If you fall asleep soon after your head hits the pillow and wake up feeling refreshed nearly every morning, then you’re lucky. For the rest of us, poor sleep could mean poor health.
It’s no coincidence that older Americans have a higher that normal incidence of both sleep disorders and health problems. More than half of Americans age 60 and over have a sleep complaint, and it’s usually associated with one or more illnesses and/or medications taken for these problems.
“Disrupted sleep has a negative impact on health, safety and quality of life, sometimes even leading to premature loss of independence. It’s clearly important to recognize sleep problems early and get treatment before they spiral out of control,” says Rick LaTurner, a registered polysomnographic technologist (RPSGT) specializing in sleep disorders at St. John’s Regional Medical Center in Joplin.
“Sleep involves a series of complex stages and cycles, and changes occur in sleep architecture as a normal consequence of aging. Older adults spend more of the night in lighter stages of sleep and usually wake up more often during the night, resulting in less total sleep time even if they spend more time in bed,” adds LaTurner.
On their own, the mentioned sleep changes don’t constitute a sleep disorder, but they are often complicated by one or more medical problems. It’s difficult to get a good night’s sleep when you have chronic back pain or arthritis. Sleep can be severely fragmented by periodic limb movements, a condition in which the legs kick or jerk at frequent intervals, or by restless leg syndrome, which involves disagreeable leg sensations and an urge to move them.
Postmenopausal women often have their sleep disrupted by hot flashes. And 30 to 50 percent of cancer patients have sleep problems – either because of cancer pain, side effects of treatment or stress brought on by the illness.
According to studies, nocturia – the need to urinate several times during the night is the most common reason for sleep interruption among seniors. LaTurner says, “men with benign prostate enlargement are vulnerable, but both male and females can develop nocturia as a result of kidney or bladder disease, congestive heart failure or even sleep apnea.” Usually associated with loud snoring, sleep apnea is characterized by repeated, brief episodes of breathing cessation – eventually leading to severe sleep debt.
At any age, depression is linked closely with insomnia or early awakening. And seniors are vulnerable to depression and anxiety for many reasons – chronic pain, grief over the loss of a loved one, worry about income, health problems or loss of independence. Depression is also linked with dementia, both as a cause and an effect.
Just as poor health interferes with sleep, poor sleep inevitable leads to health problems – often creating a vicious downward spiral. Over an extended period, poor sleep can contribute to high blood pressure, heart disease, diabetes, depression, chronic fatigue and a breakdown of the immune system, leading to frequent colds or infections. Recent research indicated that lack of sleep also affects hormones regulating appetite and weight control.
Excessive daytime sleepiness resulting from poor sleep can interfere with daily activities, cause attention and memory deficits and increase the risk of falls and accidents.
As early as 1983, researchers found that mortality is directly related to sleep time. Subjects regularly getting less than six hours sleep per night, or more than nine, had higher overall rates of heart disease, cancer and mortality.
“The first step is to recognize the problem and start to address it. Some sleep problems are serious enough to require referral to a specialist and a workup in a sleep laboratory, like the one at St. John’s,” says LaTurner. In most cases, some common sense measures can provide significant help.
Medical conditions contributing to sleep problems should be addressed. If you have trouble getting back to sleep after late night bathroom trips, there are treatments. If worries or distressing thoughts are keeping you awake, you may need counseling or treatment for depression.
Sometimes a change of medication or the timing of your doses can lead to better sleep. Whatever you do, don’t get in the habit of seeking a solution in over-the-counter sleeping pills. Over the long term, they can cause a rebound effect and make the problem worse.
Self-help measures are usually more effective.
- Establish a regular bedtime and a calming routine to help you get ready for bed.
- Make your bed and bedroom a desirable place to sleep. Remove distractions such as computers, stereos, TV’s, books, and magazines.
- Don’t stay in bed during long periods of sleeplessness.
- To avoid urges to urinate during the night, don’t drink anything for at least an hour before bedtime.
- Avoid caffeine after lunch. Although the blood level is highest 30 to 60 minutes after ingestion, the stimulant effect can linger for hours in older adults and reduce the deepest stages of sleep.
- Eat your last meal about three to four hours before bedtime and avoid spicy, fatty or fried foods, which can cause indigestion.
- If you wake up every night about 3 a.m., it’s probably because of a drop in blood sugar. Avoid sugary late night snacks, concentrating instead on proteins and complex carbohydrates.
- Get plenty of exercise during the day, but avoid strenuous activity three hours before bedtime.
- Get some light exposure each day to increase your body’s production of melatonin, a sleep-inducing hormone.
Sleep specialists recommend getting seven to nine hours of sleep nightly, but they admit there’s no one formula that’s right for everybody. The best indication is how rested you feel during the day. Although sleep problems are common after age 60, there’s no reason to accept them as normal. Studies show that if you’re healthy, you’ll probably sleep well. And if you sleep well, you’re likely to stay healthy.
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