Non-medication-based sleep habits are the first choice for improving sleep in older people.
The statement comes from Dr. Preeti Malani, MD, director of the National Poll on Healthy Aging Team, chief health officer and professor of medicine in the Division of Infectious Diseases at the University of Michigan.
The university this month released its findings from the “National Poll on Health Aging,” a survey sponsored in part by the University of Michigan, the university’s Institute for Healthcare Policy and Innovation and AARP and conducted by GfK Custom Research, LLC.
In short, too many older adults are not sleeping well; they’re taking too many prescription and over-the-counter drugs to remedy the problem; and probably most hazardous of all, they aren’t telling their doctors about any of it. See Part I of this series on Health Aging and Sleep for poll results.
The National Institute on Aging of the NIH gives some helpful advice on getting a good night’s sleep.
“Being older doesn’t mean you have to be tired all the time,” the institute states on its site. “You can do many things to help you get a good night’s sleep.”
The NIA suggests seniors:
- Follow a regular sleep schedule which means getting up and going to bed at the same time each day, including weekends, holidays and when traveling.
- Avoid napping in the late afternoon or evening, if you can.
- Develop a bedtime routine which may include taking time to relax before bedtime each night by reading a book, listening to soothing music or soaking in a warm bath.
- Try not to watch television or use your computer, cell phone or tablet in the bedroom. The light from these devices as well as any alarming or unsettling content may make it difficult to fall asleep.
- Keep your bedroom at a comfortable temperature and as quiet as possible.
- Use low lighting in the evenings and in preparing for bed.
- Exercise at regular times each day but not within 3 hours of bedtime.
- Avoid eating large meals close to bedtime. They can keep you awake.
- Stay away from caffeine late in the day. Caffeine (found in coffee, tea, soda, and chocolate) can attribute to trouble falling asleep.
- Alcohol, even in small amounts, make it harder to stay asleep.
According to the NIA, insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling asleep and staying asleep. The condition can last for days, months and even years. According to the NIA, if you feel tired and unable to do your activities for more than two or three weeks, you may have a sleep problem. Sleep problems can include:
- Taking a long time to fall asleep.
- Waking up many times during the night.
- Waking up early and being unable to get back to sleep.
- Waking up tired.
- Feeling sleepy during the day.
And being unable to sleep can become a vicious circle or even a habit because a person worries about not sleeping even before they get into bed, which may make it harder to fall asleep and stay asleep.
The NIA recommends setting up a “safe and restful place to sleep” with these suggestions:
- Make sure you have smoke alarms on each floor of your home.
- Before going to bed, lock all windows and doors that lead outside.
- Keep a telephone with emergency phone numbers by your bed.
- Have a lamp within reach that is easy to turn on.
- Put a glass of water next to the bed in case you wake up thirsty.
- Don’t smoke, especially in bed.
- Remove area rugs so you won’t trip if you get out of bed during the night.
Some additional NIA tips to help you fall asleep are:
- While you don’t really have to count sheep, you could try counting slowly to 100.
- Play mental games until you’re sleepy. For example, tell yourself it is 5 minutes before you have to get up, and you’re just trying to get a little bit more sleep.
- Relax your body. Imagine your toes are completely relaxed, then your feet, and then your ankles. Work your way up the rest of your body, section by section. You may drift off to sleep before getting to the top of your head.
- Use your bedroom only for sleeping.
- After turning off the light, give yourself about 20 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.
Twenty-three percent of respondents in the National Poll on Healthy Aging who had trouble sleeping said it was because of pain. Forty percent of those with frequent sleep problems said their overall health was fair or poor. Other reasons for sleep troubles included having to get up to use the bathroom at night, as well as worry or stress.
Insomnia and other irregular sleep patterns can interfere with daytime functioning and are associated with memory issues, depression and an increased risk of falls and accidents. “Even so, many said they didn’t see sleep issues as a health problem – in fact, this belief was the most common reason that poll respondents said they didn’t talk to their doctor about sleep,” Malani said.
She is hoping the National Poll on Healthy Aging will be just as valuable for physicians as patients. “This also highlights the need for doctors to ask their older patients about their sleep habits and what they’re doing to address any issues they may be having,” she said.
It’s true that everyone feels tired now and then. But after a good night’s sleep, most people feel refreshed and ready to face a new day. The NIA cautions that if you continue to feel tired for weeks, it’s time to see your doctor. He or she may be able to help you find out what’s causing your fatigue. In fact, your doctor may even suggest you become more active, as exercise may reduce fatigue and improve quality of life.
Some causes of fatigue, according to the NIA, are:
- Though fatigue itself is not a disease, feeling fatigued may be the first sign that something is wrong in your body.
- Taking certain medications, such as antidepressants, antihistamines, and medicines for nausea and pain can cause fatigue.
- Medical problems and treatments can add to fatigue like cancer or its treatments such as chemotherapy and radiation.
- Recovery from major surgery.
Emotions can also play a big part in fatigue for older adults:
- Are you fearful about the future?
- Do you worry about your health and who will take care of you?
- Are you afraid you are no longer needed?
Emotional worries like these can take a toll on your energy, says the NIA. Fatigue can be linked to many emotions, including:
- Depression. (Regular physical activity or exercise may help reduce feelings of depression and stress while improving your mood and overall well-being.)
- Grief from loss of family or friends.
- Stress from financial or personal problems.
- Feeling that you no longer have control over your life.
Some Lifestyle habits can cause feelings of tiredness to, including:
- Staying up too late. A good night’s sleep is important to feeling refreshed and energetic. Try going to bed and waking up at the same time every day.
- Having too much caffeine. Drinking caffeinated drinks like soda, tea, or coffee late in the day can keep you from getting a good night’s sleep. Limit the amount of caffeine you have during the day, and avoid it in the evening.
- Drinking too much alcohol. Alcohol changes the way you think and act. It may also interact with your medical treatments.
- Eating junk food. Say no to food with empty calories, like fried foods and sweets, which have few nutrients and are high in fat and sugars. Nutritious foods will give you the energy you need to do the things you enjoy.
Boredome can also make older adults feel tired. For people who used to be busy during their working years, they may feel lost about how to spend their time when they retire. They may dread waking up to long days stretching before them with nothing planned. But the NIA reports that it doesn’t have to be that way. The organization suggests engaging in social and productive activities that you enjoy, like volunteering in your community. Think carefully about what interests you and what skills or knowledge you have to offer, and look for places to volunteer based on that.
The AARP has its own suggestions for how to get a better night's sleep. The organization suggests these tips:
- Upgrade your bedroom. Buy fresh pillows Replace a worn-out mattress. Get rid of the television.
- Try Holistic Dr. Andrew Weil’s breathing exercise touted to knock you out in a minute. The “4-7-8” technique is derived from yoga: Inhale for four seconds, hold your breath for seven seconds and exhale forcefully for eight. Repeat three times and say good night.
- Leave the lights and electronics off. Turning on a lamp or getting on your smartphone when you wake in the middle of the night can reset your internal clock, warns sleep expert, Charles Czeisler, causing you to wake up at the same time the next night.
- Get rid of all artificial lighting. Insomniacs often report that their symptoms disappear during blackouts and camping trips. To mimic the blackness of the preindustrial night, “paleo sleep” advocates go full caveman in their evening routine using no artificial lighting whatsoever. They contend long dusk is your brain’s cue to pump up the sleep-inducing hormone melatonin.
- Set a schedule. Experts recommend avoiding the temptation to sleep in (or stay up) on the weekend; instead, try to maintain the same sleep-wake pattern every night of the week.
- Follow Psychiatrist Thomas Wehr lead. He placed volunteers in darkness for 14 hours for a 1992 study and found that they settled into a two-stage sleep cycle, with a mellow period of wakefulness in the middle. This segmented, or biphasic, sleep is touted for stress-reduction.
For more information about better sleep, visit the American Sleep Apnea Association,
the National Heart, Lung, and Blood Institute the National Sleep Foundation or the Restless Legs Syndrome Foundation.
To learn more about the findings of the National Poll on Healthy Aging, click here.