You’re pooped and you can’t wait to go to sleep…your head hits the pillow. Suddenly, you’re wide awake. But the next day, you’re in a fog and feeling tired. Perhaps it’s your Sleep Hygiene.
Sleep Hygiene, according to The National Sleep Foundation (NSF), are “the practices and habits necessary for a good night’s sleep and alertness during the day” and stresses its importance for both physical and mental health, improved productivity and overall quality of life. Inadequate sleep can cause depression, memory problems, irritability and falls. The NSF says the most important sleep hygiene practice is sleeping the right amount of time. But older adults often find sleep elusive even though seven to nine hours of ZZZs per night are optimal.
Sleep patterns—or sleep architecture—can change as we age. The NSF explains that we may have a harder time falling or staying asleep and, consequently, feel sluggish during the day. These changes in sleep patterns chip away at the total hours of sleep time. Sleep occurs in cycles that consist of multiple stages of either light or deep, dreamless sleep and occasional periods of active dreaming called REM sleep. Total sleep time remains constant, and the sleep cycle is repeated several times during sleep. The difference for older adults is that we stay in the lighter stages of sleep more than in deep sleep.
Many older adults are dissatisfied with their sleep, because
- it takes longer for them to fall asleep (sleep latency),
- there’s an overall decline in REM sleep; and
- there’s an increase in sleep fragmentation (waking up during the night). There are many reasons for changes in sleep as one ages, from less physical exercise to taking medicines that cause sleeplessness.
A factor affecting sleep are the changes in circadian rhythms that coordinate the timing of our bodily functions. As we age, we tend to get up earlier and go to sleep earlier. That’s why so many restaurants have created “Early Bird Specials” with dinner starting at 4 pm! Though not clearly understood, researchers think this syndrome may have to do with light exposure.
Conditions and Disorders that Interfere with Sleep
People with poor health or medical conditions also tend to have more sleep problems. Medical conditions such as diabetes, asthma, immune disorders and renal failure are all associated with sleep problems. Parkinson’s disease and multiple sclerosis also cause problems sleeping. Gastroesophageal reflux disease (GERD) is another common cause of sleep problems.
Insomnia is a condition in which you have trouble falling asleep and staying asleep. It is the most common sleep problem in adults age 60 and older. Symptoms of insomnia include: Taking a long time to fall asleep; waking up many times in the night; waking up early and being unable to get back to sleep; waking up tired; and feeling very sleepy during the day. Often, being unable to sleep becomes a habit and can last a long time.
Sleep Apnea is a condition in which people have short pauses in breathing while they are asleep. These pauses may happen many times during the night. If not treated, sleep apnea can lead to other problems, such as high blood pressure, stroke or memory loss. You can have sleep apnea and not even know it. If you feel sleepy during the day or are told you snore loudly at night, you could have sleep apnea and should see a doctor who can treat it. Or you can change your sleep position or use a special medical device, a dental device or have surgery.
Restless Legs Syndrome (RLS), Periodic Limb Movement (PLMD) and Rapid Eye Movement (REMD) disorders are common in older adults and can affect sleep. RLS feels like tingling or pins and needles in the legs. People with PLMD will jerk or kick their legs every 20-40 seconds while asleep. Medications and baths can relieve this. With REMD, your muscles move and your sleep is disrupted during REM sleep. Since this is the time when muscles are still, it interferes with your sleep.
There are some over-the-counter sleep aids or prescription medicines that may help you get to sleep, but they are not a cure for chronic sleeplessness. Developing healthy habits at bedtime is the best route.
“The amount of sleep required by the average person is five minutes more.”
Tips for a Good Night’s Sleep
- Napping in the late afternoon or after dinner may cause sleeplessness at night.
- Try to not fall asleep on your couch while watching TV—your bedroom should be your sleep sanctuary.
- You may want to consider making dinner your smallest meal of the day so that you’re not sleeping on a full stomach. If you do snack, these are foods that help you sleep: popcorn, oatmeal, whole wheat crackers, almonds and walnuts, cottage cheese, decaf tea, warm milk, bananas, pineapple and oranges.
- Develop a regular bedtime routine, like relaxing before bed, reading, soaking in a tub, listening to music.
- Don’t toss and turn. Turn off the light and try to sleep for 20 minutes. If not drowsy, try counting slowly to 100 or get up and walk around a bit.
- Try body relaxation: relax your toes, your feet, ankles, then work your way up your body to your head.
- Turn off your TV or digital devices. Their blue light signals the body to stop making melatonin, a hormone found naturally in the body, available in pill form. It regulates night and day cycles Darkness causes the body to produce more melatonin.
- Keep your bedroom at a comfortable temperature.
- Use low lighting in your bedroom or while you’re relaxing in the evening. Bright lights can alter the circadian rhythm.
- Exercise regularly, but not within three hours of going to bed.
- Stay away from caffeine or alcohol late in the day.
CJE SeniorLife is beginning a partnership with Dr. Kathryn Reid, Research Professor of Neurology at the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine. We will be presenting together on “Keeping the Rhythm: Sleep and Circadian Wellness as We Age” at the City of Evanston Aging Well Conference on Friday, May 3, 2019.
This presentation on sleep will be sure to keep you awake! Attendees should leave this session with a basic understanding of sleep, circadian physiology and the changes that come with age. Attendees will also learn how to create better sleep habits to improve health and overall wellbeing.