sleep

You know when you get enough of it, and when you don’t. We spend about one-third of our lives doing it, or at least in pursuit of it. While some may think it is a waste of time, the fact of the matter is, sleep is the bedrock of our physical and mental well-being.

Quality sleep supports overall health and enhances the immune system; improves learning; and boosts decision-making, problem-solving and coping skills, according to sleep medicine experts.

As people age, it may be more challenging to get a revitalizing night’s sleep, but experts insist that, for most adults, a solid seven to eight hours of shut-eye is still important. However, about one-third of Americans don’t get enough sleep, according to the Centers for Disease Control and Prevention.

You (don’t) snooze, you lose

“Lack of sleep is associated with injuries, chronic diseases, mental illnesses, poor quality of life and well-being, increased health-care costs and lost work productivity,” the CDC states on its website.

The organization’s goal is to increase awareness and education to mitigate the impact of sleep disorders on human health. As people get older, restful, uninterrupted sleep can be more elusive and compound existing health problems.

“Sleep is often neglected, but it is important to your body to function and to function well,” says Jen Dougherty, certified physician assistant with Pulmonary Associates of Lancaster, which works with people with sleep disorders. “Mood and memory are impacted.”

Studies have linked not getting enough quality sleep with an increased risk for dementia, she says.

Lack of sleep is connected to a cascade of health issues including Alzheimer’s disease, diabetes, heart attacks, obesity, depression, lung disease and cancer.

The American Academy of Sleep Medicine (AASM) shared a study that found that short sleeps accelerate aging of the brain. It found that “seven hours a day for adults seems to be the sweet spot for optimal performance on computer-based cognitive tests.”

While sleep needs may vary, most adults (even over 55) should shoot for a solid seven hours of sleeping like a log.

Studies are honing in on what exactly happens in sleep — and lack of it — that impacts health. One Harvard article states: “During sleep, our bodies secrete hormones that help to control appetite, energy metabolism and glucose processing. Obtaining too little sleep upsets the balance of these and other hormones.”

Poor sleep also increases the “stress hormone” called cortisol, which puts undue stress on the body and leads to weight gain, diabetes and heart disease, the article states.

Are you getting good sleep?

Older adults may encounter barriers to getting a good night’s sleep.

“Depression and anxiety are biggies that impact the quality and schedule of sleep,” Dougherty says. “Losing friends and spouses, as well as health issues,” can keep a person from getting adequate shut-eye.

Another common culprit to getting good sleep is obstructive sleep apnea. This occurs when the throat muscles relax and the airway collapses and becomes blocked during sleep, causing the person to stop breathing for short periods, then jarring awake briefly.

When this happens multiple times during the night, sleep architecture is damaged and the person may wake with a headache, feel sleepy during the day, have trouble concentrating and remembering things, and be short-tempered. Chronic sleep apnea can also increase the chance of developing health problems like high blood pressure, heart attack, heart failure, stroke or sexual dysfunction.

“Sleep apnea is more prevalent as people age,” Dougherty says, but people of all ages can have it. Her clinic sees both women and men for the problem. “Women are here because they’re tired, while men are here because they’re tired of their wife complaining about their snoring.”

Sometimes changing personal habits can get the person back on track: side sleeping to reduce airway blockage; losing weight so structures in the throat can remain open easier; avoiding alcohol and certain medications like sedatives; and keeping the nasal passage clear with breathing strips or menthol cream.

If that doesn’t eliminate the problem, a doctor may prescribe a continuous positive air pressure pump called a CPAP. A small portable pump sends air through a hose into a mask, which is worn over the nose. It provides a steady stream of air to overcome the obstruction of the airway. Once the patient gets a good night’s sleep, the benefits are profound.

“This importance is not realized until they get quality sleep again,” Dougherty says.

What's keeping you awake at night?

Another common sleep issue is insomnia, which occurs when you have trouble falling asleep or staying asleep. It is more common in older adults, women, people under stress, and people with certain medical or mental health problems.

There are two types of insomnia, based on frequency and duration, according to AASM: short-term insomnia, which lasts for up to three months, and chronic insomnia, which occurs at least three times per week and lasts for at least three months.

This sleep disorder can have many causes, including restless legs syndrome, with its uncomfortable burning or itching sensation leading to leg movements; depression; chronic pain from another medical problem like arthritis or cancer; and “monkey brain,” where a person just can’t stop thinking and rethinking about things.

Restless sleepers can make behavioral changes to ease the problem, such as avoiding caffeine at least six hours before bedtime; turning off electronic devices at least 30 minutes before bed, as many devices emit blue wavelengths that mimic daylight and can prolong wakefulness; and making the bedroom a cozy, dark, cool environment, which facilitates slumber when it’s time to hit the sack.

If people are concerned about their sleep habits, Dougherty says they should “seek help with a professional and don’t self-medicate.” Even over-the-counter sleep aids have higher side effects and more drug-to-drug interaction in older people, she says.

A truism in geriatric medicine is that improvement is often found in taking away pills, rather than adding more.

“There may be variability in your sleep patterns from night to night, but if it persists for a few months, seek professional help,” Dougherty says.

After keeping a sleep diary for several weeks, noting times to bed and to rise, fitfulness of sleep, times up in the night, alcohol and caffeine consumed, and exercise, bring it with you to meet with an AASM-accredited doctor.

At Pulmonary Associates of Lancaster, Dougherty says they talk to the patient and their sleep partner about what kind of sleeping problems they are having.

The patient may benefit from a diagnostic sleep study. A home study can show whether or not the patient has sleep apnea or not. It is around $500, but garners less detailed information than an overnight, in-clinic study. A sleep study performed at the clinic will provide detailed information about a patient’s sleep stages, brain wave activity and limb movement. A board-certified sleep specialist will interpret the results to recommend an effective course of treatment. That test is around $3,500.

There are many types of sleep disorders, and if it is impacting your waking life, it may be time to root out the problem.

Still undecided? Just sleep on it.

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