I just can’t sleep,” grumbles 77-year-old Charlie. “No matter when I go to bed, I’m awake at 3 a.m.”
Charlie isn’t alone. The National Institute of Health estimates as many as 70 million Americans chronically suffer from one of 90 different sleep disorders.
Their symptoms include inability to fall asleep or stay asleep, which typically results in daytime sleepiness.
Poor sleep has a greater cost than many people realize. For instance, the National Highway Traffic Safety Administration estimates at least 100,000 annual police-reported crashes are the result of drowsy driving — some with resulting fatalities.
In addition, sleep disorders are known to have both long- and short-term effects on health by increasing the risk of obesity, memory problems, chronic diseases, mood disorders, hypertension, stroke and heart failure as well as other impairments to quality of life.
Surprisingly, although more physicians are asking patients about their levels of pain, they seldom inquire about sleep. This is unfortunate because diagnosing and correcting sleep problems — often lumped together as insomnia — can ease a surprising number of complaints.
Common factors in sleep problems include naturally changing sleep patterns as people age, medication, stress, allergies, pain, asthma, depression, being overweight, sleep apnea and sleep-related medical, psychiatric and neurological disorders.
As people age, their sleep patterns often change and awakening in the night is common. For some people, this might not be a problem. In fact, hundreds of years ago it wasn’t unusual for people to go to bed when it got dark, then arise in the middle of the night for a small meal, to read or even to visit neighbors. Today, some people who awaken in the middle of the night simply use the time to have a snack, read a book or listen to music before falling asleep again without being bothered by their wakefulness.
Pain — whether chronic or temporary — is a major disrupter of sleep. In some cases, relaxation techniques and rituals as well as adjusting the timing of a pain-relief medication can help. Melatonin, a hormone found naturally in the body and made synthetically, appears to reduce the time it takes to fall asleep and the number of sleep interruptions in older adults with sleep-wake cycle disturbances and dementia.
It may interact with some medications, so check with your health-care provider about its safety.
Obstructive sleep apnea (OSA) can be another problem. It’s often marked by snoring and periods when the sleeper stops breathing. People with OSA awaken still feeling tired, and when untreated, it can cause serious health risks. Aging and being overweight are common contributors. Treatment includes weight loss and, in serious cases, the use of a CPAP device, which uses a mask and small machine to supply steady air pressure during sleep. (CPAP stands for continuous positive airway pressure.)
Start a sleep diary
Studies show that people with insomnia are 10 times more likely than others to become seriously depressed, but it appears to be a chicken-and-egg situation. Depression can cause sleep problems, but sometimes sleep problems can lead to depression. Treatment may include medications. Cognitive behavioral therapy (aka talk therapy), which studies show is effective, focuses on changing the thoughts and behaviors leading to both insomnia and depression.
If you experience problems with sleep, check out our pointers for getting a good night’s sleep. If after several weeks of consistently following these suggestions, you are still having trouble, try some self-diagnosis by using a simple sleep diary.
The American Academy of Sleep Medicine has a printable PDF form on its website which keeps track of things like medications, caffeine, alcohol, exercise, plus time spent napping or sleeping. Some wearable fitness trackers, such as Fitbit, can also measure sleep patterns and trends. The Better Sleep Project offers a Sleep Cycle app and a free online sleep diary that’s recommended by the Harvard Sleep Center. See thebettersleepproject.com.
If you still can’t uncover the cause of your sleeplessness, take your sleep diary of at least two weeks to consult with your physician. He or she may have suggestions such as lifestyle changes, adjustments to medication, cognitive behavioral therapy, weight management, visiting a sleep clinic or even surgery.
Charlie, who had trouble sleeping, discovered several likely contributors to his insomnia. He started exercising more vigorously in the morning, stopped his two-hour afternoon nap, and tried a cup of warm milk instead of a glass of wine for his nightcap. Within a week, his sleep had improved remarkably.
WHAT YOU CAN DO
Daily exercise that makes your body tired is frequently an effective prescription for good sleep since people can be tired mentally, but not physically. If you have physical limitations, find a pulse-raising exercise you can pursue such as water aerobics. Don’t exercise vigorously in the two hours before bedtime.
Go to bed and get up at the same time every day with a routine such as a light snack or a warm bath to signal to your body it’s time
Avoid watching TV, checking emails or surfing the web in the hour before bedtime. Just the lighting on
your electronics can
Be aware of caffeine in coffee, energy drinks, sodas, teas and even pain relievers.
Alcohol close to bedtime can make you drowsy, but disrupts sleep later when your body rouses itself to counter alcohol’s effects.
Limit daytime naps to 20 or 30 minutes and take them in the early afternoon.
Keep your bedroom cool, dark and peaceful. If it’s not quiet — or if it’s too quiet — you can run a fan or an electronic device that creates the sound of rain or ocean waves. White noise machines work well for some folks, too. The Marpac Dohm Classic, which has been around since the 1960s, uses a fan-based system to make noise, but it doesn’t move any air. It retails for about $40.
If you share a bed, be sure your partner (or pet) isn’t disrupting your sleep.
Put aside thoughts about what you must do tomorrow and dwell on something pleasant in the past. For example, one woman mentally walks room by room through her grandparents’ home where she spent happy summer vacations.
During periods of stress, find ways to calm down. Try yoga, talk with a friend or therapist, keep exercising and make lists of what you can do (and do it) and can’t do (and accept it). One man, greatly concerned worried about his wife’s failing health, found that setting a daily 3 p.m. “worry time” was surprisingly helpful. When he grew stressed, he reminded himself wait until 3 p.m. to worry. Ironically, when the time came, he found it difficult to worry on demand, so the tactic made a big difference.
Marilyn Pribus is a Charlottesville, Virginia-based author and freelancer who writes about wellness, senior lifestyles and many other topics.