CONCLUSION: This small study suggests that excessive sleepiness is not normal in healthy older adults. Symptoms of excessive sleepiness in this population, including reliance on caffeine to maintain alertness, should be evaluated and treated. Further study is needed to determine whether day- time sleepiness in middle-old (75–84 years) and old-old ( 85) adults is normal or is instead associated with sleep restriction, undiagnosed sleep disorders, medication side effects, mood disorders, or other medical disorders that disrupt sleep. J Am Geriatr Soc 57:1245–1251, 2009.