Age and Quality of Sleep: A Narrative Review of Normative, Epidemiological, Mechanistic, and Interventional Evidence

Dr Darshana Nariya

Abstract: Background: Sleep quality changes systematically across the lifespan, and older adults experience well-documented alterations in sleep architecture, continuity, and subjective quality. Given the rapid growth of the global older population, clarifying the relationship between age and sleep quality carries substantial clinical and public health relevance. Aim: This review synthesized evidence on how age influences sleep quality, drawing on 20 purposively selected studies identified through a structured PubMed and Cochrane Library search strategy targeting age- and sleep-quality-related terms. Methods: A Narrative review approach was used, prioritizing systematic reviews and meta-analyses, with single-reviewer selection consistent with narrative-review conventions rather than exhaustive dual screening of the full search yield. Included studies represented six sub-themes: normative age-related changes in sleep architecture, sleep quality in cognitively healthy versus impaired aging, prevalence of poor sleep quality and insomnia, circadian mechanisms, the relationship between sleep quality and frailty or comorbidity, and non-pharmacological interventions. Results: Sleep efficiency, total sleep time, and slow-wave sleep declined with advancing age, while sleep latency, nocturnal awakenings, and lighter sleep increased; most change occurred before age 60. Cross-sectional studies estimated poor sleep quality in roughly 20-45% of community-dwelling older adults, and insomnia prevalence ranged from approximately 12-20% using strict diagnostic criteria to substantially higher using symptom-based definitions. Circadian amplitude attenuation and phase advance were implicated as underlying mechanisms alongside reduced sleep homeostatic pressure. Cognitive behavioral therapy for insomnia showed consistent efficacy in older adults across multiple outcomes. Conclusion: Age was robustly associated with declining sleep quality through combined structural, circadian, and homeostatic mechanisms, though substantial measurement heterogeneity limited precise cross-study comparison. Future research would benefit from standardized outcome measures and broader lifespan coverage beyond the older-adult-dominant literature base.

Keywords: Sleep quality; Aging; Insomnia; Circadian rhythm; Older adults; Cognitive behavioral therapy

How to Cite?: Dr Darshana Nariya, "Age and Quality of Sleep: A Narrative Review of Normative, Epidemiological, Mechanistic, and Interventional Evidence", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 678-682, https://www.ijsr.net/getabstract.php?paperid=SR26910150620, DOI: https://dx.doi.org/10.21275/SR26910150620

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