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When counting sheep doesn’t work

Created date

October 22nd, 2013

Difficulty falling asleep and getting a good night's rest is one of the most common medical complaints and is often referred to as insomnia. As much as 35% to 50% of adults report difficulty with sleep and the numbers are even more dramatic for seniors. In one study, 57% of older Americans complained of sleep difficulties and only 12% actually reported normal sleep. As we all know, the impact of poor sleep can be dramatic and distressing. Daytime difficulties such as decreased social and work performance, loss of motivation, anxiety, headache, mood disturbance, and more can all result from not getting enough sleep. The reason insomnia is so common is that there are many causes. Along with disorders such as sleep apnea and restless legs syndrome, the presence of certain medical conditions such as dementia, lung disease, depression, and chronic pain have been shown to interfere with a good night's rest. A number of prescribed medicines, including diuretics, steroids, and over-the-counter medicines such as decongestants can also be detrimental to your sleep. If you are experiencing insomnia on a regular basis, it is important to discuss it with your physician and consider what may be the underlying cause.

Get in the habit

Once you and your physician are confident that you have ruled out medical causes of insomnia and that you have optimized your medical regime, your very next step should be developing good sleep habits. Look closely at what you eat and drink. Regular meals during the day and a small snack an hour or so before bed can help. Drinking too much liquid can mean too many nighttime bathroom trips. Although usually okay in the morning or early afternoon, caffeine should be avoided at least eight hours before you settle down at night. Many people try a night cap before bed to make them drowsy. While an alcoholic beverage may help you get to sleep, it has a rebound stimulant effect later in the night and ultimately disrupts your sleep cycles. The nicotine in tobacco is also a stimulant and this is another good reason to quit smoking. Changing some things in your daily routine such as avoiding naps, getting up at the same time every day, and being more active can help, as can creating a slumber-friendly environment by making your bedroom quiet, free of light, and temperate neither too hot nor cold. Establish a relaxing evening ritual. If changing your habits on your own doesn t help, speak with your doctor about cognitive behavioral therapy, a counseling program designed to help you identify ways to improve your sleep hygiene. In general, over-the-counter medicines for sleep are dangerous for seniors. Many of them contain diphenhydramine, which can be responsible for confusion, blurred vision, constipation, and difficulty urinating, along with other side effects. There are prescription sleeping pills as well which your physician may prescribe. They should ideally only be used for short periods of time or intermittently as they are habit-forming and can be associated with falls, daytime drowsiness, and driving impairment. While sleep difficulties are common, there is a lot you can do about it. Cultivate good daytime and evening habits and don t hesitate to speak with your doctor. Pleasant dreams.