Crystal Oliveira says when a senior in her care wakes during the night, often they can be scared, confused or start to wander.

`` I tell them who I am, I just remind them where they are, and sometimes they'll snap out of it or they'll look and see familiar pictures around,'' says Oliveira, of Attleboro.

In her job as a caregiver with Home Instead Senior Care out of Norton, Oliveira sits at night with older adults, primarily ages 75 to 95, some of whom have Alzheimer's Disease or dementia, who may have trouble sleeping at night and fear being alone.

She assists them to use the bathroom and helps them back to bed and comforts them until they fall back asleep, many times just to repeat the process several hours later.

Aging and sleep, especially for older adults, is attracting growing attention as more people are expected to live longer. And for those who suffer `` night fright,'' it can be even a greater challenge for both the individuals and their family or their caregivers. While just a small segment of the older adults suffer from night fright, seniors' sleep problems can arise from various sources say senior care health officials, who note that the quality of sleep and sleeping patterns change as people age, yet that many sleep problems in older adults are caused by underlying medical, psychological or environmental conditions rather than by the aging process itself, according to the American Geriatric Society's (AGS) Foundation for Health on Aging Web site (www.healthinaging.org/agingintheknow).

Interrupted sleep can be caused by social problems, drug and alcohol dependency, medical problems, sleep apnea and sleep disorders, among others. Some primary sleep disorders, such as sleep apnea and periodic limb movements during sleep become more common with age.

It is a serious issue since many older adults often have problems sleeping, including difficulty falling asleep, waking up during the night and waking up very early in the morning, according to the AGS.

According to a Gallup survey of adults over the age of 50 released by the International Longevity Center-USA (ILC) in November 2005, almost half (46 percent) of older adults reported receiving fewer than seven hours of sleep each night; a quarter (25 percent), believe they have a `` sleep problem.''

Sleep problems decrease the quality of life and can lead to injury or other health problems, can cause poor judgment and lead to accidents.

Daytime sleepiness is also common, with 20 percent of Americans living at home reporting that they are `` usually sleepy in the daytime,'' according to the AGS Web site.

And at least half of older adults living at home use either over-the-counter or prescription medications to help them sleep, which can be risky and even make the situation worse, according to medical officials.

Between 2000 and 2004, use of prescription insomnia drugs climbed by 16 percent among people 65 years and older, according to an analysis recently released by the New Jersey-based prescription-management firm Medco Health Solutions.

According to the Gallup survey, older adults reported having concerns about taking prescription sleep medications including addiction, next-day grogginess and long-term side effects.

Although most older adults, about 80 percent, said they recognized the importance of sleep to their health, many who experienced trouble sleeping remained untreated, according to the survey. `` The importance of sleep to healthy aging is often overlooked in the medical community, but it's becoming increasingly apparent that good sleep could be a new vital sign,'' said Dr. Robert Butler, president and CEO of the ILC in 2005.

`` Poor sleep is a condition that needs to be addressed, diagnosed and treated -- it could be as important as nutrition, exercise and social engagement to the health of older adults,'' he stated.

Up to 70 percent of family caregivers report that nighttime difficulties and sleep disruption played a significant role in their decision to place an older adult in a nursing home or other institution, according to the AGS.

For older adults living at home alone, nighttime can cause anxiety for any number of reasons and for those who suffer from Alzheimer's and dementia, that anxiety can give rise to fear, further adding to sleepless nights.

Debbie Nichols, owner of the Home Instead Senior Care office that serves the Attleboro area, said her agency does a lot of Alzheimer's and dementia care.

She estimated that about 10 to 15 percent of their clients at any one time suffer from `` night fright'' in which getting a good night's sleep is particularly challenging for those people `` because they are really fearful,'' whether it's of a fear of someone breaking into their home or just of being alone, she said.

Some are coming home from hip or knee surgery and afraid they will fall. For yet a smaller segment of elder seniors, `` it's just the fear of being alone if they pass through the night,'' Nichols said. `` It's a real fear and a sad one to face.''