Frequent Or Longer Naps In Older Age May Signal Declining Health, Study Suggests

In this study, researchers from Mass General Brigham and Rush University Medical Center followed 1,338 participants for up to 19 years, monitoring both the duration and frequency of their naps.

Their findings suggest that with age, naps tended to become longer, more frequent, and more likely to occur earlier in the day.

The researchers found that individuals who took longer or more frequent naps, particularly in the morning, had a higher risk of death compared with those whose napping habits remained stable.

Notably, each additional hour of daytime napping was associated with a 13% increase in mortality risk. Likewise, each additional nap per day corresponded to roughly a 7% higher risk.

People who napped in the morning had a 30% higher mortality risk than those who napped in the afternoon. The study suggests that inconsistent napping patterns were not associated with an increased risk of mortality.

While the study does not prove that napping itself causes poorer outcomes, it highlights a strong potential association between evolving nap patterns and declining health.

The study authors suggest that increased napping may reflect underlying biological changes, such as disruptions in the body’s circadian rhythms or the early stages of chronic illness.

Lead author Chenlu Gao, PhD, an investigator in the Department of Anesthesiology in the Mass General Brigham, who is also an affiliated research fellow in the Division of Sleep and Circadian Disorders in the Department of Medicine, spoke to Medical News Today about the key findings from this study:

“For clinicians, the key message is that daytime napping patterns may be worth asking about as part of routine health monitoring in older adults. Clinicians tend to focus on nighttime sleep, but our findings suggest that what’s happening during the day is also informative.”

“Importantly, the associations between daytime napping and mortality remained significant even after accounting for nighttime sleep duration and fragmentation, which tells us that daytime napping carries independent information about health status,” Gao explained.

“For the general public, the takeaway is to pay attention to daytime napping patterns. Excessive daytime sleepiness, especially if it’s becoming more frequent or predominantly occur in the morning hours, may be a signal of an underlying condition.”

— Chenlu Gao, PhD

These findings suggest that napping could act as an easily observable marker of health status in older adults.

Through wearable devices or simple observation, it is possible to track sleeping patterns noninvasively. This may provide clinicians and caregivers with a practical way to monitor changes in napping behavior and help identify those who could benefit from further medical evaluation.

“Caregivers are often well-positioned to notice changes in daytime napping patterns,” Gao told MNT.

Signs to watch out for

“Signs worth paying attention to include: a loved one napping much more than they used to, falling asleep frequently and having trouble staying awake during the day, or regularly feeling drowsy in the morning hours despite having slept overnight. Snoring, gasping during sleep, or frequently waking during the night are also worth paying attention to, as these are potentially symptoms of sleep disorders that drive daytime sleepiness.”

— Chenlu Gao, PhD

Gao also noted to MNT that wearable technology could play a role in potentially identifying risk earlier.

“We think this is a promising direction. In our study, wrist-worn actigraphy was used to objectively capture habitual napping patterns, rather than relying on self-report, which can be unreliable,” she said.

“However, consumer wearable devices vary a lot in how accurately they assess sleep. Validating these devices and establishing which changes in nap patterns are most predictive of health decline will be important next steps. If we can identify reliable wearable-based markers, there is real potential to integrate them into routine care,” she added.

However, the researchers emphasize that it is not occasional napping that is concerning, but rather progressive increases in napping duration and frequency over time.

“Unfortunately, our study did not look at specific thresholds. Napping is indeed very common among older adults. In our study, 99% of the participants napped at least once during the monitoring period, so napping itself is not a red flag,” Gao said to MNT.

“What is concerning is a pattern of long and frequent naps, especially in the morning hours, when a healthy adult should feel refreshed after a night of rest.”

– Chenlu Gao, PhD

“In addition, a noticeable change from one’s usual nap patterns, such as napping much more than they used to, is also worth paying attention to. Future studies are needed to establish specific guidelines on napping behaviors to promote health,” she said.

While further research is still necessary to understand the association between increased napping and higher mortality risk, this study adds to a growing body of evidence linking sleep regularity with overall health and longevity.

For now, the researchers suggest that clinicians consider changes in napping habits as a potential red flag in aging populations, which may warrant closer attention and possibly earlier intervention.

MNT also spoke with Opel Baker, MBChB, DipOccMed, MRCGP, a general practitioner from the Mayfield Clinic in Brighton, United Kingdom, who was not involved with the study.

Napping is a common behavior in older adults, and while it can have a restorative effect, it is advisable to limit naps to shorter durations. Setting alarms can be an effective way to help manage nap duration.

Evidence suggests that up to 30 minutes of napping may have the most benefit, while napping for more than 1 hour can lead to sleep inertia, a temporary state of disorientation upon waking. Additionally, longer or more frequent naps are also more likely to disrupt sleeping patterns at night.

Speaking to MNT, Gao highlights that addressing underlying conditions may help to reduce excessive daytime napping:

“If someone regularly experiences daytime sleepiness and needs to take naps, the first important step is to figure out why. If it is driven by conditions like obstructive sleep apnea or medical conditions that cause fatigue and frailty, then diagnosis and targeted treatments will be needed.”

Additionally, she adds that certain lifestyle changes can also be beneficial.

“If the excessive daytime sleepiness is driven by poor nighttime sleep, then improving sleep hygiene may help. Tips include: maintaining a consistent sleep schedule, limiting caffeine and alcohol especially in evening, avoid using electronic devices before bedtime, and staying outside of the bed when not intending to sleep,” Gao said.

MNT also spoke with Steve Allder, MD, a consultant neurologist at Re:Cognition Health in London, U.K., who was not involved with the study.

He emphasized that persistent excessive sleepiness should be medically evaluated rather than managed with lifestyle changes alone. He adds that the goal is to improve sleep at night and stay more alert during the day.

Allder concludes that reducing excessive napping is less about restriction and more about identifying and correcting the underlying drivers, whether neurological, behavioural or systemic. He suggests the following tips: