The importance of sleep is required in every age range throughout the lifespan. As one ages sleep can be hampered in part by lifestyle choices, sleep hygiene, and aging processes. Throughout the lifespan, it is important to have meaningful conversations with those who participate in the healthcare team. Identifying vital information that is provided by the patient or patient family can lead to appropriate treatments and the identification of common sleep disorders. In understanding the significance of the conversation and physical examination providers can delineate the information into meaningful assessments. Using processes that are reviewed here which will assist in gathering a complete history and physical and providing differential diagnosis for the essential factor of sleep that is needed not only for overall health and well-being but to promote in the older adult population a good quality of life while decreasing mortality and fall risk. We will review and discuss the objectives of the examination, routinely screening patients for sleep changes, monitoring age-related changes, and readdress the use of C-PAP machines and concerns for adherence, while also discussing the hurdles of Covid-19 in both diagnosis and treatments. Using diagnostic testing and screening tools to guide the differential diagnosis to the optimal treatment and management of sleep disorders with a focus on obstructive sleep apnea in older adults.