The sleep epidemic troubling older Australians — what’s behind it?

While it’s common to think poor sleep is just part of ageing, ongoing sleep difficulties can seriously affect our health, well-being and daily functioning. For older people, especially those with chronic health conditions, such as post-polio syndrome, understanding and managing sleep is essential. Fortunately, some strategies and treatments can help improve sleep quality and reduce health risks.

Sleep and ageing
The Sleep Health Foundation fact sheet on this topic notes that older adults generally need the same amount of sleep as younger adults — around seven to nine hours per day — but how they sleep changes. Many find it takes longer to fall asleep and that they wake up more during the night. Deep sleep becomes shorter and naps during the day become more common. These changes are partly due to the body’s internal clock shifting with age and a decrease in melatonin, the hormone that helps us sleep. Sleep disorders such as sleep apnoea and insomnia are also more frequent, affecting nearly half of older adults. Health issues like arthritis, heart and lung disease, depression and dementia can interfere with sleep, as can the medications used to treat them. Lifestyle habits, like consistent sleep routines, exposure to sunlight, exercise and limiting long daytime naps, can help improve sleep quality.

Sleep and chronic conditions
In Australia, nearly half of adults report having at least two sleep-related problems according to the Australian Institute of Health and Welfare. Poor sleep is linked to serious health conditions like type 2 diabetes, cardiovascular disease, stroke and depression; both too little and too much sleep increase these risks. Insomnia is more common in women, while obstructive sleep apnoea — where breathing stops briefly during sleep — is more common in men. People aged 65 and over are more likely to experience longer sleep, but poorer quality. Sleep problems become more frequent in people with multiple chronic health conditions, such as arthritis or hypertension. Despite how common these issues are, many sleep problems go undiagnosed. If you have ongoing sleep troubles, it’s important that you talk to your doctor.

The cost and consequences of poor sleep
Poor sleep doesn’t just affect individuals — it’s a national issue also identified in the AIHW 2021 report on this topic. The economic cost of sleep disorders in Australia is estimated at over $51 billion per year. Sleep problems increase the likelihood of chronic diseases, mental health issues, road and workplace accidents and early death. People living with a disadvantage or chronic illness, those without a partner and older Australians are more vulnerable. Sleep quality is affected by lifestyle choices, like caffeine, alcohol, stress and screen use before bed, but is also tied to broader social factors like employment, housing and healthcare access. Despite this, sleep is often overlooked in healthcare settings. Just one in five Australians with sleep problems have been assessed by a medical professional, highlighting the need for more awareness and support.

Screen use in the hour before bed in those reporting two or more sleep difficulties:

• one in four adults who use the internet most nights;

• one in 20 who do not use the internet before bed.

Sleep and post-polio health
People who had polio earlier in life may experience unique sleep and breathing problems as they age. Breathing can be affected by weak respiratory muscles or changes in chest structure caused by polio. This can lead to shortness of breath, frequent chest infections or speech difficulties. Many also report feeling sleepy during the day, waking up with headaches or having trouble concentrating — signs that their breathing may be affected during sleep. Conditions, such as sleep apnoea or night-time hypoventilation — under-breathing during sleep, are also common in post-polio. Treatment may involve a respiratory assessment and the use of devices like BiPAP machines. Addressing posture, respiratory muscle strength and mental health is also important. Polio survivors should not ignore signs of sleep disturbance, as these could indicate worsening of other health problems. They should become familiar with Polio Australia’s Sleep and Breathing fact sheet.

Sleep dysfunction is not unique to ageing, common health conditions or post-polio conditions — it is also a major concern in other neuromuscular health conditions. Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS; Motor Neuron Disease), several muscular dystrophies and Myasthenia Gravis each feature disturbed sleep as a core symptom or consequence. For those with such conditions, poor sleep can worsen physical symptoms, impair thinking and mood and reduce quality of life. These conditions often require tailored sleep strategies, highlighting the need to recognise and manage sleep problems as part of comprehensive chronic disease care.

Sleep challenges in later years
For older Australians, especially those living with co-existing health conditions like post-polio syndrome, sleep can be particularly fragile. Pain, breathing problems and limited mobility can all contribute to restless nights and tired days. Poor sleep can affect memory, mood and independence. It can also worsen existing health issues, creating a cycle that’s hard to break. However, poor sleep quality is not something we have to accept as ‘just part of ageing.’ With proper assessment, personalised support and consistent habits, older adults can enjoy better, more restorative sleep, improving both their health and their quality of life.

For more information about vaccination and post-polio survivors, please visit the Polio Australia website to learn more and access a range of resources to keep each other safe.