Sleep is a core determinant of healthy ageing, yet sleep disorders are frequently overlooked in older adults. While some sleep changes occur with ageing, persistent poor sleep should not be considered normal. Sleep disturbance contributes to key geriatric syndromes including falls, frailty, cognitive impairment, mood disorders, and loss of functional independence, and interacts bidirectionally with multimorbidity.
Obstructive sleep apnoea (OSA) is highly prevalent in later life and commonly under‑diagnosed. In older adults, OSA is associated with hypertension, atrial fibrillation, stroke, cognitive decline, mood disorders and increased accident risk. Symptoms may be atypical, increasing the likelihood of missed diagnosis. Effective treatments—including positive airway pressure therapy, mandibular advancement devices, weight and lifestyle interventions, and targeted multidisciplinary care— have strong evidence they can improve symptoms, blood pressure control, cognition, mood and quality of life. Age alone should not be a barrier to diagnosis or treatment.
Sleep disorders are also strongly influenced by polypharmacy, circadian disruption, reduced physical activity, social isolation, and institutional environments—factors commonly encountered in geriatric practice. Incorporating routine assessment of sleep into geriatric evaluation represents an opportunity to improve functional outcomes, support healthy ageing, and deliver truly integrated care. Sleep should be recognised as a cornerstone of geriatric medicine, rather than a secondary symptom, and embedded within models of care for older adults.