By Julie Limon PT, MCSP, Rehab Director, Seven Acres & The Medallion
Our sleep and wakefulness patterns are controlled by an internal clock located in the hypothalamus. Aging causes that brain region to decline, resulting in disrupted circadian rhythm. Light exposure is another important clue for our circadian rhythms.
Unfortunately, research shows elderly people have limited exposure to daylight, averaging one hour a day. Further, changes in hormone production also affect sleep. With age, our bodies secrete less melatonin, resulting in extended wakefulness.
Mental and physical health conditions can also interfere with our sleep. In a large study, 24 percent of people 65 - 84 years old reported four or more health conditions. Those with multiple health conditions were more likely to get less than six hours of sleep, have poor sleep quality, and experience a sleep disorder.
Last, medications can also impact quality of sleep. Almost 40% of adults 65 and older take five or more medications. While antihistamines and opiates can cause daytime drowsiness, antidepressants and corticosteroids may keep older people awake and contribute t symptoms of insomnia.
All of the above factors lead to a simple conclusion: older people take longer to fall sleep and wake up more during the night, robbing them of the much-needed rest to regenerate. So, what can we do?
1. Exercise. Studies show that regular exercise is the single best thing you can do to help achieve a good night’s sleep. However, you should not exercise within three hours of going to bed. Consult your physician or physical therapist if you have health concerns which may require a personalized exercise plan.
2. Nutrition matters. Avoid eating large, heavy meals in the evenings and eat your last meal or snack at least 2-3 hours before bedtime. Do not consume stimulants, such as alcohol, caffeine or nicotine within five hours of going to bed.
3. Adjust your medications. If you’re on multiple medications, especially if prescribed by multiple doctors, make sure to consult your physician and discuss how they affect your sleep. If possible, adjust the dosage or the time you take each medication to improve your ability to sleep.
4. Develop a bedtime routine. Aging decreases the ability to recover from lost sleep. It’s important to develop a sleep time routine to help your mind and body wind down. This may include having a relaxing bath, diming the lights, having a glass of warm milk, listening to an audio book or putting on relaxation music. Go to bed and wake up at the same time every day and be careful about napping too long, to develop a regular sleep schedule.
5. Avoid artificial light before bedtime. The blue light from digital tablets, television sets and smart phones tricks our brains to think it is daytime. Therefore, we produce less melatonin, the hormone responsible for triggering our sleep. Ideally, turn off all these devices at least an hour before your bedtime. If that is not possible, limit the blue light exposure by dimming the screen brightness, use an external blue light screen filter or install an app that mimics evening light frequency. Reading glasses with blue light filter are also a good option.
6. Create a soothing bedroom. Clear your bedroom of unnecessary distractions, such as exercise equipment, unfolded laundry, or work-related items. Clutter can cause stress and anxiety. Reduce noise by using curtains, rugs and upholstered furniture and decorate using cool colors, such as blue, green or lavender. Heavy blinds can also help with light pollution and heat reduction. A ceiling fan can also help keep your bedroom cooler and promote sleep.
7. Go outside in the morning. Remember that blue light helps us to wake up. Reset your internal clock and help produce vitamin D. In Texas, an early morning outing for ten - thirty minutes is preferable. As we age, we sunburn and overheat more easily, so avoid prolonged exposure to heat and direct sun.
8. Treat your sleep disorders. If you’re suffering from the following disorders and ailments, do not delay consulting your physician and getting appropriate treatment.
- Sleep apnea: Gasping for air or snoring loudly can indicate sleep apnea which may increase the risk of stroke or high blood pressure. A CPAP (continuous positive airway pressure) machine or surgery may help.
- Restless Leg Syndrome is very common in older adults. Stretching or medication may help relieve the severity of the issue.
- Limb Movement Disorders: Jerky movements such as kicking or punching during dream sleep can be disruptive. Reduce these with regular exercise.
As we age, we become resigned that a reduced quality of life is a fact of life, including the quality of our sleep. But by implementing the above strategies, you can enjoy longer, more restful sleep to regenerate your body so you can enjoy your life more.