Why we can’t sleep

What can be done about it.

Sleeping is a problem for almost everyone I know — mind you, they’re all old people, meaning over 60 years of age. Whenever one of us gets a good night’s sleep, it’s bragged about and we’re all a little envious. Honestly, I can’t remember sleeping 7 or more hours straight through, and I’ve seen more than my fair share of sunrises over the past 10 years. When I was younger I wasn’t wise enough to appreciate what a blessing a good night’s sleep is.

So what’s the problem? Maybe it has something to do with not needing as much sleep when you get older. Unfortunately, that’s not true. According to people who know this stuff, we need 7-8 hours per night, and that’s especially the case if you’re 65 or older. So, if the need is still there, why can’t we have it fulfilled?

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Well, although your need for sleep doesn’t change, your sleep patterns — what the experts call “sleep architecture” — change as you get older. Sleep has multiple stages of light and deep sleep. Older people spend more time in the lighter stages, take longer to fall asleep, and have more fragmented sleep. These changes are in part due to hormones. As we age, our bodies produce less melatonin, which regulates the sleep cycle.

Certain health conditions become more prevalent as we get older and they can also interrupt and deprive us of sleep. GI problems, body aches and pains, sleep apnea (stop breathing while sleeping which causes the brain to wake you up to breath), other breathing disorders, restless leg syndrome or periodic limb movement disorder, are the primary ones.

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Furthermore, men with prostate issues wake up often to urinate; for women, it could be menopause with it’s hormonal changes and accompanying hot flashes that leads to restless nights. The truth is, for many of us, the sleep problems we experience as we get older are tied to underlying medical or psychological conditions — bad sleep is a by-product of these heath issues.

Then there are the medications we take to treat these health problems. Some medications, such as antidepressants, beta-blockers, and cardiovascular medications have side effects that will interrupt sleep.

So, what to do if sleeping is a problem? The experts first recommend that you try some behavioral changes, and these are mostly in the form of what not to do. Don’t…

  • Nap longer than about 20 minutes.
  • Read, watch TV, or eat in bed.
  • Take caffeine less than 8 hours before bedtime.
  • Have nicotine and alcohol in the evening. Alcohol can cause you to wake up in the middle of the night.
  • Lie in bed for long periods trying to sleep. After 30 minutes, get up and do something relaxing, such as reading or listening to music.

And here’s a few do’s…

  • Try to be active and exercise every day.
  • Try mindfulness meditation, a form of meditation where you focus on the immediate, such as your breathing, or your belly rising and falling as you inhale and exhale.
  • Learn cognitive-behavioral techniques to avoid negative thoughts that interfere with falling asleep.

Sleep medications should only be used as a last resort, and some should be avoided completely because they interfere with brain functioning and can speed up cognitive decline, and chronic use has been linked to dementia. Also, try to avoid benzodiazepine drugs and those that are “anticholinergic” — a common anticholinergic is diphenhydramine (e.g., Benadryl), a sedating antihistamine that is included in most night-time analgesics, but many prescription medications are anticholinergic as well.

Now, here are a few medications that you might want to try if all else fails:

  • Melatonin, which is the hormone involved in the sleep-wake cycle and that we produce less of as we age.
  • Ramelteon is a synthetic form of melatonin.
  • Trazodone is an anti-depressant that is mildly sedating, and as it is not anticholinergic, is less risky than the alternatives.
For more information on mindfulness meditation, go to mindful.org
For more information on cognitive-behavioral therapy for insomnia, go to sleepeducation.org

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