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Sleep? Or count sheep?

Created date

April 30th, 2009
Harry is 72 and goes to bed early, at about 7 p.m. He wakes up at 5 a.m. and takes a two-hour nap at 3 p.m. every day. But he still feels tired. His wife, Helen, on the other hand, goes to bed at 11:30 p.m. and also gets up at 5 a.m. She is frequently awakened during the night by Harry s loud snoring, is sleeping less as she gets older, and doesn t have her usual energy. Both Harry and Helen think their situations are normal because they ve heard that snoring, fatigue, and needing less sleep are normal aging changes. Experts agree, however, that older adults need as much sleep as younger ones, anywhere from seven to nine hours (ideal needs vary among individuals). Your ability to sleep undisturbed may change as you age. "There are age-related changes in the brain that affect how long it takes you to fall asleep, the number of times you wake up, and how deeply you sleep," says Philip Taylor, M.D., medical director at Maris Grove. ' When counting sheep doesn t work ' Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia may take a long time to fall asleep, wake up several times in the night, or wake up early and be unable to get back to sleep. According to the National Institute on Aging, adults who have trouble sleeping may feel tired during the day, have memory problems, be depressed, fall more often, or use more over-the-counter sleep aids. There are many causes of insomnia. It may be a sign of other problems; for example, if you are worrying about bills you might have trouble sleeping. Sometimes insomnia is a side effect of medication. Diuretics and other medications for lowering blood pressure, statin drugs for lowering cholesterol, cortisone for fighting arthritis, and drugs to reduce the effects of Parkinson s disease are just a few of the medications that might be keeping you awake. "Sleep problems can also be caused by underlying health conditions like arthritis. You might not be able to sleep because of joint pain, for example, or you may have heartburn or urinary problems keeping you awake," Taylor says. Other health problems affecting sleep may be restless legs syndrome or sleep apnea. ' Snoring can be serious ' Loud or regular snoring, gasping while sleeping, and feeling tired or groggy during the day can be signs of sleep apnea. Sleep apnea is a condition characterized by temporary breathing interruptions during sleep. The most common form of sleep apnea is obstructive sleep apnea which, according to the Mayo Clinic, occurs two to three times more often in older adults and is twice as common in men as in women. "There is a relatively high prevalence of sleep apnea in older adults, particularly in those who have had a stroke," Taylor says. In addition, if you have high blood pressure, smoke, or use sedatives or tranquilizing medications, you might be at risk of developing sleep apnea. And because adults tend to gain weight as they age, even a modest weight gain of 10 to 15 pounds can increase neck size enough to obstruct the airway during sleep. "If I think someone has sleep apnea, I refer them for sleep studies," Taylor says. Treatment for sleep apnea depends on the type and severity. It may include simply learning to sleep in a way that keeps your airway open. You may need a medical device called a continuous positive airway pressure (CPAP) machine, a dental device, or even surgery. ' Restless legs it s not just age ' "Older people are often told that restless leg syndrome (RLS) is just aging, " says Richard P. Allen, Ph.D., a leading researcher on RLS at Johns Hopkins Bayview Medical Center in Baltimore, Md. Allen emphasizes that RLS is a real neurologic disorder, with the main form of RLS (primary RLS) affecting up to 60% of sufferers. RLS can develop at any age but increases in severity as you get older. A major symptom is an unpleasant creeping or pulling sensation that makes it impossible to keep your legs still. The condition worsens at night, causing sleep disruptions. "Most people with RLS have as many as 200 to 300 leg movements a night. Some may experience increases in heart rate and blood pressure because of it," says John W. Winkleman, M.D., Ph.D., of Harvard Medical School. Primary RLS has no underlying cause, and there s no definitive test for it. It is sometimes misdiagnosed. "Some people are told it s arthritis, others that it s anxiety or some other psychological illness," Allen says. Treatment may involve medication and lifestyle changes. Eliminating stimulants like caffeine and alcohol may help, so can finding a relaxing activity and eating a balanced diet, as iron deficiencies can worsen (but not cause) RLS.