Sleep is the Best Medicine

Sleep is the best medicine. Although older adults need as many hours of sleep as younger adults—7-9 hours each night—we often hear the commonly-held but mistaken belief that you need less sleep as you age. Disruption of sleep can cause memory problems, depression, and a higher susceptibility to falls.

In the United States, insomnia is the third most common reason for a medical visit, behind only headaches and the common cold.  As sleeping patterns change for older adults—going to sleep earlier, getting up earlier and napping during the day—it becomes more difficult to fall asleep at night. Once asleep, older adults spend less time in deep sleep—rapid eye movement (REM) sleep—and are often therefore light sleepers. By themselves, even these normal changes can to disrupt sleeping patterns. More than half of older adults have a sleep disorder. The rate is higher among long-term care facility residents. Although researchers have described more than 70 sleep disorders, four disorders hold top billing.  These include insomnia, , sleep apnea, restless legs syndrome, and narcolepsy.

Among older people, women experience insomnia than men.  Insomnia—which is the most common sleep problem in adults age 60 and older—results in trouble falling and staying asleep. About 60 million Americans a year have insomnia, which tends to increase with age. It affects about 40 percent of women and 30 percent of men.

Sleep apnea is a disorder of interrupted breathing during sleep. It usually occurs in association with fat buildup or loss of muscle tone associated with aging. These changes allow the windpipe to collapse during breathing when muscles relax during sleep and is usually associated with loud snoring (though not everyone who snores has this disorder). An estimated 18 million Americans have sleep apnea.

Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD)--an unpleasant crawling, prickling, or tingling sensations in the legs and an urge to move them for relief--affects as many as 12 million Americans.  In one study, RLS and PLMD accounted for a third of the insomnia seen in patients older than age 60.

Older adults with narcolepsy have frequent "sleep attacks" at various times of the day, even if they have had normal amounts of night-time sleep. Narcolepsy affects an estimated 250,000 Americans who have attacks lasting from several seconds to more than 30 minutes. The disorder is usually hereditary, but is occasionally linked to brain damage from a head injury or neurological disease.

Disruption of sleep becomes more common  as we get older. Some clinical research now focuses on the role of melatonin in this cycle. Some serious conditions need consultation, while others just require a more disciplined approach to going to sleep.

Amanda Dew and her colleagues at the University of Pittsburgh, USA looked at one such reflection of peace of mind, sleep and how it can influence an early death. After controlling for things that can also influence death, such as age, gender, and how healthy they were, they then could predict death based on their sleep patterns. Individuals who take longer to sleep than 30 minutes were more than twice at risk of death. While those who sleep for less than 4/5th of the time while in bed were nearly twice as likely to die earlier. Even those who either dreamt too much or too little (Rapid Eye Movement sleep) were nearly twice as likely to die earlier. Sleeping just right is an important process that can promote longevity.

Follow a regular sleep schedule. Go to sleep and get up at the same time each day, even on weekends. Try to avoid napping and make an effort to get outside in the sunlight each day. Stay away from caffeine late in the day. Exercise and light meals also contribute to better sleep. You can sleep yourself to good health.


Refernces

Dew, M. A., Hoch, C. C., Buysse, D. J., Monk, T. H., Begley, A. E., Houck, P. R., ... & Reynolds III, C. F. (2003). Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosomatic Medicine, 65(1), 63-73.