Sleep Expert Tells How to Tame the Insomnia That Can Come with Age
According to the National Sleep Foundation, changes to our sleep patterns are a part of the normal aging process. The foundation states that as people age, they tend to have a harder time falling asleep and more trouble staying asleep than when they were younger.
Knowing this, and knowing about the common thinking that adults need less sleep as they age, HealthCentral asked Dr. Martha Cortes some questions via email about aging and sleep.
Dr. Cortes, DDS, is a dental-sleep medicine expert who owns and operates Sleep Fitness LLC. Dr. Cortes attends to chronic sleep- and breathing-related conditions such as sleep apnea, upper airway resistance syndrome, and craniofacial deficiencies.
HealthCentral: Dr. Cortes, is there a large difference between the amount of sleep adults need at different ages, for instance, age 30, age 50, age 70 and age 90?
Dr. Martha Cortes: The National Sleep Foundation recommends that people 18-25, or young adults get seven to nine hours of sleep; people 26-64, or adults, should get seven to eight hours of sleep; and people 65+ should get seven to eight hours of sleep, so there is not much difference in need as we age.
HC: As the brain changes with age, should people make adjustments in the way they approach sleep?
Dr. Cortes: Changes in the patterns of our sleep – what specialists call sleep architecture – occur as we age and this may contribute to sleep problems. Sleep occurs in multiple stages, including dreamless periods of light and deep sleep, and occasional periods of active dreaming (REM sleep).
The sleep cycle is repeated several times during the night, and although total sleep time tends to remain constant, older people spend more time in the lighter stages of sleep than in deep sleep, but it is a common misconception that sleep needs decline with age.
Along with the physical changes, as people age they tend to have:
A harder time falling asleep
A harder time staying asleep
A decrease in deep sleep (time of body repair)
A decrease in REM SLEEP (body memorizes what has occurred during waking hours)
Advice for better sleep as people age includes avoiding alcohol, nicotine, and loud noises / bright lights in preparing for sleep.
HC: Do you believe in short naps at any age?
Dr. Cortes: NO! Establish a routine and maintain good habits. Naps can interrupt the cycle and delay actual natural sleep. People need to maintain good and consistent habits for sleeping.
HC: Significant evidence has been found lately showing that lack of sleep can contribute to Alzheimer’s disease. Yet many people, as they age, have trouble sleeping. What do you suggest older people do to increase their ability to sleep?
Rule out medical causes for your sleep problems. A sleep disturbance may be a symptom of a physical or mental health issue, or a side-effect of certain medications.
Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends.
Get regular exercise. Regular exercise can improve the symptoms of many sleep disorders and problems. Aim for 30 minutes or more of activity on most days—but not too close to bedtime.
Be smart about what you eat and drink. Caffeine, alcohol, and sugary foods can all disrupt your sleep, as can eating heavy meals or drinking lots of fluids too close to bedtime.
Get help with stress management. If the stress of managing work, family, or school is keeping you awake at night, learning how to handle stress in a productive way can help you sleep better at night.
Improve your sleep environment. Keep your bedroom dark, quiet, and cool, and reserve your bed for just sleeping and sex.
Develop a relaxing bedtime routine. Avoid screens, work, and stressful conversations late at night. Instead, wind down and calm your mind by taking a warm bath, reading by a dim light, or practicing a relaxation technique to prepare for sleep.
Postpone worrying. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve.
Should sleep on your side – not on your back.
A ceremony that you go through in preparation for bed signals your body that it’s time for sleep.
HC: Most sleeping pills are considered a negative influence on older adults, but if there is no choice because of chronic pain or other issues, what would you suggest?
Dr. Cortes: When you take prescription sleeping pills over a long period of time, your body grows accustomed to the drug. You may need more and more. Best is not to start. Melatonin is a good choice. Speak to your doctor. Chronic pain, however, does require intervention with your sleep and pain team, which could include drugs.
HC: Are there any vitamins, minerals, or herbs that can help?
Magnesium calms nerves and relaxes muscles, aiding in sleep. Most of us are deficient in this mineral, so it’s often added to sleep supplements. People with chronic pain or sleep issues often become magnesium-deficient.
Epsom salt baths enable you to absorb magnesium through your skin. In the ceremony in preparation for bed, one can take a relaxing Epsom salt bath before sleep.
B vitamins help tryptophan in your body convert to niacin and serotonin, which regulate sleep and increase REM.
Chamomile tea at bedtime soothes and calms, acting as a very mild natural sedative
Valerian root tea calms the nervous system without causing a fog.
HC: What is your take on the popular melatonin?
Dr. Cores: Melatonin is a hormone made by the pineal gland, a small gland in the brain. Melatonin helps control your sleep and wake cycles, through a natural internal clock. Light affects how much melatonin your body produces. Natural melatonin, with age, decreases. Melatonin is a good supplementation especially for women to maintain sleep and improve sleep without side effects of drowsiness and sleepiness. I recommend that my patients take a supplement that provides three mg. of melatonin to support the sleep cycle regulation and 400 IU of vitamin D for bone, teeth, muscle and immune health.
HC: Thank you, Dr. Cortes, for your thoughts on aging and sleep. You’ve given people of all ages some valuable advice, but for those who are in the older age bracket, this will be especially noteworthy.