May has been designated Older Americans Month. Established in 1963, Older Americans Month strives to promote the health and welfare of senior citizens. Each year has a theme, and these have included "Health: Make it Last a Lifetime," "Living Longer, Growing Stronger in America," and "Aging Well, Living Well." This year's theme: "Making Choices for a Healthier Future." One of those choices should be for better sleep.

The Need for Sleep

The elderly need at least seven or eight hours of restful sleep every night. However, many are not getting the sleep they need. They may have more trouble falling asleep than younger people, and spend less time in deep sleep. Early morning awakening may be another problem. They also have more arousals and awakenings.

Many doctors, when examining elderly patients, tend to ignore sleep problems and fail to inquire into sleep habits. This is wrong. Just because the elderly have more disrupted sleep than younger people, does not mean that they need less.

Why the Problems?

The reasons for sleep problems in the elderly are many and varied. They may secrete less of the sleep-producing hormone, melatonin or there may be changes in the circadian rhythm pattern.

Other causes:

• The elderly are more sensitive to noise and light.
• Poor sleep habits
• Caffeine - coffee, chocolate, and in many medications
• Alcohol - Never use alcohol as a nightcap
• Nicotine - Nicotine is a stimulant, so smoking near bedtime may keep you awake.
• Medications for other illnesses
• Acute or chronic illnesses - arthritis, diabetes
• Psychiatric disorders - Alzheimer's, dementia
• Sleep Disorders - Insomnia, Sleep Apnea, Restless legs syndrome, Periodic limb movement disorder

However, the elderly have their own specialized sleep problems. Social changes and a loss of social support have disrupted their lives. They may have lost the mate of a lifetime, moved from their homes into senior lodges or rest homes. In some cases, these people are neglected by family and former friends.

Sleep Deprivation

Sleep problems lead to sleep deprivation and can cause many problems for the elderly, including depression and memory loss. Excessive daytime sleepiness destroys the quality of life and can lead to falls and accidents because the victim is unaware of what he or she is doing.

If the sleep deprivation continues, it can eventually lead to other health problems, including obesity, hypertension, heart disease and diabetes.

"It is not the need for sleep but the ability to that diminishes with age."

This quote, from Harold Rubin, Rehabilitation Counselor, and himself a senior citizen, is very true for many of the elderly.

What can we do?

So, what recourse do we have? Here are a few suggestions:

• Regular hours for retiring and rising.
• Cut down on naps or eliminate entirely.
• No caffeine after lunch. This includes coffee, chocolate and soft drinks containing caffeine. Also check medications for caffeine content.
• No alcohol in the evening.
• Cut down or eliminate smoking.
• Avoid heavy meals close to bedtime.
• Keep a regular schedule for all meals.
• A glass of warm milk before retiring sometimes is helpful.
• Try herbal teas that promote sleep or relaxation.
• Keep the sleep environment as quiet as possible.
• Forcing sleep only aggravates the problem. Get up and do something.
• Find out from the doctor if medication might be the culprit.
• Ask the doctor for help with medical or sleep problems.
• A little exercise earlier in the day is beneficial.
• A warm shower or bath before bed can be very relaxing.
• Try deep breathing or relaxation exercises.
• Ask your doctor about melatonin.
• Keep bedroom lighting dim.