The joy of sleeping is occasionally interrupted by
insomnia—typically for me at three o’ clock in the morning. I may toss and turn
for an hour or more before going back to sleep. Surprisingly, I have insomnia
more often at home than when traveling in our motorhome. This may be because I
am more relaxed when away from the annoyances that go along with home
ownership.
As people age, we
tend to go to bed earlier and rise earlier than when we were younger.
However, insomnia interferes with sleep for many of us. Some of us
wake up extremely early and are unable to go back to sleep. Worrying about
problems may cause sleeplessness. In addition, age affects the type of sleep people
have. The deepest, most restful sleep is called non-REM (rapid eye movement). The elderly
tend to spend less time in non-REM sleep and more time in REM sleep, when there
is more dreaming.
However insomnia affects people, it can leave them tired and
irritable. They may find it hard to think clearly, may feel depressed, and even
may be more likely to have falls and accidents if they are not well rested.
Over-the-counter or prescription sleep medicines may help,
but they are a temporary aid for insomnia. Developing good sleep habits and
treating physical or emotional problems that may affect sleep can lead to a
permanent improvement. Sleep habits that can help include:
- Provide a safe, restful environment for sleeping. Lock the doors and windows of the home, have a telephone and lamp within easy reach of the bed, and turn on nightlights in the hallways and bathroom. Don’t watch television there or read thrillers in bed. Have a pillow that supports your head and neck properly and enough blankets in cold weather.
- Never smoke in bed. If a heating pad is used, be sure it is turned off before you fall asleep.
- Do not eat large meals or drink coffee or alcohol in the evening. Drink less liquid of any type during the evening if it makes you get up to use the bathroom at night.
- Exercise during the day, not within three hours of bedtime. Try not to nap during the day if you have trouble sleeping at night.
- In daytime, get out in the sunlight.
- At bedtime, do anything nontoxic that you know will help you sleep: Drink a little milk, make a to-do list for the next day so that you will not lie awake thinking about things you need to do, or do whatever else you find effective.
For many people, these habits will help greatly. Some
conditions, though, call for more extreme measures. If a medicine is causing
insomnia, it may be possible to substitute another drug for it. Some disorders
that interfere with sleep can be cured or alleviated. Anti-anxiety drugs are
useful for some people.
One sleep-disturbing condition is apnea. The apnea sufferer
stops breathing periodically during sleep, gasping for air and snoring loudly.
During the day, apnea causes sleepiness. Left untreated, it can even cause
hypertension, stroke, or loss of memory. Specialists in sleep problems can
diagnose sleep apnea and treat it. The standard treatment includes a device
that delivers what is called continuous positive air pressure (CPAP), which
pushes air into the lungs during the sleep. Other treatments may use dental
devices or surgery.
Other conditions that can cause sleep disorders are restless
legs syndrome and periodic limb movement disorder. With restless legs syndrome,
which tends to be worse at night, people feel sensations in their legs such as
tingling, pins and needles, or crawling. Periodic limb movement disorder makes
people jerk and kick their legs often during sleep. Medications for both
conditions can be prescribed.
Anything that interferes with sleep should not be ignored. As Macbeth said in despair, "sleep knits up the raveled sleave of care," restoring us every morning.
(Much of this post is based on my reference book Geriatrics [Greenwood Press, 2011].)
