Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. she reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a "racing heartbeat," and she is losing her appetite. she emphasizes that she is not hungry like she used to be. the only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. mom had always been healthy, but she fell down a flight of stairs and broke her hip. her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. martha has to put a lot of time into caring for her mother, so it is almost a "blessing" that martha is sleeping and eating less. she is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

Older adults like Martha tend to have troubled sleep patterns at night and often fall asleep during the day. Less production of melatonin is often the major reason behind it. This specific hormone promotes sleep, therefore, its low production tends to affect sleep schedule. Other than that, sleep issues are also associated with psychiatric and psychological issues. Like in the case given, Martha seems slightly disturbed about her post-retirement routine as this was not what she had expected. She spends more time caring for her mother and less for herself. Moreover, her past experience with hypertension also has an important role to play.