When Counting Sheep Just Isn’t Enough

Nothing makes you feel as refreshed as a good night’s sleep. How unfortunate, then, that good sleep–dare we say great sleep– becomes elusive as we age. Everyone yearns for that deep, satisfying sleep that renders you oblivious to all life throws at you. But how can you achieve this critically restorative sleep in today’s hectic world?
In this two-part series we will differentiate normal sleep changes that are common with aging from abnormal symptoms more suggestive of true sleep dysfunction. The first part of this series will help you to determine if your sleep challenges are normal or abnormal. The second part of this series will look at treatments for improving disruptive sleep.

Why sleep is so important:
• Improves memory and concentration
• Repairs daily cell damage in the body
• Renews the immune system to fight disease

Too little sleep contributes to:
• Depression
• Excessive daytime sleepiness
• Decreased ability to focus which may lead to increased accidents
• Increased pain sensitivity
• Increased cardiovascular disease risk
• Increased risk of breast cancer
• Increased risk of diabetes
• Increased body weight

As we age, sleep architecture becomes somewhat modified. Our ability to experience deep slow wave sleep is challenged and, when achieved, is substantially shorter in duration than in earlier years. From the 12 hours of an infant (think: sleep like a baby) to a measly 6-7 hours in our senior years: this is somewhat natural. What is most concerning are those sleep changes that leave seniors with daytime exhaustion along with various types of disturbed and disrupted sleep.

Normal Sleep Changes Related to Aging:
• Sleeping is more fragmented
• Waking more often throughout the night
• Becoming sleepy earlier in the evening
• Waking earlier in the morning
• Finding daytime naps necessary

Sleep Problems NOT Associated With Aging (Abnormal)
• Difficulty falling asleep even when tired
• Trouble getting back to sleep if awakened
• Daytime irritability or sleepiness
• Difficulty staying awake when sitting still, driving, watching tv, reading
• Waking up not feeling refreshed
• Trouble controlling emotions
• Using sleeping aids or alcohol to fall asleep
• Difficulty concentrating during the day

If you have any of the symptoms from the second list, you may be dealing with some genuine sleep problems caused by more than the natural aging process.

Common Causes of Sleep Problems in Older Adults Include:
• Psychological Stress – Any significant life change (death of family member, move to a new home) may cause stress that keeps you awake.
• Psychological Disorders- Sadness and anxiety robs you of restorative sleep and may lead to more depression and anxiety.
• Sleep Disorders- Restless Leg Syndrome (RLS) and abnormal sleep breathing such as snoring and apnea can lead to fragmented sleep.
• Medications- Drugs and their side effects can impair sleep. Diuretics taken later in the day cause you to need to use the bathroom throughout the night. Some blood pressure medications and thyroid medicines can cause insomnia.
• Exercise- Lack of exercise means you may never feel sleepy or feel sleepy all the time. Exercise is important, but done too late in the day may contribute to sleep problems.
• Pain or medical conditions- Alzheimer’s, arthritis, asthma, osteoporosis, heartburn, menopause, diabetes may all impair sleep.
• Poor sleep habits- Using alcohol before bedtime, irregular bedtimes and wake times, sleeping with the computer or T.V. on can all add to sleep difficulties.
• Learned Response- Believe it or not, what may have begun as a legitimate cause for poor sleep (emotional trauma), may cause you to lie in bed trying to force sleep. Eventually, the body learns to assimilate this new norm (not sleeping) as a learned response that can last long past the initial trauma and emotional recovery.​

Check back next month for details on how to improve your sleep hygiene.

References:
1. Udesky, Laurie, Better Sleep for Seniors, Retrieved from https://www.caring.com
2. How to Sleep Well as You Age, Retrieved from http://www.helpguide.org

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