Have difficulty sleeping?

By Flavia Nassaka

Don’t worry, doctors offer tips to help

We all need sleep although the reason why is not quite clear. But as people age, falling asleep sometimes becomes difficult. At some point, some elderly people cannot fall asleep unless they use pills. As doctors explain, lack of sleep is a normal aspect of aging and one should not resort to pills. In fact, both the amount of time one spends sleeping and the quality vary with age.

Dr. Kaboyo Mugamba, a neurologist, says the amount of time we spend each day sleeping declines over a life span. Newborns spend from 16 to 20 hours asleep each day, while children aged one to four years sleep for about 11 to 12 hours.

This gradual decline continues through childhood, such that adolescents will need about nine hours of sleep to function at their best and middle age adults require seven to nine hours. The elderly require up to eight hours of sleep though may struggle to obtain them at once.

Mugamba explains that children sleep for more hours because they have extremely high levels of melatonin; a substance produced in the brain to control waking-sleeping patterns. High levels mean one passes quickly into deep sleep. The levels of melatonin keep decreasing with age.

Dr. Harriet Oketcho, a psychiatrist stresses that sleep requirements vary from person to person.

“Seven to nine hours is the normal range but there are people who fall outside that range and do just fine. People who get less than seven hours each night tend to be more susceptible to sleep deficiency problems,” she says. Under normal circumstances, for one to have a healthy sleep, they have to go through three stages. At first, your eyes are closed but it’s easy to wake you up. This phase may last for five to 10 minutes.

The second stage is where you fall into light sleep where the heart slows and the body temperature drops getting ready for deep sleep. Finally is deep sleep where it’s harder to awaken you during this stage, and if someone woke you up, you would feel disoriented for a few minutes.

Why older people sleep less

Aging may bring unwelcome changes in our bodies and sleep.  At Adolescence stage, sleep is interrupted by the changes that take place in the body as children transform into adults. For females, hormonal fluctuations right before the menstrual cycle can also disrupt sleep.  Young adults begin to lose the ability to deep sleep in their 20s and 30s. By age 40, deep sleep may disappear altogether. At 40, people start experiencing issues such as more fragmented sleep and more awakenings between sleep cycles. Experts explain the likely causes:

Hormones: As we age, our bodies secrete less of two important sleep hormones: melatonin whereby a person lacking the hormone may feel sleepy in the early evening and wake up very early or not feeling sleepy at all whereas the growth hormone which is responsible for deep sleep is also lost since body temperatures tend to flatten.

Oketcho says menopause comes with a number of changes including night sweats and headaches which result into lack of sleep. Chronic health conditions can also interfere with sleep. These illnesses result in changes in our body that interfere with normal sleeping. For instance diabetes and large prostate can make one frequent the bathroom in the night and so interrupt deep sleep.   Illnesses associated with old age will definitely see you taking a lot of medicine. Some of these medicines, however, have sleep depriving contents. It’s important to talk to your doctor for a possibility to change your medication to one that does not cause you to lose sleep. Anti-depressants, steroids and diabetes medications are some of the drugs known to interfere with sleep.

Oketcho says there are also changes in lifestyle that occur as one progresses. For instance, one may buy a car, get a desk job, or even retire. This means they’ll be getting less exercise, less exposure to outside weather conditions ,and  getting a lot of day time napping all of which will impact on the quality of sleep.

Oketcho says psychological stress that come with loss of a loved one, living alone, and other issues that bring sadness can keep one awake even though they are not using drugs or even when  they are exercising.

How to sleep well as you age

Dr. Kaboyo says it’s important for one to investigate the root cause of failure to sleep. If it’s medication you are using, a doctor may be consulted to change the intervals during which the medicine is administered, lower the dosage, or replace it with one that has limited side effects.  There is a siesta technique where one can do 20 minutes naps. These should not be close to bedtime.

What about those of us who need to get up and work all day?

There are strategies that can help people consolidate sleep:

Be keen on the number of hours spent in bed and maintain a regular sleep-awake schedule. This encourages more efficient sleep. Middle-of-night wakes may not provoke anxiety if you know you’re going to get another interval of sleep in the morning.

Develop bed time rituals such as taking a bath or switching off the lights.

Avoid sleeping pills as they can be addictive and will not solve the problem.

Avoid alcohol and cigarettes because the caffeine therein can keep one awake.

Have at least two hours of exposure to sunlight each day as light increases melatonin, which regulates your sleep patterns.

Though it’s helpful at all ages, exercise is particularly encouraged for those 50 years and above as it increases daily body temperature fluctuation. “Those who are physically fit have deeper sleep and fewer nighttime awakening. Exercise is the only way adults can increase the amount of time they spend in deeper sleep” says Dr. Kaboyo.

Set a good sleep environment with limited noise and light.

However, if your situation does not change with these tips, the doctor says it could be a more problematic ‘sleep disorders’ like insomnia. That can only be reversed with medical attention.