When Sleep Won’t Come
What’s a concern and what’s not worth losing sleep over
Photo by verdes cosmin on Unsplash
If you have trouble sleeping at night, you are in excellent company. Researchers estimate between 40% and 70% of older adults have chronic sleep issues. The reason the estimate is so imprecise is that as many as half of all cases may be unreported.
It’s not unusual for sleep patterns to change as we age. That’s normal. Unfortunately, sleep issues may well be the result of other medical conditions, or even a partial cause of them. Moreover, sleep deprivation seems to trigger molecular processes in our bodies that drive biological aging. Researchers believe detecting sleeping problems and intervening early will produce long-term health benefits.
Contrary to folk wisdom, it is not true that older adults need less sleep. The medical consensus is that we continue to need as much sleep as we did when we were younger adults – seven to eight hours each night.
If that’s more than you’re getting now, how do you know whether your sleeping is a sign of trouble or just a normal part of aging?
Based on my reading – and bearing in mind that my only medical qualification is having once read a medical journal article – here is some guidance that may be useful.
The Normal
“Early to bed, early to rise...” yada yada yada. It’s not unusual for sleep patterns to change, thanks in part to a master internal clock lodged in the brain called the suprachiasmatic nucleus, or SCN. The SCN controls the body’s 24-hour cycles, a.k.a. circadian rhythms, which influence when you get hungry, when you feel sleepy, etc. While you were aging, so was your SCN, and it might have lost a cog or a spring or two, resulting in a big reset. As a result, your normal wakeup time of 7 a.m. might become 5 a.m.
The SCN responds to light, and exposure to daylight helps maintain circadian rhythms. But many older adults don’t get enough daylight exposure to keep the 24-hour clock calibrated.
Another thing that may happen is changes in hormone levels. As we age, our bodies secrete less melatonin, which is normally produced in response to darkness (hence, the idea behind melatonin supplements as a sleep aid.)
There’s no harm in waking up earlier, as long as you go to bed earlier to compensate. Another way to cover the sleep deficit is by napping. Short naps can be helpful in refreshing your brain and body. But use discretion. Naps of more than one hour and naps in late afternoon may disrupt your sleep pattern even more.
The Not So Normal
Then there are a host of maladies that afflict many older adults, and to which attention must be paid.
Insomnia. If you can’t fall asleep easily every now and then, maybe you’re too keyed up. But if it happens frequently, you have insomnia, and you want to address it quickly. Insomnia can be triggered by a number of other conditions - most often by anxiety, depression, or changes in circadian rhythms - but it is often treatable.
Sleep apnea. If your airway becomes obstructed while you sleep, your breathing pauses. This condition often leads to snoring and fragmented sleep – for you and anyone ese nearby. Uncorrected, sleep apnea can affect the body’s oxygen levels, which can lead to headaches, difficulty thinking clearly, and daytime sleepiness. Wearing a CPAP device at night keeps the airway open and allows for sounder sleep.
Restless leg syndrome. People with this condition experience a tingling, crawling, or pins and needles sensation in one or both legs. Medicines are available to treat it.
Periodic limb movement disorder. This condition causes involuntary movements in the legs or feet at frequent intervals during sleep. In addition to medicines, relaxation exercises and warm baths can bring relief.
REM behavior disorder. Rapid eye movement (REM) sleep is the point in the sleep cycle when we dream. Normally, when the body reaches this state, the brain sends a signal to immobilize the muscles. When you have the disorder, your muscles move and your sleep is disturbed.
Nighttime urination. An estimated 80% of older adults experience physical changes in the urinary system, meaning we need to urinate more often during the night. Even for those who can easily fall back to sleep, the disruptions may lower the quality of sleep.
Helpful Habits
If you’re on the fence about whether your sleep issues are normal or problematic, try these helpful home remedies before consulting a doctor.
Bedroom restrictions. Get your mind and body used to the idea that the only things that happen in the bedroom are sleeping and sex. No reading, no texting, no television – make the bedroom exclusively the room where sleep is the primary activity.
Regularity. Help your internal body clock find its rhythm by keeping a regular sleep schedule. Go to bed at the same hour every night, get up at the same hour every morning – even weekends.
Exercise. Try to exercise daily – just not within three to four hours of bedtime.
Warm bath or shower. Studies consistently show that a bath or shower before bed shortens the time it takes to fall asleep. The reason is that your core body temperature – the temperature of the cavities containing your internal organs – needs to decrease in order for you to fall asleep. The quick shower or bath helps cool the body down.
Avoid alcohol before bed. Alcohol, on the other hand, warms your insides – the opposite of what you need to go to sleep.
Solitary activity. Reading (the more boring, the better), light yoga, or listening to mellow music are all good things to do before bedtime, because they encourage mind (and body) to wind down.
Warm milk. This home remedy has worked for generations, and it even has good science behind it.
If you’re still having sleep issues after trying the appropriate home remedies, check with your doctor. Don’t let lack of sleep make you feel older than you are.
A Personal Apology
If you were among the first subscribers to The EndGame, you may have received a message from me this week about coming attractions. I did not intend to send it. Please accept my sincere apologies for this spam-like clutter in your inbox. That message was originally sent in March 2021 to announce that I was beginning The EndGame, and to my dismay been sent by my computer to the same list four more times in the past two years. I am happy to report that my brilliant tech support guru, Pablo Jusem at TenacITy, found the problem, isolated it, and blasted it into the ionosphere. Henceforth, you will receive only the freshest, newsiest bulletins from me, I guarantee.
Don't forget.. don't drink even a glass of water before bed..
Good information as we age. I used to sleep like the proverbial log until menopause hit. I had no clue how much of an effect hormones play in our bodies! Now, I wake briefly whenever changing position, but usually go right back to sleep. I cut out reading on my phone in bed and that has helped.