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Sleep Better Without Drugs
Older adults are particularly at risk of poor sleep, but a recent study looking at the self-help methods they use to try to sleep better suggests they frequently choose treatments that can potentially worsen their problems.
The study also indicates that many older adults don’t consult their healthcare provider about their treatment choices—and this could put their health and well being at risk. How can you ensure you sleep better while staying safe?
Poor sleep common. Older adults face many sleep challenges. “Age-related health issues such as arthritis may lead to pain and discomfort overnight,” notes Harrison Bloom, MD, associate clinical professor of geriatrics and a senior associate with the International Longevity Center. “Wakefulness also may result due to medications used to treat these health issues.” It’s common for older adults to feel sleepy during the day, due to poor slumber the night before, but have difficulty getting to sleep once they’re in bed. Early waking also is a tendency.
“When we’re resting there are still internal metabolic, neurologic and cardiovascular processes going on,” Dr. Bloom notes. “If poor sleep disturbs these processes, the body’s systems can end up out of synch.” As such, sleeping badly takes its toll on our health: It is associated with a higher risk of cardiovascular problems, high blood pressure, diabetes, and obesity. Daytime tiredness can make you susceptible to falls, with the attendant risk of fractures; and it also leaves you irritable, unable to focus, and vulnerable to depression.
Sleep means switching off, not on. A study of 242 adults age 65 and older, published online Feb. 11 in the Journal of the American Geriatrics Society, suggests that seniors engage in a variety of treatment regimens to try to improve their sleep. Commonly used interventions were reading, watching television, and listening to the radio: all innocuous pursuits that can help you drift off. However, much depends on how you use them. In order to fall asleep quickly you need to condition yourself to “switch off” in bed—and if you use the bed for other pursuits, such as reading, you may not develop this conditioned response.
Many older adults reported using alcohol, but while alcohol has a natural sedative effect that might help you go to sleep initially, it disturbs the balance between REM sleep (lighter sleep that includes dreaming) and non-REM sleep (deep sleep), preventing the brain from performing the normal restorative job it does overnight. Add to this the fact that alcohol can interact with medications you may take and affect your balance, putting you at risk of falls, and your nightcap is likely doing you more harm than good.
Prescription and over-the-counter sleep medications were also popular in the study. But while there’s no doubt these can be useful to break a pattern of poor sleeping when all else has failed, they come with their own potential problems. In older adults, sleeping pills can cause daytime drowsiness and impair memory, and they’re also associated with falls. Over-the-counter medications often contain diphenhydramine (Benadryl), which can cause confusion in some older people. “Sleep medications can be a useful short-term measure,” says Dr. Bloom, “but simple sleep hygiene could make a difference without you having to rely on drugs.”
Look to your sleep hygiene. Studies suggest that people who sleep seven hours a night live longer, and Dr. Bloom adds that consistency is important. “Go to bed at about the same time each night, and get up at the same time in the mornings,” he advises. “Establish a pre-sleep ritual: a bath, a light snack, and a few minutes of reading or meditation to help you relax.” Avoid coffee and other caffeinated beverages, since caffeine is a stimulant and will keep you awake.
Dr. Bloom adds that sleep hygiene also extends to where you sleep. “Your sleeping environment can work against good sleep,” he says. “A room that’s too bright can prevent you from falling asleep, while noise can startle you fully awake in the small hours of the morning.” Being too warm or too cold also can interfere with sleep. Non-drug sleep aids such as ear plugs, sleep masks and white noise machines can help you create a dark, peaceful environment that might remove the need for sleep medications.
