Why Sleep Falls Apart After 70 and What Actually Helps

You fall asleep in front of the television, move to bed and suddenly feel wide awake. A few hours later, you are up to use the bathroom. By 4 am, you are watching the clock and wondering how you will get through another tired day.

For many older Australians, this becomes a familiar routine. Families may notice more afternoon dozing, cancelled outings or a parent who seems increasingly exhausted.

The explanation is often dismissed as “just getting older”. But while sleep changes with age, persistent sleep difficulties deserve attention. Pain, medicines, emotional distress and treatable sleep disorders can all contribute.^[1]

Understanding what has changed is the first step towards finding something that actually helps.

What Happens to Sleep as We Get Older?

There is no sudden switch at 70. Sleep usually changes gradually, and the pattern varies from person to person.

Older adults tend to spend less time in deep sleep and may wake more frequently. The body clock can also shift earlier, bringing sleepiness earlier in the evening and waking earlier in the morning.

These changes do not mean the need for adequate rest disappears.^[2]

An earlier bedtime and earlier start may be manageable if someone feels refreshed. The concern is sleep that leaves them struggling during the day.

Being older is not a reason to accept ongoing exhaustion without assessment.

What May Be Disrupting Sleep?

Several problems can overlap. Someone may initially wake because of pain, then develop anxiety about sleeping, while daytime naps make the following night more difficult.

Pain, Health Conditions and Emotional Strain

Joint pain, breathing difficulties, digestive symptoms and restless legs can interfere with sleep. Grief, anxiety and depression can also make it harder to settle or return to sleep.

Medicines deserve a place in the conversation too. A sleep problem that begins after a prescription change should be discussed with the GP or pharmacist. Do not change doses or timing without their advice.^[3]

Repeated Trips to the Bathroom

Waking to urinate, known as nocturia, becomes more common with age. However, repeated bathroom trips can reflect bladder or prostate problems, diabetes, medicines or other conditions.

Sometimes the order is less obvious: a person wakes because of a sleep disorder and then decides to use the toilet.

If bathroom trips regularly disrupt the night, discuss them with the GP. Reducing large drinks close to bedtime may help some people, but cutting fluids too far risks dehydration. Follow any existing medical advice about fluid intake.^[4]

Sleep Apnoea

Loud snoring, breathing pauses noticed by a partner, gasping during sleep and pronounced daytime sleepiness can point to obstructive sleep apnoea.

This condition repeatedly interrupts breathing during sleep. A person may be unaware of those interruptions and simply report that they never feel rested.

A GP can assess the symptoms and arrange further investigation, which may include a sleep study. Treatment depends on the findings and can include continuous positive airway pressure, or CPAP.^[5]

What Actually Helps With Persistent Insomnia?

The most useful treatment depends on the cause. Treating sleep apnoea, reviewing night-time pain or addressing bladder symptoms may be essential.

For ongoing insomnia, there is also a specific treatment worth asking about: cognitive behavioural therapy for insomnia, or CBT-I.

The July 2026 Australian Recommendations

On 29 July 2026, six Australian sleep and primary care organisations published a joint position statement on managing adult insomnia. These included the Australasian Sleep Association, Sleep Health Foundation, Royal Australian College of General Practitioners and Australian Psychological Society.

The statement recommends multicomponent CBT-I as first-line treatment. It also explicitly states that sleep hygiene advice alone is not an adequate treatment for chronic insomnia.

For readers who have already tried cutting coffee, changing pillows and putting their phone away, this distinction matters. Persistent insomnia warrants access to structured treatment.^[6]

What CBT-I Involves

CBT-I helps change patterns that keep sleep difficulties going, including spending long periods awake in bed and becoming increasingly anxious about the next night.

Treatment may involve a sleep diary, adjustments to sleep timing, relaxation skills and strategies for managing sleep-related worries.

It usually takes several sessions, and improvement is gradual. Its benefits can continue after treatment ends. Trained psychologists may offer CBT-I in person or through telehealth, and structured digital options are also available.

Any programme that reduces time in bed should be tailored to the person’s health and safety needs. Someone who is frail, unsteady or very sleepy during the day should seek clinical guidance before attempting this themselves.^[7]

Everyday Changes That Can Support Better Sleep

A routine does not need to be complicated to be useful. Start with a few manageable changes:

• Keep a consistent waking time. Aim for a similar start each day.
• Get daylight and suitable physical activity. Build these into the day where health and mobility allow.
• Go to bed when sleepy. Moving bedtime much earlier after a poor night can mean more time lying awake.
• Review naps. If naps affect night-time sleep, keep them short and earlier in the day.
• Try keeping caffeine to the morning. Tea, coffee, cola and some other drinks contain caffeine.
• Avoid using alcohol as a sleep aid. It can make sleep more broken later.
• Make the evening quieter. Allow time to wind down and keep the bedroom comfortable.
• Reduce clock-watching. Repeatedly checking the time can add frustration.

These habits support sleep, although they may not resolve an underlying disorder.^[8]

Ask the treating professional to adapt advice to your health and mobility.

Where Do Sleeping Tablets and Melatonin Fit?

Sleeping medicines can have a role, but the choice should follow an assessment of the problem and the person’s other medicines.

Some commonly prescribed sleeping tablets can cause next-day drowsiness, impaired concentration, dizziness and falls. Dependence can also develop with certain medicines.

If someone already takes a sleeping tablet regularly, ask the prescriber about a review and, where appropriate, a gradual reduction plan. Do not stop it abruptly without advice.

Melatonin may help selected people, but it is not a universal solution. A doctor or pharmacist can advise whether it is appropriate and check for interactions.

Over-the-counter products also need care. Sedating antihistamines should not be used as sleep treatments, and “natural” remedies are not automatically safe or effective.^[9]

Accessing Treatment: What Medicare May Cover

Knowing that CBT-I exists is useful. Knowing how to access it makes that advice actionable.

GP Chronic Condition Management Plans

On 1 July 2025, the GP Chronic Condition Management Plan, or GPCCMP, replaced the previous GP Management Plan and Team Care Arrangements framework. Existing plans have transitional arrangements until 30 June 2027.^[10]

A GPCCMP may be available when a person has a medical condition that has lasted, or is expected to last, at least six months, or a terminal condition. The GP assesses whether a structured plan is appropriate. Psychology and mental health services can be included; a separate diagnosed mental health condition is not required for this pathway.^[11]

Eligible patients can generally access Medicare rebates for:

• Up to five individual allied health services per calendar year.
• Up to ten for Aboriginal and Torres Strait Islander patients.

These limits are shared across eligible services. If some sessions are used for physiotherapy or podiatry, fewer remain available for psychology. The referral must be consistent with the management plan.^[12]

Ask whether a referral to a psychologist trained in CBT-I is appropriate. Confirm the appointment fee, rebate and any gap before booking; a Medicare referral does not necessarily mean the service is free.

Support at Home: Psychology Without a Participant Contribution

Support at Home replaced Home Care Packages and the Short-Term Restorative Care Programme on 1 November 2025.^[13]

Under Support at Home, clinical supports attract no participant contribution. This includes eligible clinical allied health services.^[14]

Psychology is included among aged care allied health and therapy services. However, access depends on assessed needs and programme rules. My Aged Care also identifies exclusions for therapies subsidised through other government programmes and services more appropriately provided through the primary healthcare system.^[15]

For a person receiving Support at Home, the practical step is to ask their care partner whether psychology for persistent insomnia can be included in their approved care.

The service must align with assessed needs and be documented in the care plan and individualised budget. A zero contribution rate does not mean unlimited sessions or automatic approval for CBT-I.^[16]

Before arranging treatment, ask:

• Is this service approved for my needs?
• Can my available budget cover it?
• Does the psychologist provide CBT-I?
• Should treatment be accessed through Medicare or another health service first?

Preparing for a Sleep Appointment

A dedicated appointment can give sleep the attention it needs.

Beforehand, keep a simple record of bedtime, estimated sleep, waking, naps and how you feel during the day. Bring a current medicine list and mention pain, mood changes, bathroom trips or breathing concerns.

Useful questions include:

1. Could a health condition or medicine be disturbing my sleep?
2. Do my symptoms suggest a sleep disorder?
3. Would CBT-I be appropriate?
4. Which referral and funding pathway suits my circumstances?
5. When should we review whether treatment is helping?

Seek assessment when poor sleep is persistent or affecting everyday life. There is no need to wait until you feel completely worn out.^[3]

Finding Support When Leaving Home Is Difficult

For someone already tired and struggling with mobility, arranging another appointment can feel overwhelming.

Ask the GP which parts of assessment and follow-up can happen remotely or at home. When seeking psychological treatment, ask specifically about experience in CBT-I.

Home Visit Network helps Australians find independent mobile healthcare professionals by location. Families can browse providers and discuss whether their services suit the person’s needs. Confirm availability, sleep-specific expertise and funding arrangements directly before booking.

The aim is a clear plan: understand what is disrupting sleep, arrange appropriate treatment and review whether daily life is improving.

Frequently Asked Questions

Is waking during the night normal after 70?

Brief awakenings can occur as sleep becomes lighter. Repeated waking that causes distress or leaves someone exhausted deserves assessment.^[1]

Are better bedtime habits enough to treat chronic insomnia?

They can help, but the July 2026 Australian joint position statement says sleep hygiene alone is inadequate for chronic insomnia. CBT-I is the recommended first-line treatment.^[6]

Can Medicare help pay for CBT-I?

An eligible patient may receive psychology services under a GPCCMP when the referral is consistent with their plan. Ask the GP about eligibility and confirm that the psychologist offers CBT-I. Annual allied health limits apply.^[12]

Is psychology free under Support at Home?

Approved clinical psychology services attract no participant contribution, but access still depends on assessed needs, funding and programme rules. Ask your care partner to confirm arrangements before booking.^[14][15]

Can sleep improve after years of difficulties?

Yes, improvement is possible. CBT-I can help with longstanding insomnia, while other sleep problems need treatment directed at their cause. Progress may take time and follow-up.^[7]

References

1. Sleep Health Foundation. Ageing & Sleep.
2. Sleep Health Foundation. Ageing & Sleep: Overview.
3. Healthdirect Australia. Insomnia.
4. Sleep Health Foundation. Nocturia.
5. Healthdirect Australia. Obstructive Sleep Apnoea.
6. Sweetman A et al. Management of adult insomnia in Australia: a joint position statement of the Australasian Sleep Association, Sleep Health Foundation, Royal Australian College of General Practitioners, Australian Psychological Society, Pharmaceutical Society of Australia, and Australian Primary Health Care Nurses Association. Sleep Advances. Published 29 July 2026. doi:10.1093/sleepadvances/zpag086.
7. Sleep Health Foundation. Cognitive Behavioural Therapy for Insomnia (CBT-I).
8. Sleep Health Foundation. Sleep Hygiene: Good Sleep Habits.
9. Healthdirect Australia. Safe Use of Sleeping Pills.
10. Services Australia. Requirements of chronic condition care plans and case conferences.
11. Australian Government Department of Health, Disability and Ageing. Australian Government-funded mental health support through the Medicare Benefits Schedule.
12. Services Australia. Services available under a GP chronic condition management plan.
13. My Aged Care. Support at Home resources.
14. My Aged Care. Support at Home costs and contributions.
15. My Aged Care. Allied health and therapy.
16. Australian Government Department of Health, Disability and Ageing. Services under Support at Home.