The Impact of Sleep on Brain Health during Aging: Recognize Signs of Poor Sleep

Dr. Amy Sanders, MD, FAAN
Neurologist Specializing in Dementia
5 min

Sleep is vital to good health. It allows the body to repair and rejuvenate tissues, muscles, and cells. Lack of sleep is recognized as a risk factor for weight gain, heart disease, stroke, and diabetes. Sleep has profound effects on all aspects of mental, physical, and emotional health. 

Making sleep a priority by building good sleep habits is one of the best things you can do for your short-term and long-term health.

Key Takeaways

  • Do not ignore troubled sleep.
  • Signs of troubled sleep can be related to the way we sleep in both direct and indirect ways.
  • Online sleep questionnaires can assess daytime sleepiness and the need for additional evaluation. 
  • “There’s an app for that.” Applications for smartphones, tablets, and wearable devices increasingly include sleep-tracking protocols. 
  • Sleep studies are readily available and are the gold standard for diagnosing most sleep disorders. 

How can I tell if my sleep needs work?

The American Academy of Sleep Medicine and the Sleep Research Society recommend adults sleep at least 7 hours a night.1 

Many warning signs can signal that sleep needs attention and improvement.

Some warning signs are directly related to sleep; others are non-sleep factors that worsen when sleep is poor. 

Sleep-Related Warning Signs of Poor Sleep

Trouble Dropping Off: Also known as “long sleep latency,” lying in bed for more than 20 or 30 minutes without falling asleep is part of poor sleep habits. It may indicate the presence of an underlying sleep condition or a mood disorder like anxiety. 

Trouble Staying Asleep: Having trouble staying asleep or struggling to fall back to sleep after awakening disrupts your sleep and leads to poor sleep quality. In particular, a pattern of early morning awakening is often seen in depression.

Sleep that does not Refresh: People who wake up tired and groggy may be experiencing poor-quality sleep. 

Daytime Sleepiness: Feeling unusually tired during the day and feeling a need to nap often hints that nighttime sleep is too little, broken up, or both. 

Sleep Disorders: Untreated sleep problems, like insomnia and sleep apnea, are definite signs of poor sleep. In obstructive sleep apnea (OSA), breathing stops and starts during sleep up to hundreds of times. This leads to lower levels of oxygen in the blood and fragmented, poor-quality sleep.  

Non-Sleep-Related Warning Signs of Poor Sleep

Poor Focus: Struggles with attention or being more distractible than usual are common signs of chronic sleep problems.

Poor Productivity: If you are making more mistakes yet are behind on completing tasks, sleep deprivation may be to blame. 

Mood Changes: Both depression and anxiety can emerge or worsen when sleep is poor. Irritability and being more “snappy” than usual also go along with poor sleep.

Appetite/Weight Change: Poor sleep affects hormones that control appetite and metabolism. Poor sleep can increase hunger and cause unwanted weight gain.

Immune System Compromise: Poor sleep impedes immune function, leading to frequent illnesses and infections.

What do I do if I notice these signs in myself or someone close to me?

If you are worried about your sleep, the first—and single most important—thing to do is to act. 

Do NOT ignore troubled sleep. Then take one or all these steps:

Keep a Sleep Diary

  • You can go “old school” and write down data about your sleep. Two weeks is a reasonable time frame for recording your sleep patterns. Your primary care clinician or sleep specialist will thank you for these data. 
  • Key things to track are what time you woke up, how many total hours of sleep you got, how rested you felt upon rising (eg, try a scale of 1 to 5), and whether you exercised, napped, or consumed alcohol, nicotine, or caffeine the preceding day. 
  • More and more often, “There’s an app for that.” VeryWellMind, a leading website on consumer health and wellness, recently ranked computer and smartphone sleep tracker applications.

Take a Little Sleep Test

  • Online sleep tests are easy to use and can help you determine whether you are at risk for obstructive sleep apnea (OSA), one of the most common sleep disorders after insomnia. 
  • The STOP-BANG test uses 8 yes-or-no questions based on the major risk factors for OSA (STOP-BANG is an acronym for the first letter of each factor).3
  • The Epworth Sleepiness Scale4 is a subjective assessment of the likelihood of dozing off under each of 8 conditions. The maximum score is 24. Talking with a medical professional is recommended for scores of 10 or more.

Consult a Healthcare Professional

  • Talking with a knowledgeable medical professional about your sleep concerns is crucial for prioritizing good sleep health. 
  • A primary care practitioner can review sleep symptoms and identify underlying causes, ranging from sleep disorders to other medical conditions or medications that might impair nightly rest. 
  • If symptoms warrant, referrals can be made to talk with a sleep specialist or for a sleep study. 

What is a sleep study?

A simple sleep study for OSA can usually be performed in one’s very own room without having to spend the night in a “sleep lab.” 

  • This type of sleep study typically measures breathing rate, heart rate, and blood oxygen levels. 
  • A simple device fits over a fingertip to monitor blood oxygen levels during sleep, especially during periods of non-breathing, known as apnea. 
  • Usually, a belt is worn around the rib cage to track breathing movement during sleep. 

Polysomnography (PSG) is overnight sleep testing. It takes place in a specialized laboratory that looks like a mid-range hotel room. 

  • PSG examines multiple (hence, “poly”) factors during sleep (hence, “somnography”). 
  • PSG records brain waves, an EKG tracing, and leg and eye movements using sensors and electrodes attached to the scalp, face, chest, and legs. 
  • PSG is often needed to diagnose conditions like restless leg syndrome or problems with REM sleep. 

Making good sleep a priority is key for both short-term well-being and long-term health. 

People who note warning signs of troubled sleep, such as poor focus, daytime sleepiness, and mood changes, can take action to address their sleep health. 

Sleep diaries, taking online sleep tests, and talking with knowledgeable clinicians are key strategies for identifying and managing sleep-related issues. Additionally, having a sleep study at home or in a specialized laboratory may yield valuable insights into sleep patterns and aid in diagnosing sleep disorders. 

Taking action and seeking professional guidance are key steps toward improving sleep quality and overall health.

Learn more about sleep and how it impacts brain health during aging here.

Do you have another question that the Sunday Health brain health experts can answer? We invite you to send your questions to


  1. Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 2015;11(6):591–592.

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