Sleep Solutions: Why We Should Snooze On Big Decisions

Sleep is a vital part of our lives, and yet, for many, a good night's rest remains elusive. While it may be tempting to simply brush off a lack of sleep as a minor inconvenience, the consequences can be far-reaching and severe. From obesity to heart disease, the adverse effects of chronic insomnia on our health are well-documented. So, the next time you find yourself tossing and turning, consider the impact of your actions – or lack thereof. After all, a good night's sleep is essential for both your physical and mental well-being.

The impact of age on sleep

Age has a significant impact on sleep patterns and quality. While it is a common misconception that older adults need less sleep than younger people, the current recommended sleep guidelines suggest that all adults should aim for seven or more hours of sleep per night. Adults over 65 should get seven to eight hours each night. However, older adults often experience changes in the quality and duration of their sleep due to various factors.

One of the main reasons for disrupted sleep in older adults is the deterioration of the suprachiasmatic nucleus (SCN), which is the body's internal clock located in the hypothalamus. The SCN controls 24-hour daily cycles, called circadian rhythms, which influence when people feel sleepy or alert. As the SCN ages, it can disrupt these rhythms, causing older adults to feel tired earlier in the day and wake up earlier in the morning. This is known as a phase advance.

Additionally, older adults may experience changes in their sleep architecture, or how they cycle through the different stages of sleep. They tend to spend more time in the earlier, lighter stages of sleep and less time in the deeper, dreamless sleep. This contributes to older adults waking up more frequently during the night, often three to four times, and having more fragmented and less restful sleep overall.

Medical conditions and medications can also impact sleep in older adults. Conditions such as depression, anxiety, heart disease, diabetes, arthritis, and other sources of discomfort or pain can interfere with sleep quality. Medications for these conditions may cause sleepiness during the day or make it challenging to sleep at night.

Lifestyle changes that come with aging, such as retirement, loss of independence, and social isolation, can further contribute to sleep issues. A less structured sleep-wake schedule, increased stress and anxiety, and a lack of physical activity can disrupt the normal sleep/wake cycle.

To improve sleep quality, older adults can focus on good sleep hygiene and develop healthy habits. This includes regular exercise, reducing distractions in the bedroom, avoiding substances that interfere with sleep, maintaining a regular sleep schedule, and establishing a relaxing bedtime routine.

Lifestyle choices and sleep

Sleep is just as important for your health as diet and exercise. Poor sleep has been linked to a variety of health issues, including obesity, high blood pressure, heart disease, diabetes, and depression.

Morning Exercise

Exercising in the morning can help set the tone for the day and expose you to light, which is good for your circadian rhythm. Morning workouts can also boost your daytime energy and improve your sleep quality and duration. However, exercising too late in the day may cause sleep problems due to increased alertness and stimulation.

Healthy Diet

A healthy diet that includes fiber-rich vegetables, fruits, legumes, whole grains, nuts, and fish can promote better sleep. Minimizing processed meats, refined carbohydrates, and sugary drinks, as well as avoiding trans fats, can also improve sleep quality. Eating a large meal close to bedtime can leave you feeling uncomfortably full and disrupt your sleep. Spicy foods can cause heartburn, and caffeine too late in the day can interfere with sleep. Alcohol consumption can negatively impact sleep quality and increase the risk of sleep apnea.

Calorie Balance

Consuming more calories late at night can lead to less peaceful sleep. Distributing your calorie intake evenly throughout the day and avoiding sugary, caffeinated, or alcoholic beverages before bed can promote more restful sleep.

Relaxing Rituals

Stress can significantly impact sleep quality. Finding practices to help you relax, such as meditation, deep breathing, or writing, can improve your sleep. Gratitude practices or journaling can also enhance sleep quality. Creating a relaxing bedtime routine and optimizing your bedroom environment by minimizing noise, light, and electronic device usage can be beneficial.

Consistent Sleep Schedule

Maintaining a consistent sleep schedule, even on weekends, is crucial for improving sleep quality. Going to bed and waking up at similar times every day helps regulate your body's circadian rhythm and enhances long-term sleep quality.

The effect of medication on sleep

Sleep is incredibly important for our health and well-being, and when we don't get enough of it, it can have serious consequences. While there are many reasons why we may not be getting a good night's rest, one factor that is often overlooked is the impact of medication.

Certain medications can interfere with sleep, and this is especially true for those taking prescription drugs. For example, some antidepressants can disrupt sleep, and it is well known that corticosteroids (prednisone), cold and flu remedies, and specific antidepressants can also be a hindrance. Additionally, those with sleep apnea may be prescribed CPAP machines to aid breathing, which can further disrupt sleep.

Over-the-counter medications can also impact sleep. Antihistamines like diphenhydramine (Benadryl) are known to cause drowsiness and are often used as sleep aids, but they can also lead to dependence and other problems if used for extended periods. Melatonin supplements, which help regulate sleep, are another common over-the-counter option. However, studies are divided on whether they truly work.

For older adults, the risks associated with sleep medications are even more pronounced. They are more likely to experience health problems, and the effects of the drugs can last longer, impacting their daily functioning and increasing the risk of falls and accidents.

It is important to note that while medication can interfere with sleep, it can also help treat sleep disorders. For example, certain prescription drugs like Ambien, Lunesta, and Sonata can help people fall asleep faster, and Rozerem, a unique sleep aid, acts on the brain hormone melatonin without being addictive. Silenor, a low-dose form of the antidepressant doxepin, is another non-addictive option.

In conclusion, while medication can sometimes be the cause of sleep disturbances, it can also be part of the solution. It is essential to carefully consider the potential benefits and risks of any medication and to follow the advice of a medical professional to ensure optimal sleep and overall health.

Sleep and underlying conditions

Sleep disorders can be caused by underlying health conditions, including insomnia and sleep apnea. They can also be caused by too much stress, a hectic schedule, or other outside influences.

Insomnia, the most common sleep disorder, is characterised by the inability to fall asleep or remain asleep. It can be caused by jet lag, stress, anxiety, hormones, or digestive problems. It is most prevalent among older adults and women. Chronic insomnia is diagnosed when someone experiences insomnia at least three times a week for at least three months.

Sleep apnea is a serious medical condition that causes pauses in breathing during sleep. This disrupts the body's oxygen intake and can cause the sleeper to wake up during the night. There are two types: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea occurs when the flow of air is blocked or the airway is too narrow, while central sleep apnea occurs when there is a problem with the connection between the brain and the muscles that control breathing.

Parasomnias are a class of sleep disorders that cause abnormal movements and behaviours during sleep. They include teeth grinding, jaw clenching, and restless leg syndrome.

Narcolepsy is a sleep disorder that causes "sleep attacks", or sudden and irresistible urges to sleep during the day. It can also cause sleep paralysis, which may make the sleeper physically unable to move after waking up.

Other underlying health conditions that can cause sleep disorders include:

• Allergies and respiratory problems
• Frequent urination (nocturia)
• Chronic pain
• Mental health conditions such as depression or anxiety
• Genetic factors
• Side effects of medication
• Substance use before bedtime, such as caffeine or alcohol
• Low levels of certain chemicals or minerals in the brain

Sleep-maintenance insomnia

Symptoms of Sleep-Maintenance Insomnia

• Waking up for no apparent reason in the middle of the night
• Taking 20 to 30 minutes to fall back to sleep
• Unusual daytime fatigue or sleepiness that affects your physical or mental health or ability to function

Causes and Risk Factors

• Frequent nighttime urination
• Caffeine consumption in the afternoon
• Napping too late in the day
• Going to bed too early
• Age: As people get older, they spend less time in deep sleep, which can disrupt the sleep-wake cycle
• Sex: Women and people assigned female at birth are more prone to all forms of insomnia
• Hormones: Those going through menopause often find it harder to stay asleep

Treatment Options

If you are experiencing sleep-maintenance insomnia, there are several steps you can take to improve your sleep:

• Seek help from a healthcare provider: They may refer you for a sleep study to identify any underlying sleep disorders or disruptive conditions, such as obstructive sleep apnea or restless leg syndrome.
• See a sleep specialist: A behavioural sleep medicine specialist can help address behavioural, psychological, and physical factors that may be disrupting your sleep. They will assess your diet, lifestyle habits, sleep habits, and views on sleep to help identify ideal sleep patterns and regulate your sleep drive.
• Keep a sleep diary: Tracking your sleep patterns, sleep efficiency, sleep-wake cycle, and total sleep time can help identify disruptions and potential solutions.
• Cognitive behavioural therapy for insomnia (CBT-i): This specialised form of psychotherapy is considered the gold standard of treatment for all forms of insomnia. It combines sleep education and therapy techniques to identify and change behaviours, emotions, and beliefs that contribute to poor sleep. CBT-i focuses on behaviours and habits, such as bedtime routines and napping, as well as your relationship with sleep and how your emotions affect your slumber.
• Relaxation and sleep meditation techniques: These include breathing exercises, such as the 4-7-8 technique, and progressive muscle relaxation exercises, which can help you sleep more soundly.

In addition, it is important to maintain good sleep hygiene by limiting caffeine and alcohol intake, avoiding nicotine, establishing a regular sleep schedule, making your bedroom a sleep-friendly environment, and practising a relaxing bedtime routine.

Frequently asked questions