There are significant changes in sleep as part of the normal aging process. For example, it has been shown that sleep architecture changes with aging. It is generally thought that the elderly spend less time in deep sleep, also known as slow wave sleep (stages 3 and 4) and more time in lighter stages of sleep, such as stage 1 sleep.[4] However, a recent meta- analysis revealed that reductions in slow wave sleep begin at 60 years of age. However, it appears that aging per se does not cause sleep disturbances. The majority of disturbances are related to medical and psychiatric disorders associ- ated with aging as well as to environmental chal- lenges.[6] There is increased wakefulness and more fragmentation of sleep in older adults. Other changes in sleep include decreased time to rapid eye movement (REM) sleep (REM latency), reduced REM sleep, and early morning awakenings, which are thought to result from dysregulation of circadian rhythms.[7,8] Finally, there is a phase advance in circadian rhythm for sleep in the elderly, meaning that one becomes tired earlier in the evening and wakes up earlier in the morning. The end result is that the person sleeps the same number of hours, but experiences early morning wakening. Some people may try to stay awake longer and go to sleep later, but still wake up very early and have less sleep in total.[9]