Why We Don’t Sleep As Well as We Age

(and what we can do about it)

One of the hardest things for many of us as we grow older is trying to fall asleep, stay asleep, and sleep like we used to! When we were young, we typically slept deeply and well for many hours. But as we age, that’s often not the case.

Because sleep patterns change so much in our lifetimes, it’s important to recognize what’s normal. According to doctors, how much sleep do we really need?

Research has shown that, as we grow older, our body shifts to a “new normal” for sleep. We sleep fewer hours and our sleep patterns shift a little earlier in the night. This is called our “Clock” — and it is a surprisingly tough bedfellow. In our older years, we may prefer to go to bed at 9:00 — a change, but again, completely normal. And, we don’t need as many hours of rest. Young people may sleep as many as eleven hours per night. But an older person can sleep as few as six hours.

But here a problem arises. Remember, if we are getting ready for bed at 9:00, and we sleep six hours, we are going to wake up and feel ready to go at 3:00 am! Most older adults don’t think it’s “right” to get up at 3:00 am, so they lie in bed another four hours. And then, the next morning they complain they had a terrible night.

One of our jobs as we get older is to adjust our expectations for our sleep patterns. We shouldn’t expect to sleep as many hours as we used to, and, beyond that, shouldn’t always count on sleeping through the night. This being the case, how do we then ensure that we get the best night’s sleep possible?

Geriatricians have found there are four highly effective remedies for achieving a restorative night’s sleep. None of these involves sleeping pills — which is good, as they can be dangerous for people over 65. Sleeping pills increase the danger of falling, risk of fracture, as well as augment confusion and cognitive decline.

1. Get good and tired

When we were young, and before the advent of video games, we spent our days outside — running and playing. Guess what? We slept great. But by the time we are 70, 80, or 90, we are not spending our entire days running about. Conversely, we spend most of our time sitting and watching TV, reading, napping, or sending emails to our grandchildren. This means we have reduced our opportunity to find ourselves tired at bedtime. The more active we can be during the day, helps with our sleep. And, if we have to nap, make sure it’s for no longer than one hour and only in the afternoon.

2. Maintain your clock

Our clocks are generally hardwired from birth. But it is possible to disrupt our natural patterns and mess up our sleep. The surest way is to expose our brains to “blue light” in the evening. Our brain sees blue light as morning and will wake back up. What is blue light? TV and computers and, yes, our cell phones. Ideally, all three should be avoided in the evening. On the other hand, getting bright light (such as being outside or using a light box) in the morning is an effective way to re-energize ourselves.

3. Don’t drink anything for three hours before bed

A majority of older men and some older women need to get up several times per night to urinate. Not consuming fluids at least three hours before going to bed can greatly reduce the need for nighttime urination.

4. Manage sleep trouble proactively

If worry creeps into the night time hours, geriatricians recommend keeping a pad of paper and pen next to the bed. Before going to sleep, write everything that is worrying you and everything you need to do the next day. If you wake in the night and are worried about something, write it down so you can do it the next day. This simple trick helps to relieve anxiety and lets your brain stop churning.

Most people will find success employing these four remedies. For some, though, these methods just don’t work. In this situation, geriatricians recommend cognitive behavioral therapy to help with sleep. Under the guidance of a trained psychologist or therapist, cognitive behavioral therapy can assist persons in making realistic changes to sleep habits. It can help with sleep hygiene (e.g., keeping a stable bedtime; keeping the same awakening time), help reduce negative sleep stimuli (worry at bedtime) and change negative perceptions about sleep, such as: “I must have 8 hours to feel rested!”

Research has proved that cognitive behavioral therapy is highly effective in improving sleep. What’s more, it can often help with improving the rest of the day as well!

Restorative sleep greatly increases our quality of life as we age. If we don’t have it, life can get us down. If this happens, don’t resort to sleeping pills. Rather, try these remedies and talk to your doctor. Safe, non-medication approaches, can give us the relief we seek, and we will be able say: Good Night!

By Elizabeth Eckstrom, MD and Marcy Houle, MS
This is an excerpt from The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare

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