The financial strain from rising costs has become relentless for many retired Americans.

Retirees say everyday expenses are running higher than expected, according to a new survey from investment manager Schroders, and nearly 6 in 10 say they don’t know how long their retirement savings will last.

“The affordability crisis is a daily struggle for many retirees,” Deb Boyden, head of US defined contribution at Schroders, told Yahoo Finance. “With nearly half of retirees reporting their expenses are higher than anticipated, it’s clear many entered retirement without a plan for managing rising costs.”

Read more: How much do you really need to save for retirement?

Healthcare is taking a particularly heavy toll. Retirees report spending an average of 16% of their monthly income on medical expenses such as insurance premiums and prescriptions. Nearly two-thirds said they expected Medicare to cover far more of those bills.

“Many seniors already forgo essentials like medical care because they can’t keep up with rising costs,” The Senior Citizens League executive director Shannon Benton previously told Yahoo Finance.

The survey found retirees’ top financial worries are inflation, healthcare costs, a major market downturn, uncertainty about how to withdraw money from retirement accounts wisely, and the enduring fear of outliving their savings.

The stress is spilling into their daily lives. More than a third worry that financial strain will hurt their overall health. Nearly 3 in 10 say they’ve lost sleep over money and worry about it every day.

Read more: Retirement planning: A step-by-step guide

Asked to describe their current financial situation, just 4% of retirees said they were “living the dream.” Another 37% said they were “comfortable,” while 35% described their situation as “not great, but not bad.”

“It should be a wake-up call for retired Americans who have no idea how long their savings will last,” Boyden said. “Retirement planning doesn’t end once someone stops working. The real challenge begins afterward — creating a strategy for income, inflation, market volatility, and unexpected expenses.”

Kerry Hannon is a Senior Columnist at Yahoo Finance. She is a career and retirement strategist and the author of 14 books, including “Retirement Bites: A Gen X Guide to Securing Your Financial Future,” “In Control at 50+: How to Succeed in the New World of Work,” and “Never Too Old to Get Rich.” Follow her on Bluesky and X.

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