A 65 year old recently retired male presenting with persistent daytime sleepiness requires a systematic geriatric evaluation because sleep disturbances in older adults are often multifactorial. Age-related changes in sleep architecture include reduced slow wave sleep, increased sleep fragmentation, and earlier sleep onset and awakening. However, excessive daytime sleepiness is not a normal consequence of aging and warrants clinical assessment. The patient has significant comorbidities including hypertension and dyslipidaemia and is overweight with a height of 5 feet 8 inches and weight of 96 kg. His body mass index is approximately 32 kg/m², placing him in the obese category. Obesity is an important risk factor for several sleep disorders, particularly obstructive sleep apnoea and gastroesophageal reflux disease. Although there is no history of snoring, choking, or witnessed apnoeic episodes, absence of classical symptoms does not completely exclude sleep-related breathing disorders in older adults. Nevertheless, the wife’s report of frequent night-time cough, along with morning hoarseness and occasional epigastric discomfort, strongly suggests nocturnal gastroesophageal reflux as a probable cause of sleep disruption. In clinical geriatrics, atypical presentations are common. Nocturnal reflux may manifest primarily as chronic cough, throat clearing, hoarseness, or disturbed sleep rather than typical heartburn. Laryngopharyngeal reflux can cause irritation of the upper airway, leading to night-time coughing bouts that fragment sleep and result in non-restorative sleep and daytime somnolence. Morning hoarseness is a classic symptom of acid exposure to the larynx during the night. Occasional epigastric discomfort and previous self-medication with antacids further support this possibility. Hydrochlorothiazide, used for hypertension, may contribute indirectly to sleep disruption by causing nocturia if taken late in the day. Nocturia is a common cause of sleep fragmentation in older adults and can exacerbate daytime fatigue. It is important to review the timing of diuretic administration and advise morning dosing to minimize night-time awakenings. Rosuvastatin is less likely to cause sleep disturbance, although rare cases of insomnia have been reported with statins. Hypertension with a blood pressure of 140/90 mm Hg indicates suboptimal control. Poor sleep quality itself may worsen blood pressure control, creating a bidirectional relationship. Chronic sleep deprivation increases sympathetic activity, contributing to cardiovascular risk. In an elderly individual with cardiometabolic risk factors, untreated sleep disorders can significantly increase morbidity. The clinical picture points