Better sleep for better health

Created date

January 5th, 2018
Man trying to sleep.

Man trying to sleep.


A persistent misconception is that seniors need less sleep. Not true. According to the National Institute on Aging, your sleep needs stay constant throughout your life, and almost all adults need seven to nine hours of good rest to remain healthy. 

“Compare your body to a store,” says Naveed Shah, M.D., medical director of the LifeBridge Health Sleep Centers in Baltimore, Md. “To remain a viable business, a store needs to be cleaned, have expired merchandise removed, and have its shelves restocked. When you sleep, that’s what your body is essentially doing with the cells of your body.”

Changes in sleep pattern 

Many sleep issues arise as we age. The brain changes in ways that lead to disrupted sleep patterns. 

“Sleep architecture, which is what we call the structure of sleep, changes in older people,” Shah says.  “The percentage of REM, a type of deep sleep, stays about the same. The most restorative phase of deep sleep, however, diminishes, and you spend more time in light phases of sleep.”

Another pattern develops with age called advanced sleep phase syndrome. “Seniors begin going to bed earlier and waking up earlier,” Shah says. “People may not notice it at first, but it can gradually creep up to the point where you are going to bed at 8 p.m. and waking up at 4 a.m.” 

“Part of why you feel sleepy is how long it has been since you last slept, so you should avoid naps during the day,” says Aneesa Das, M.D., assistant professor of internal medicine and sleep medicine specialist at Ohio State University Wexner Medical Center in Columbus, Ohio. “Your brain tells you when it is time to be up and when it is time to sleep. That’s your circadian clock at work.”

Medical problems

“If you have to wake up to use the bathroom, if heart or lung problems make breathing difficult, or you have arthritis-related pain, your quality of rest is affected even more,” Shah says. 

“Depression, anxiety, or other emotional health conditions can disrupt sleep,” Das says. “In addition, numerous medications can interfere with sleep. Talk to your doctor about what you take and whether you should change the time of day you take them.”

“Adhering to treatments for medical conditions is necessary to minimize the effect they can have on your sleep,” Das continues. “Talk to your doctor about anything that bothers you in the nighttime.”

Making the most of what you get

“Sleep hygiene becomes more important as you age,” Shah says. 

Good sleep hygiene includes avoiding light-emitting electronics. Studies show that the use of these devices (including e-readers) before bedtime prolongs the time it takes to fall asleep. They’ve also been shown to suppress the level of melatonin, a sleep-promoting hormone. “I tell my patients that when the sun is up, make sure you are in bright lights, and when it is down, decrease extra light,” Das says.

Being more active during the day promotes good nighttime sleep, but not too close to bedtime. “People should not engage in certain types of exercise within two hours of bedtime,” Shah says, “but one type of activity I do recommend is stretching your muscles in the evening, and doing it again when you wake up. It can help relieve stiffness and cramps, which makes it easier to get the proper amount of exercise you need during the day.”

To medicate or not

Whether they are prescription or over the counter, sleep medicine can be harmful. “Using sleeping medicines over the long term can cause dependence,” Shah says. “Diphenhydramine, which is known as Benadryl and is the active ingredient in many over-the-counter medicines such as Tylenol PM, has been associated with dementia in seniors who take it for a long time.”

The American Geriatrics Society strongly discourages use of diphenhydramine and similar antihistamines, including doxylamine, which is the active ingredient in Unisom.

Cognitive behavioral therapy (CBT) is a good nonmedication option. CBT is a form of talk therapy that helps you adjust your thinking and develop solutions to problems. Research on CBT in seniors has shown that it may work in part by reducing the impact of health conditions that contribute to insomnia, such as osteoarthritis pain, depression, and anxiety. 

All seniors should bring up sleep with their doctors. “Women are more likely to talk about insomnia with their doctors than men are,” Shah says. “I encourage all patients to express their concerns about the quality of their sleep. Sleeping poorly is not something you have to live with. There are sleep medicine physicians who can help.”

Did you know?

Research shows that approximately 90% of Americans use some type of light-emitting electronics at least a few nights per week

Source: Journal of Clinical Sleep Medicine