February 2001

 

Are You Getting the Sleep You Need?
Vera Massey Nichols, nicholsv@missouri.edu

Getting a good night’s sleep can be difficult, but it’s even harder to come by as you get older.

American adults are now averaging about seven hours of sleep a night, an hour short of what the experts recommend. Some folks are deliberately skimping on sleep. They may be opting for late night entertainment like TV/Internet surfing or maybe they are feeling a need to cut back on sleep to keep up with work and family obligations. Others find themselves unable to sleep because of stress, biological changes (like menopause), or various health problems. The American Academy of Sleep Medicine, reports as many as 40% of all Americans suffer from acute insomnia (sleep difficulties lasting one month or less), and 10% have chronic insomnia (sleep problems lasting for more than six months).

Whatever the cause of lost sleep, it can affect your quality of life. Fatigue, irritability, memory problems, and concentration difficulties are just a few of the common symptoms of not sleeping well or not sleeping long enough. Lost sleep also has a negative affect on work performance and increases the risk of accidents. Last year alone, more than 150,000 car crashes were blamed on drowsy drivers.

The dangers of not getting enough sleep can affect your overall health too. Through mechanisms still not understood, your body is restoring and healing itself during sleep–repairing damaged muscle tissue and replenishing the immune system. Some studies indicate that inadequate sleep may weaken the body’s immune system. Other studies suggest that even moderate, chronic sleep debt may increase the risk of developing insulin resistance, a condition that predisposes people to diabetes, as well as hypertension and heart disease.

Getting a good night’s sleep is more than just a good idea. It’s essential for your physical and psychological well-being. If you’re having trouble sleeping, here are some tips for getting the sleep you need:

Create a "sleep-friendly" environment. A darkened, quiet room with a temperature on the cool side is essential. Developing a relaxing bedtime routine is important too. Find something that prepares you for sleep like a bath or reading. A hot bath at the end of the day improves sleep of some people—it’s actually the cooling off afterwards that seems to trigger the drowsiness. But for women who are experiencing hot flashes, you’ll want to avoid this overheating so close to bedtime.

Watch caffeine intake. We tend to become more sensitive to the stimulating effects of caffeine around age 40 or 50. If you find you are sensitive to caffeine, cut out all caffeinated drinks (coffee, tea, colas) by about 4 p.m. It appears caffeine can disturb sleep quality even in people who have no trouble falling asleep.

Consider eating patterns. There are no specific foods or drinks that have been shown to improve sleep. However, overeating or eating too close to bedtime can create problems for some people—especially if you suffer from heartburn or indigestion. Try to schedule your evening meal at least three hours before bedtime.

Be careful if using supplements. Because many of the over-the-counter and prescription sleep aids can lead to drug dependence and side effects, people have been turning to "natural" alternatives. Melatonin (hormone) and Valerian (herb) are two of the most commonly used dietary supplements to fight insomnia. Even though some people report they experience improved sleep with both of these supplements, the controlled research studies have not shown either to be highly effective. In fact, if you suffer from sleep apnea, melatonin supplements could make your condition worse. It’s important to remember that with any dietary supplement, there are no guarantees of product quality or long-term safety. Another word of caution—never take either of these supplements with other sedatives or alcohol, since there is danger of oversedation, especially in older adults.

Check your medications. Many over-the-counter drugs contain caffeine and other stimulants. Some research evidence suggests that aspirin and ibuprofen can trigger nighttime awakenings if taken late in the day. Antihistamines can induce sleep in many people but can make others feel "wired." Prescribed drugs like diuretics, some antidepressants and even thyroid medications may interfere with sleep. Anyone taking a drug on a long-term basis, who has difficulty sleeping, should speak to their physician about whether the drug could be at least partially responsible. If so, perhaps the timing of taking it or the dosage could be adjusted.

Limit alcohol intake. While it’s true that alcohol is a sedative and a glass of wine may make you feel drowsy, alcohol actually interferes with your sleep. That’s because as your body metabolizes the alcohol during the night, you get fragmented, disturbed sleep. Alcohol has also been known to cause nighttime awakening after you fall asleep.

Obtain regular physical activity. Being physically active is one of the most powerful tools we have against insomnia. It appears that physical activity early in the day has the greatest impact on improving sleep. Being active can decrease the time it takes to fall asleep as well as improve the time spent in the more restful deep sleep. Avoid vigorous physical activity too close to bedtime because this can speed up your metabolism for a while—leaving you "pumped up" and unable to fall asleep right away.

For more information on this topic contact:

National Institutes of Health, National Center on Sleep Disorders Research. Call 301-435-0199 (www.nhlbi.nih.gov/about/ncsdr)

The American Academy of Sleep Medicine. Call 507-287-6006 (www.aasmnet.org)