepines, Z-drugs) raise fall and cognitive impairment risk in seniors and should be used sparingly. A sleep diary or home sleep test can help identify underlying issues. Caveat: No one-size-fits-all; a medical evaluation is recommended before starting any treatment.
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