Tips for restful sleep

Insomnia, the most common sleep complaint, is the feeling of not having slept well or long enough. Common problems are sleeping too little, difficulty falling asleep (taking more than 30-45 minutes), awakening frequently during the night, or waking up early and being unable to get back to sleep.

Age-related changes contribute to one's ability to sleep continuously and soundly. Many older adults have problems sleeping.  With advancing age, some people switch to shorter nights and some to longer ones. Such a switch may be simply a normal condition of aging; or, it may result from shifts in daily patterns, retirement, or changes in physical or mental health.

Causes of Insomnia

Short-term insomnia, lasting up to three weeks, may result from anxiety, nervousness, and physical and mental tension. Typical causes are worries about money, the death of a loved one, marital problems, excessive concern about health, boredom, social isolation, or physical confinement.

Long-term insomnia often stems from such health conditions as heart disease, arthritis, diabetes, asthma, chronic sinusitis, epilepsy, ulcers, and depression. Long-term impaired sleep can also be brought on by chronic drug or alcohol use as well as by excessive use of beverages containing caffeine and abuse of sleeping pills.

Anxiety, Depression, and Sleep

Many of those who have severe problems sleeping report a high level of emotional distress. In depressed people, an overwhelming feeling of sadness, hopelessness, worthlessness, or guilt can be associated with abnormal sleep patterns. Often, the depressed person awakens early and cannot return to sleep. Yet, sometimes, just the opposite is true. Some depressed people find relief in sleeping. They deny or escape from the problems of living.

Many depressed people complain of insomnia without recognizing that they are depressed. If you have lost interest in activities you used to enjoy or if you have feelings of hopelessness or suicidal thoughts, your sleep problems may be a result of depression. Discuss the problem with your physician, who may recommend mental health counseling. When the depression is treated, the accompanying sleep problems usually disappear.

Ways to Improve Sleep

Insomnia is a complex problem, not given to simple solutions. Chronic insomnia usually develops over a long period of time; similarly, the response to treatment occurs gradually. Most experts agree that the following are the first steps to obtaining better sleep.

Exercise

Regular exercise tends to benefit sleep; however, vigorous exercise--especially just before sleep--can arouse a person and delay sleep. Exercise in the morning also has little beneficial effect on sleep. The best time to exercise is in the afternoon.

Daytime Naps

Daytime naps tend to disrupt normal nighttime sleep. Naps should not be used as a substitute for poor sleep at night. There are exceptions to this general rule; many older people do sleep better at night when they take daytime naps. However, if you nap regularly and sleep poorly at night, your nighttime sleep might improve if you skip the naps.

Bedtime Snacks

If hunger keeps you awake, a light snack might help you sleep, unless it causes problems with digestion. Avoid heavy meals, alcohol, and caffeine beverages. For those who can tolerate milk, that old, time-tested remedy may work best.

Regular Bedtime

The best way to sleep better is to keep a regular schedule for sleeping. Go to bed at about the same time every night, but only when you are tired. Set the alarm clock to awaken you at about the same time every morning including weekends and regardless of the amount of sleep you have had. If you have a poor night's sleep, don't linger in bed or oversleep the next day. If you awaken before it is time to rise, get out of bed and start your day.

Most people who have trouble sleeping stay in bed too long and get up too late in the morning. By establishing a regular wake-up time, you help solidify the biological rhythms that establish your periods of peak efficiency during the 24-hour day.

Alcohol

The effect of alcohol is deceiving. It may induce sleep, but chances are it will be a fragmented sleep. The sleeper will probably wake up in the middle of the night when the alcohol's relaxing effect wears off.

Trying too Hard

Trouble falling asleep may be brought on simply by going to bed too early. Sleep cannot be forced. You should not go to bed and try to sleep until you are sleepy.

If you turn in too early--even if you do fall asleep--you could experience a disturbed night's rest or could wake early without feeling refreshed.

If you go to bed and you find you can't fall asleep, don't stay in bed brooding about being awake. It is best to get out of bed. Leave the bedroom. Read, sew, watch TV, take a warm bath, or find some other way to relax before slipping between the sheets once more. Go to bed only when you are sleepy.

Sleeping Pills: A Temporary Solution

All sleeping medications should be used sparingly, for the shortest possible time, and in the smallest effective dose. At best, sleeping pills have only limited usefulness. Although temporarily helpful, sleep-promoting medications can eventually cause disturbed sleep, side effects, a sleep "hangover" during the day, and dependence on the drug. Sleeping medications pose particular difficulties for older people, because of their reduced tolerance to all medications. Sleeping pills may cause older people to stumble or fall, feel groggy or hung-over, or appear forgetful and senile.

Conclusion

If you have difficulty sleeping, try the suggestions in this pamphlet for improving your sleep. If you are still having difficulty, discuss the problem with your physician. Poor sleep may be a sign of some underlying health problem. Most sleep disorders, whether caused by physical or mental factors, can be treated or managed effectively once they are properly diagnosed.

Adapted from Sleep Disorders, U.S. Department of Health and Human Services; Public Health Service; Alcohol, Drug Abuse and Mental Health Administration, 1987.

 

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