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Aging and Sleep Problems

depressionen im alterAs you get older, have you noticed that it gets harder and harder to get a good night’s sleep? Your mind may race from thought to thought as you lie awake, or the opposite may occur – you can’t stay awake and fall asleep watching TV, only to find yourself wide awake at 4 am with no chance of drifting off again. In frustration you think, how do I break this cycle?

Dr. Zack knows that getting enough sleep helps you stay healthy, maintain your weight, and stay alert. But many older people don’t sleep well. If you wake up feeling tired or feel sleepy throughout the day, but can’t fall asleep or stay asleep, it is time to visit Dr. Zack at Johns Creek Family Medicine.

The Relationship of Aging and Sleep Patterns

Contrary to popular belief, more mature adults need just as much sleep as young adults, which is between 7 to 9 hours a night. The difference is: whereas young adults may stay up later and sleep in whenever possible; older adults tend to fall asleep earlier (hence the early bird dinners), although they rise and shine earlier too. Napping during the day also becomes more prevalent, so although an older adult’s body may be tired at night, their minds are alert, making it harder to fall asleep.

In addition, the type of sleep changes as one grows older. As people mature, the amount of time spent in deep REM (rapid eye movement) decreases, so older people typically are light sleepers. We dream mostly during REM sleep and have the deepest sleep during non-REM sleep

Sleep Problems

What causes older people’s sleep patterns to change? Chronic pain and not feeling well can make it harder to sleep. If a person naps too much during the day can disrupt sleep patterns. Certain medications can cause wakefulness. When you don’t get a good night’s sleep, the following may occur:

• Irritability
• Becoming forgetful or having trouble with memory
• Depression
• Tendency to trip, fall or have accidents
• Feeling groggy

Insomnia

Mature adults experience insomnia as their most common sleep problem. In general, insomnia is either having have trouble falling asleep or staying asleep. Insomnia can last for a range of time – days, months, or even years.

Insomnia may be caused by a number of factors. Some of them can be managed, but others may be of intrinsic origin which cannot be controlled. Excitement, anxiety or pain may keep you awake even if you feel tired. People with insomnia often focus on small noises or a light source until it seems like a huge intrusion to falling sleep. However, there are also circumstances where insomnia may be an indication of other problems, such as a side effect of a medication or an illness. There are even situations when someone who has insomnia worries so much about not being able to fall asleep that it keeps them up even longer.

Insomnia can be managed with over-the-counter sleep aids or prescription medication. However, medication isn’t a long term cure for the condition. Dr. Zack will work with you to develop healthy sleep habits to promote a good night’s sleep.

Movement Disorders

There are a number of movement disorders common in older adults that can deprive you of sleep. These include:

Restless Leg Syndrome: Affects one or both legs with tingling, crawling, tickling or pins and needles sensations which tends to intensify at night. Moving the legs around seems to lessen the sensations in the short term, but the feeling for the need to move is a sleep robber. And chances are, if either of your parents or siblings have this condition, you might suffer from it also. If this condition affects you, talk to Dr. Zack – there are medications that can help.

Periodic Limb Movement Disorder: This condition causes people to jerk or kick their legs every 20 to 40 seconds while sleeping. These movements can disrupt sleep, or the constant movement can cause you to be tired – some people say it feels like running in your sleep. Medication, exercise, warm baths, yoga and other relaxation techniques can help relieve the constant movement interruptions while sleeping.

Rapid Eye Movement Sleep Behavior: REM sleep is the most active stage of sleep when dreaming often occurs. Normally, your muscles don’t move during REM sleep. However, with this condition, your muscles move while dreaming, (similar to a dog moving it’s legs like they are running while sleeping) and again the movement can wake you up.

Tips for Better Sleep

You don’t have to accept feeling tired all the time just because you can’t get a good nights’ sleep. Dr. Zack shares some tips to help you snooze uneventfully.

• Follow a regular sleep schedule every day. Naps in the late afternoon or evening can create wakefulness later at bedtime.
• Develop a bedtime routine, such as watching television, reading, listening to music, or a warm bath.
• The bedroom should be dark, a comfortable temperature, and quiet (or earplugs may be needed).
• A supportive, comfortable mattress is key in addition to a good pillow and layered blankets to adapt to the season.
• No exercise within the 3 hour window before bedtime, although regular daily exercise is recommended.
• Try to get some fresh air every day.
• Moderate your meals. Whereas a light snack in the evening can help you become drowsy, eating a large, heavy meal can keep you awake (and feel bloated and uncomfortable too).
• Avoid caffeinated beverages in the evening.
• Limit the amount of liquid consumption in the evening to avoid having to wake up to use the bathroom in the middle of the night.
• Alcohol can make it more difficult to remain asleep even though it might make you initially drowsy, so avoid it right before bedtime.
• It should take about 20 minutes to fall asleep. If you can’t fall asleep, it’s best to get out of bed and leave the room until you feel drowsy. Return to bed when you really feel sleepy.
• Establish safety habits in the bedroom including: a phone with easily accessible contact numbers; a lamp; a glass of water nightlights in bathroom; no smoking in bed; turn off heating pads; don’t put area rugs in the path to a bathroom to avoid tripping.

Nighty Night

Relaxation before bed is extremely beneficial, no matter how you accomplish it. However, after a few weeks, if you continue to feel tired and have trouble falling and/or staying asleep after implementing these techniques, you may have a sleep problem. Talk to Dr. Zack at Johns Creek Family Medicine, serving patients in South Forsyth, Gwinnett and North Fulton counties and surrounding North Atlanta area about your sleep issues so he can help you establish a sleep inducing routine.

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