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Age Related Sleeplessness

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Dr. Ernest Levister, Jr.
Dear Dr. Levister: I’m 72. I have trouble falling asleep at night. Should I take sleeping pills? Can switching my mattress help? R.V. 

Dear R.V.: Sleeping pills are rarely the answer. Simple self-help steps and, if necessary, treatment by a sleep specialist can often remedy insomnia. In a National Institute on Aging study of more than 12,000 people aged 65 and older, over half of the men and women reported frequent trouble with sleeping. This finding confirms what you’ve already observed: with aging, it becomes harder to get to sleep and to stay asleep.

The consequences of chronic sleep disturbance are considerable. Daytime drowsiness, for example, may lead to falls and accidents.  Frequent interruptions in breathing at night (sleep apnea) can strain the heart and lungs. It is therefore, important to discuss any unusual sleep problems with your physician rather than reaching for an over-the-counter sleep aid. Oftentimes, all that is needed to reduce sleeplessness is a change in behavior that can make it easier for you to sleep better and longer.

You need to accept that there may be a reduction in sleep quality, quantity and depth as we age. But if you are experiencing excessive daytime sleepiness – not just fatigue, but feeling so drowsy that you fall asleep inappropriately during the day – you should seek medical help.

Normal sleep consists of two main states REM (rapid eye movement) sleep, which is associated with dreaming and the four stages of non REM sleep. The deepest stage is referred to as delta sleep. Compared to young adults, middle-aged and elderly people spend less time in delta sleep. In fact, some elderly people cease to experience it at all.  If you’ve stayed in a luxury hotel lately you’ve probably seen all the hype over Swedish “comfort sleep systems” like Tempur-Pedic, Dux Beds and Sleep Number Beds. New scientific research suggests the memory foam mattresses and pillows increase air flow around the body and help to support the body’s natural curves and angles maximizing sleep comfort and responsiveness.

These systems can be costly and may not solve your sleep problem.

Before visiting your doctor, keep a “sleep diary” for a week or two. Include information regarding what time you go to bed and rise, how long does it take you to fall asleep, how often you wake up during the night and how long you think you sleep at night or do you take nabs during the day, are drowsy or fall asleep during the day. Your doctor may order a sleep study, in which you sleep overnight in a lab while your sleep pattern and vital signs are monitored.

Avoid coffee, tea, alcohol or chocolate late in the evening. Don’t read or watch TV in bed. Go to bed and get up at the same time each day. Some patients report sex, light exercise, deep breathing and aromatherapy helps.  For short term insomnia related to stress or anxiety from an unusual event in your life (i.e.  death, illness, divorce) your physician may prescribe a sleep aid.

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