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Sweet Dreams

Optimizing the cycle of sleep and health

iStock 000011898433SmallAs a physician, I’ve seen time and again how factors related to good sleep affect a person’s health and overall well-being, and vice versa. Good sleep has a direct impact on vibrant health and healthy people tend to sleep well. Conversely, people who are unwell often sleep poorly, which can exacerbate existing problems and impair the healing process. Either way, sleep and health create an interdependent cycle with one another.

What is “normal” when it comes to sleep? We know that we all need good sleep—it’s one of the basic requirements of keeping the human body functioning. While it varies from person-to-person, an average adult requires about 7-9 hours of solid, restful sleep each night to keep the battery charged.

Now, there’s a myth that older adults need less sleep than younger people, or that seniors don’t sleep as well as others. That’s just not true. What is true is that older adults spend less time in the deepest stages of sleep than younger people. And, frequently, circumstances related to disease and medications can interrupt sleep in seniors. However, the fact that you’re aging does not mean that you should expect to sleep poorly!

While we sleep, our bodies experience a pattern of of REM (rapid eye movement) sleep and Non-REM sleep, which consists of four phases, each deeper than the last. During Non-REM, our bodies are being re-energized, restored and repaired. In the REM stage, we dream.

Why can’t I sleep, doc? There are a wide variety of sleep disorders with many different causes, often lumped together under the layman’s term, “insomnia.” Some people have trouble falling asleep initially while others may find themselves awakened in the middle of the night by bothersome symptoms. Sleep should happen in a pattern, with a routine. And when that pattern is upset it can be difficult to get to back on track.

It’s important to fully understand the dynamics of a person’s sleep pattern and consider all of the factors that could be disrupting a good night’s sleep. When a patient comes to me complaining of poor sleep, I ask the following questions to gain an understanding of what’s going on

  • When do you go to bed?
  • How long does it take you to fall asleep?
  • What do you do when you’re trying to fall asleep?
  • How long do you stay asleep?
  • What wakes you up?
  • Are you sleepy, or are you fatigued (there is a big difference)?

Depending on the answers to these questions, along with an evaluation of the patient’s medical history, there may be a clear clinical cause that needs to be addressed. Sometimes treating an injury or disease state, or making adjustments to medications, will go a long way to solving sleep problems.

What can I try on my own? You may have heard the term “sleep hygiene,” which refers to the habits and behaviors that affect your sleep. Getting into a routine and practicing good sleep hygiene is essential. Harkening back to the common sense advice we probably got from our mothers at some point in our lives can contribute greatly. Good, clean living and healthy daytime habits can improve your ability to sleep well:

  • Eat a healthy, balanced diet, and don’t eat right before bed
  • Exercise regularly within your range of physical ability
  • Get outside, for at least a little while every day if you can, for fresh air and sunshine
  • Go to bed and get up at the same time every day
  • Limit alcohol consumption (although a “nightcap” might make you fall asleep, alcohol can actually counter your ability to sleep well through the night)
  • Avoid caffeinated beverages in the late afternoon or evening
  • Don’t smoke!

In addition, there are other things you can try to help you relax and prepare for bedtime:

  • Take a warm bath
  • Listen to quiet, soothing music
  • Do some gentle stretching exercises
  • Use a meditation technique
  • Keep your bedroom dark, cool, and quiet
  • Some alternative health practices and supplements--melatonin, for example--may be helpful (Always be sure your healthcare provider knows about any supplements, herbal or homeopathic remedies, or over-the-counter medicines you may be taking.)
  • Drink uncaffeinated herbal teas, such chamomile (contrary to popular belief, the protein in warm milk will actually stimulate your digestive system and could keep you awake)
  • Avoid watching television before bedtime—it is extremely stimulating and will not contribute to good sleep!

And remember, your bed is a sanctuary that should only be used for sleep and sex. If you are struggling to fall asleep, get out of bed to read or do a quiet activity and return when you are sleepy.

WomanSleepingWhen do I need help? Getting good sleep will help your body stay as vital as possible and enhance the healing process if you are unwell. If you have an illness, injury, or chronic condition, chances are that it may be deterring you from sleeping well. And this can obviously become a vicious cycle.

If sleep problems impair your ability to function and feel well, you should consult your healthcare provider for assistance.  They may be able to treat an existing condition and eliminate or reduce the symptoms that cause you to wake in the night. Or they may change or adjust medications that keeping you from optimal sleep.

For some patients, a sleep aid can be appropriate and beneficial. There are good medications available to us today that enable you to fall asleep quickly and deeply, stay asleep for the right amount of time, and wake refreshed and rejuvenated. For example, your doctor might prescribe Ambien (zolpidem), Lunesta (eszopiclone), or Rozerem (ramelteon). These sleep aids have few side effects and are not addictive when taken as directed.

To nap, or not to nap?
There are conflicting opinions about whether napping is helpful or detrimental to good sleep hygiene. Again, it depends upon the person and his/her specific situation and condition. Naps can be rejuvenating and healing if they’re short and sweet—“cat naps” or “power naps” are wonderful. But if you sleep too long, you’re likely to encroach on your ability to fall asleep at the right time at night. The key is to gain an understanding of your own sleep cycle and wake from your nap when you’re in the lightest stages of sleep. If you wake yourself with an alarm while you’re in deep sleep, chances are that you’ll feel groggy and disoriented instead of rested and refreshed.

Good sleep and good health go hand in hand. Don’t underestimate the benefits of a good night’s sleep. And consult your healthcare provider if you need help getting the best sleep possible.

Senior Health Articles