Why it’s important to get a good night’s sleep

Inadequate sleep in older adults can trigger a wide range of health issues

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As we age, it’s not uncommon to start to grapple with sleep.

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Not getting enough sleep can impact quality of life and trigger a host of health issues, from depression to heart disease.

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If that weren’t enough, inadequate sleep can also pose increased risk of cognitive decline, dementia and even death.

Scientists theorize that one reason inadequate sleep increases dementia risk is that the beta amyloid protein, seen in abnormal levels in the brains of people with Alzheimer’s disease, has a lowered opportunity to be flushed from the brain during sleep. Greater buildup of the protein was seen in people with shorter sleep patterns and poor sleep quality.

A study out of Harvard Medical School of 2,800 participants 65 and older found that people netting fewer than five hours of sleep per night doubled their likelihood of developing dementia, and were twice as likely to die, in contrast to their peers who got six to eight hours of sleep.

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And our chances of getting a good night’s sleep decrease markedly as we age.

Scientists estimate that between 40 and 70 per cent of older adults have chronic sleep problems, and about half of these individuals go undiagnosed.

“The common sleep problems with aging are insomnia, obstructive sleep apnea — which increases in men but also in post-menopausal women not on hormone therapy, and after 50 it increases for both — and advanced sleep phase syndrome,” says Dr. Katherine Rasmussen, director of the Behavioural Sleep Medicine Program at The Centre for Sleep and Human Performance in Calgary.

Insomnia is characterized by having difficulty initiating and maintaining sleep for three or more nights per week, taking more than 30 minutes to fall asleep, and having nighttime awakenings, for three or more months.

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Obstructive sleep apnea happens when the muscles supporting tissues in the throat relax, narrowing or closing the airway and momentarily cutting off breathing. It can cause snoring, daytime tiredness and lead to serious health problems such as high blood pressure, diabetes and obesity.

Advanced sleep phase syndrome is a disruption of circadian rhythm, seeing sufferers go to bed early and arise very early. Though our body’s circadian rhythm shortens as we age, there is a strong genetic link found connected to the syndrome as well. However, sometimes it has other causes.

“Sometimes it’s because of boredom if they’ve retired and are less socially active in the nighttime,” Rasmussen says.

The effects of inadequate sleep can be seen in next-day functioning, with low energy and mood, increasing the risk of depression and anxiety. We’re also more sensitive to pain with poor sleep, which can cause a vicious cycle in people with chronic pain, since chronic pain itself disrupts sleep, and the poor sleep increases the pain.

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Older adults ideally need seven to eight hours of quality sleep, Rasmussen says.

The behavioural sleep program Rasmussen heads is a non-drug, evidence-based, patient-centred program that addresses psychological and physiological causes of sleep issues. The centre offers sleep studies, which are paid out of pocket, but visits for assessments and treatments are covered by Alberta Health Services. The program focuses on using cognitive behavioural therapy as a first-line treatment for insomnia.

“There is no ideal sleep medication for seniors due to side effects, drug interactions and long-term safety concerns including decreased cognition, morning hangover effects, dependency and increased risk of hip fractures,” Rasmussen says.

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While our sleep does change as we age, “becoming older doesn’t mean your sleep is going to fall apart,” Rasmussen says.

“If you’re healthy and exercising, you can have good sleep throughout your life. But you won’t sleep like you did when you were 10. Our sleep does become more fragmented — increased light sleep, decreased deep restorative sleep, although our REM sleep remains fairly stable when we age.”


Rest assured

So how do we tackle some common sleep issues that crop up as we get older? Here are some tips to boost your chances of nabbing some good Zzzs.

  • Dr. Katherine Rasmussen, director of the Behavioural Sleep Medicine Program at The Centre for Sleep and Human Performance in Calgary, recommends “strategic napping” to preserve total sleep over a 24-hour period. A 30-minute nap in the afternoon finished at least eight hours before bedtime can help capture some lost sleep, optimize cognitive function and boost energy for the rest of the day.
  • Morning light exposure can strengthen circadian rhythms. Get outside in the direct light for 30 to 45 minutes, without sunglasses or a visor.
  • Exercise and plenty of daily physical activity are two of the best strategies to help deepen sleep.
  • Be cautious with melatonin supplements. While our levels of the sleep hormone decline with age, the supplement only works in about 20 per cent of the population. And the timing of taking it can negatively affect circadian rhythms.
  • Keep the house cooler at nighttime. Older people are less able to regulate body temperature as they age. Our body temperature needs to drop to maintain sleep.
  • Have a consistent routine of going to sleep and rising at the same time every day.
  • Dedicate the last couple of hours of your day to engaging in calming activities in dim light to prime your body and mind to enter sleep.
  • Limit caffeine after noon, and alcohol in the evening.
  • Put down electronic devices the last couple of hours before bed. The blue light they emit is alerting and can delay your ability to fall asleep, and the activity of clicking, reading and shopping are stimulating activities that can affect sleep onset.

— Karen Rudolph Durrie

This story was created by Content Works, Postmedia’s commercial content division.

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