Friday, 20 November 2009
How Well Do You Sleep?
As I have undoubtedly mentioned here from time to time, I don't sleep worth a damn. If it's not that I need to pee, it's waking at ungodly early hours - like 2:30AM - without a chance of going back to sleep. On nights when that doesn't happen, the cat's circadian rhythm has him poking me by 4AM or 4:30AM with breakfast in mind. He is the personification of persistence.
In just the past two weeks, however, I've regularly been sleeping for seven or eight hours without interruption. Even the cat has slept past 4:30AM on a few occasions. I can't say what changed, but I'm grateful for it.
Even so, since there is no telling how long my new-found full-night's sleep will last, I was eager when I was invited by the International Longevity Center to take part in a teleconference earlier this week with four of the authors - all medical doctors and all experts in sleep and aging - of new report published this year in The Journal of the American Geriatrics Society (paid subscription required) outlining new recommendations for treating sleep disorders.
Many people believe that sleep disturbances are a normal part of getting old. Not so, say the authors. Nevertheless, 30 to 50 percent of elders report problems with insomnia – that is, difficulty falling asleep and/or staying asleep. Other sleep disorders that effect smaller numbers of people include
• sleep apnea
• restless leg syndrome
• circadian rhythm disorders
• disorders associated with nursing homes
Lack of a good night's sleep has a strong impact on elders' quality of life contributing to balance difficulties leading to falls, an inability to concentrate, frailty and decreased cognitive function. The causes are many – among them, hypertension, stress, depression, some illnesses, any medications that affect neurotransmitters, use of nicotine, alcohol, caffeine, some herbal and over-the-counter medicines.
Certain changes in our bodies as we get older also affect sleep. Circadian rhythms appear to change so that old people tend to fall asleep earlier and wake earlier than when they were younger. The amount of light sleep increases and the amount of deep sleep decreases.
I asked about the effect of the last item. It is known, the doctors told us, that growth hormone which is needed for a body to repair itself, is secreted primarily during deep sleep. It is not yet known what causes the decrease or its effect on old people.
As Dr. Robert N. Butler, the president and CEO of the International Longevity Center, noted during the teleconference, sleep is a profound piece of the human condition. It deserves more attention than we or our physicians often give it. Few doctors ask about sleep problems; I know I have never, when young or old, been asked how I sleep.
Elders need to be more pro-active and let our physicians know if we have trouble sleeping and discuss possible treatments. Be wary of hypnotic drugs such as Ambien and Lunestra which, say the researchers, are often prescribed because it is easiest thing to do rather than search out causes.
Depending on the type of sleep disorder, treatment can include changing medications, light therapy and cognitive behavioral therapy, among others.
Here are the researchers' tips for a better night's sleep. We all sort of know these things, but don't necessarily follow them. I often read and watch television in bed.
• Go to bed and wake up at the same time every day
• Develop a sleep ritual
• If you cannot fall asleep in 20 minutes, get up and do something relaxing until you feel sleepy
• Avoid exercising within two hours of bedtime
• If you must nap during the day, limit it to 30 minutes and try to nap before 3:00PM
• Use the bedroom only for sleep and sex; do not watch television or work in bed
• Get regular exercise and exposure to outdoor light
The PBS series, Life (Part 2) continues. This week's episode deals with what makes us happy. Here is a short clip of a whole lot of people answering that question.
You can watch the whole episode here.
At The Elder Storytelling Place today, Clarence Bowles: A Pet Peeve