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Reflections: On the Constitution

The Longevity Prescription of Dr. Robert Butler: Seek Essential Sleep

category_bug_journal2.gif An old wives' tale holds that old people require less sleep. Not true. With the exception of a tiny minority, people of all ages need between seven and eight hours of sleep a day. And poor sleep is not an inevitable part of growing old, as some believe.

“Age in itself is not a predictor of insomnia,” writes Dr. Robert Butler in his book, The Longevity Prescription, “and when it occurs, it is precipitated by other factors, many of which can be changed or compensated for.”

What is associated with insomnia (the catch-all word for a variety of sleep problems) in elders, however, is a range of diseases and conditions such as diabetes, hypertension, depression, lung disease, heart disease, pain and certain medications. Since these afflict elders in larger numbers than the young, more of them may have trouble sleeping and half of all people older than 65 experience sleep problems.

Too little sleep can be devastating, resulting in:

• memory lapses
• deterioration of mental and physical skills
• fatigue
• disorientation
• slowed reaction time
• inability to concentrate
• difficulty carrying out daily tasks
• increased risk of falling

It can pretty much ruin your life. A good night's sleep, says Dr. Butler,

“...is one that leaves you feeling well rested and able to function at your best throughout the day. It does not have to be any more complicated than that.”

A simple definition, but for many it is hard to come by. You probably know most of Dr. Butler's suggestions for overcoming insomnia that is not disease- or medication-related - all worth being reminded of. A few:

  • Slow your pace in the hours before bedtime
  • Make a ritual of preparing for bed at the same time every night
  • Avoid alcohol which disrupts sleep
  • Limit liquid intake in the evening
  • Exercise early in the day
  • Avoid heavy meals in the evening
  • Limit caffeine altogether or after 12 noon

Although it sounds counterintuitive, Dr. Butler recommends a short nap each day, no longer than 30 minutes and not after 3PM. If you simply cannot get to sleep, says Butler, don't fight it.

“If you waken in the night, experience restlessness, and cannot go back to sleep, accept your body's verdict. Read for a time; write in a journal; listen to an all-night classical radion station. When you feel tired again, go back to bed – and to sleep.”

Butler also covers some disorders of sleeping – snoring, sleep apnea and restless leg syndrome (RLS). The first can be a warning sign of other serious health problems and you should consult your physician as you should for sleep apnea.

There are treatments. RLS can be relieved with moderate exercise and relaxation techniques at bedtime or, a medication might be the cause. Again, discuss it with your physician.

Butler also covers sleep medications and warns they should be used only in the short terms as they do not address underlying causes of sleeplessness. And never use alcohol when taking them – it can be a deadly combination.

I found the most interesting section of Chapter 3 to be a short overview of what is known about sleep and why we spend a third of lives unconscious. So far, it is mostly guesswork and a lot of unproved theory, says Dr. Butler.

”REM [rapid eye movement] sleep probably is a time when distant but linked memories are processed and stored...REM sleep may also be a time when the brain, like an overloaded computer, reorganizes itself.

“Another working theory has it that the cortex, the outer layer of the brain where we do our thinking, needs complete rest from time to time, and sleep provides it. Dreams probably also play a role in managing stress, regulating mood, and exercising the imagination.

“In contrast, Stage 4 is thought to be restorative, a time when our body conserves energy, the nervous system recuperates, and the brain replenishes itself biochemically. In young people, sleep is a busy time for growth and development. Perhaps the body as a whole also requires a time of energy conservation.”

The bottom line is that for continuing good health, insomnia is not to be ignored. Don't dismiss it. Discuss it with your doctor. And,

  1. Set yourself up for sleep by changing patterns and habits that interfere with sleep
  2. Set the scene for sleep by making your bedroom a haven, as escape from the excitement of the world.

Next week, we'll discuss Chapter 4, on stress. You are reading along, aren't you?

The Longevity Prescription Series
A Proposal
Introduction
Chapter 1: Mental Vitality
Chapter 2: Nurture Your Relationships/a>


At The Elder Storytelling Place today, P.J. Davis: God's Love and Math

Comments

It is so frustrating to follow all the guidelines - tick off all the boxes and still have the occasional night where sleep is absent - and often the feeling is very clear even before going to bed - 'no sleep for you' - I can heartily agree with Dr Butler's prescription - accept your body's decision and do something else.Enjoy the extra time with that great book!

So quick to jump onboard drinking a glass of wine everyday to increase longevity but oh so slow to go to bed at a decent hour! :)

I always read in bed before sleeping. Some years ago I read/heard that if you feel sleepy stop immediately. Don't read to the end of the chapter, end of the page or paragraph, not even the end of the sentence. Stop there and turn out the light.
I do this and it sort of works, certainly better than previously.

I agree with Peter, read and stop when the first drowsies hit.
I can't seem to get enough sleep, even when I do a serious nap in the afternoon.
I should count my blessings.

I sleep best when I get exercise, or maybe, to be precise, when I'm physically active and it's at least a litte bit demanding--gardening, brisk walking, some lifting.

So far, I haven't put the TV in my bedroom. I know it's a big no-no for sleep, but it's such a treat when I stay at a hotel, and I can put the TV on and set it for Sleep. I think it puts me to sleep. Any body else have thoughts/experience with TV as sleeping pill? (Hockey games knock me out cold!)

Mary...

I put the TV in the bedroom decades ago after too many visitors felt free to turn it on in the living room which immediately stopped conversation.

For me, it is the perfect sleeping potion. Even shows I want to see put me to sleep. There is no telling how many half-programs and movies I've seen in my life.

I keep a small TV with just basic cable next to my desk to check news in the mornings and evenings.

I, too, have a TV in the bedroom. It is not hooked up to cable, so I can only watch DVD's. Golden Girls gives me a chuckle and puts me to sleep every night!

Now, I've heard of RLS, but I suffer from RCS (restless cat syndrome)! Seriously, I heard that people that allow pets to sleep on the bed with them get much less REM sleep. I know it would be better if I closed my door to the cats at night, but I guess I can deal with losing some REM for the furry companionship.

This is the hardest important chapter of Dr. Butler's book for me. I'll (almost always) sleep if I go to bed, but I sometimes get into cycles when I just don't. I read dumb stuff online and obsess. This year, I'm pushing myself to JUST GO TO BED!

BTW, a friend had serious RLS for several years. It completely disrupted his life and his wife's. Then he was put on a new med for something else that required him to stop drinking alcohol. He wasn't a drunk; he just had several drinks a day. But when he stopped drinking, his RLS immediately stopped. ...Anecdotally interesting.

Sleep isn't a problem for me but I have long accepted that the best I can do is fall asleep after lying there 15 minutes while I am married to a partner who literally can fall asleep within 30 seconds of his head hitting the pillow. It simply amazes me. I don't mind taking some time to get to sleep unless he starts to snore which makes my getting there harder. It would be a better match if the person who takes the longest to fall asleep was the snorer, but I wonder how often it happens that way.

Dreaming is the fun part of my night especially if I can remember them the next morning but even when I don't, I am aware of the dreaming happening and it's generally something to look forward to. Sometimes I incorporate my real life into a dream (like last night a charley horse, enough to wake me up, from some of the 'different' work of the week-end, became dreaming about them).

I feel fortunate because I seldom have any problem with sleep. Once in awhile, I get too stimulated by info or some interaction with a friend, then can't get relaxed,but I have a homeopathic that works at that point. I am nearly finished reading the book. It is a good basic primer.

Anyone can escape into sleep, we are all geniuses when we dream, the butcher's, the poet's equal there.Emile Cioran

Sleep is not my friend most nights. Television is not my soother nor disrupter; my computer talks me into staying up way too late.

A book will work most of the time to get me drowsy, but I have to follow a routine of sorts: hot hot bath soak, a cold bedroom, and a not too interesting book.

I have had trouble sleeping for years and have tried every thing that Dr. Butler recommends at one time or other. None of the sleep recommendations work for me.

I just went through a week of sleeping through the night and then I started my old pattern of waking up after three hours and being unable to go back to sleep. Four nights in a row have found me sleeping for 3 hours, waking for 3 or 4 hours, and sleeping for another 2 or 3 hours.

When I wake up in the middle of the night I stay in bed for a longer time than Dr. Butler recommends trying to go back to sleep and when that fails I get up, make hot chocolate and boot up the computer. Sometimes I don't feel sleepy again for four hours and when I do, I head for bed again.

I have just had four nights in a row of interrupted sleep. I do take a med prescribed by my doctor that is non-habit forming and it helps. Without the medication I would never get a full night's sleep. It is not a med prescribed for sleep, but one given for tingling legs (That used to be a problem for me) and the side effect is drowsiness. It is non habit forming. Nonetheless, I still try to do without it once in awhile and insomnia takes over again.

I always read when I am unable to sleep, but that rarely helps if I have had 3 hours sleep prior to doing so. After years of trying everything I have accepted the fact that this is my pattern of night time and I must live with it.

I do know is that I am not getting enough exercise during the day and Dr. Butler and I agree that this is very important. I vow to do better in that area of my life.

My dad told us that we wasted one-third of our lives sleeping in bed ( as long as you were awake in bed the time wasn't wasted) so I never worried much about not getting enough sleep until recently.
Then I began to experience some of the symptoms that Dr. Butler and others ascribe to insufficient sleep. Now I am sleeping at least six hours every night.
Often seven but rarely eight.

Over-the-counter anti-histamines help as does tryptophen

I used to take L-tryptophan until it got yanked off the U.S. market a number of years ago due to some perceived health hazard (I forget what it was) and it worked great. I sleep fairly well (RCS and all) but I know that I should get up sooner when I can't sleep. However, I don't want to wake my husband--or our 3 cats if they're snoozing. Also, our condo gets COLD at night since we turn off the heat. We prefer a cool sleeping area, and it also helps with the utility bill. However, it takes me a long time to get warm again, so I usually stay in bed until I go back to sleep.

Hynotherapy can usually solve sleep problems.

Tryptophen is now available again. It was probably pulled because the drug manufacturers were afraid it would eat into their megabuck sleeping pill sales.

My sleeping improved when I moved to my own room, and let my active sleeper husband thrash, yell and make other noises to his (sleeping) heart's content. Ahhhhh.

I found it interesting that Dr. Butler never mentioned adrenal fatigue and how it disrupts sleep. That turned out to be my problem with sleep for over a year. It was a waking nightmare and did irreparable damage to my work relationships over time. It resulted in a lot of misunderstandings and hard feelings because for over a year I had:
• memory lapses
• deterioration of mental and physical skills
• fatigue
• disorientation
• slowed reaction time
• inability to concentrate
• difficulty carrying out daily tasks
...everything but falling down.

The adrenal fatigue was from my adrenal glands constantly waking me up after I would be asleep for an hour to two hours. I would wake thinking it was morning. It was explained to me that I was in "fright" mode because I was being poisoned, frankly. I had an allergy to wheat (gluten), of all things! Not enough to swell up and die but just enough to trigger the survival responses in my body, apparently.

Having had that experience, I can't help but wonder about some of other restless sleepers and what might really be under their symptoms, if anything. I thought for the longest time that my thyroid medication was off somehow. Not looking deep enough into the causes of sleeplessness can be dangerous.

There is nothing near as blessed as a good nights sleep. I've been insomnia free now for almost a year. I'm so relieved. It was a form of torture!

I've tried just about everything to cure my insomnia. About 15 years ago, I went to the hospital for a "sleep study." They "wired me up" from head to toe to measure everything from my brain waves to my leg twitch. Then they told me to go to sleep. After examining 211 feet of recording chart, the doctors told me I had "unexplained insomnia." It cost me $2,500 for the doctors to tell me what I already knew. Such is life. Bill

I'm always amazed at how well I sleep if I just back away from my computer and get a little exercise during the day. Otherwise it's 3-4 hrs of sleep then I wake up for 3-4 hrs of worrying because I'm not sleeping. I hate to get up in the middle of the night because it wakes the dogs, who then act like it's morning.

Have never had and don't want TV in my bedroom. Years past have enjoyed instrumental music on low volume and may resume.

Computer use has been a problem for me, coinciding with when my husband died -- you can see by the time I'm writing this. Have learned the hard way just how adversely to health the sleep matter can be. Have difficulty disciplining myself to go to bed at earlier hour.

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