By Joy Pape, FNP-C CDE CILC
As I get older, I am more aware of a certain saying almost every morning, “Waking up is hard to do.” I’ve always been a morning person, but the time I wake up is earlier, and cheerfully jumping out of bed is harder.
There are several misunderstandings about sleep. Before the 1950s, we thought that, during sleep, one’s brain and body “shut down” to recover and refresh. We now know that sleep is a much-needed time for brain activity. There are five stages within a sleep cycle, in which one’s brain goes through different patterns of activity. One full cycle lasts about 90 minutes. The amount of time in each stage changes as we age.
Another misconception is that, as we get older, we require less sleep. According to the National Sleep Foundation (NSF), this is not true. What is true is that, for many, sleep patterns change as they get older, which can contribute to sleep problems. For example, older people spend less time in deep sleep and more time in the lighter stages of sleep. Studies on the sleep habits of older Americans also show an increase in the time it takes to fall asleep, less time in the Rapid Eye Movement (REM) stage of sleep, and more frequent waking up during the night (sleep fragmentation). The prevalence of sleep disorders tends to increase with age, but is it all due to age alone?
Research suggests that age-related sleep problems can be associated with physical and psychiatric issues and/or the medications used to treat them. For example, high blood glucose levels in people with diabetes can cause increased urination that prompts waking up to urinate (nocturia) often. Even low blood glucose can wake someone up. Prostate problems in men can also cause more frequent urination, including nocturia. Women going through menopause can be affected by hormonal changes—being awakened by hot flashes or just changes in sleep patterns. Other issues can be related to arthritis, restless leg syndrome, sleep apnea, and the list goes on.
You may wonder what you can do to sleep better. Here are some simple techniques you can try for now. (Next month, I will provide more information on this topic.)
- Set up and maintain a daily sleep/wake cycle. Plan the same time you will go to sleep and wake up. Set your alarm for the morning and get up and out of bed. Also, avoid naps.
- Create a sleep environment. This means closing the curtains for darkness, keeping your room temperature comfortable, and darkening all lights such as those on your television or clock. Have a flashlight by your bed to use when you need to get up and move around.
- Eat and drink according to what helps you sleep best. Some people sleep better a few hours after eating; some sleep better after eating before they go to bed. Avoid caffeinated beverages and foods such as coffee, certain sodas, and chocolate after noon.
- Be active during the day. Physical activity can improve sleep but be careful not to be too active close to bedtime. It could keep you up.
- Watch your thoughts. Worrying can keep you awake. Most of the time there is nothing you can do about your concerns at this time of day. Remind yourself of that. If needed, write a list of issues on your to-do list for tomorrow.
- Speak to medical experts (including your pharmacist) to see if any medications could be affecting your sleep. If so, ask if there are alternatives.
Until next month, try these techniques. I hope they help you enjoy better sleep.
Joy Pape is an internationally known, board certified Family Nurse Practitioner, author, writer, and presenter. She believes that every person is an individual and deserves personalized medical, integrative care, and hope for a healthy and full life. She can be reached at (212) 933-1756 or joypape@mac.com.