Sleep Better at Night

Many older adults report poor sleep. Disturbed nights can happen because of painful conditions like osteoarthritis, or because of health issues we may not even be aware we have, such as obstructive sleep apnea (OSA). Medications that often are taken by older adults can cause poor sleep—for example, some blood pressure drugs and statins. Age also makes us less able to last through the night without needing to go to the bathroom (some health conditions—such as prostate enlargement—and medications also may be a factor in nighttime bathroom trips).

Poor sleep can affect your ability to focus, concentrate, and remember things. It also puts you at risk of depression, high blood pressure, and stroke. The daytime drowsiness that often results from poor sleep increases your risk of automobile accidents and falls. Clearly it’s important to get enough sleep, but should you catch up by napping? You may have seen some alarming headlines about recent studies pointing to a possible association between napping and cardiovascular disease risk in older adults. We’re looking at the data in this month’s issue, but it’s important to keep in mind that previous studies have suggested that napping may lower cardiovascular risk. As we note in our article, it’s likely that naps are harmless and that the links seen in these studies are related to poor sleep at night. I’m generally in favor of naps—as long as they are fairly short and scheduled early in the day, they can help you sleep better at night because they help prevent you becoming so tired that it’s hard to relax into sleep at night.

As far as better overnight sleep, there are strategies that may help you sleep better. These include avoiding caffeinated beverages, such as coffee, in the run-up to bedtime. Limit alcohol intake too—although it may help you fall asleep, it can cause you to awaken during the night. Don’t take strenuous exercise too close to bedtime, since it may energize you instead of tire you out. Ensure that your room is cool (around 65°F is ideal) and dark, and if you “think too much” when the lights are out, keep a notepad nearby so you can jot down any concerns that are keeping you awake. Getting them out of your system may help your mind relax, but if you’re still wide awake a half-hour after lights-off, get up and read until you feel tired.

Another strategy relates to our second sleep-themed article this month. If you have OSA and your doctor has recommended you use a continuous positive airway pressure (CPAP) machine at night, it really does pay to follow your doctor’s advice. Our article has useful tips for choosing a machine and mask. I have OSA myself, and my CPAP machine has made a huge difference in how well I sleep at night. From needing to nap for several hours at the weekend due to intense fatigue, I went to waking up in the morning feeling completely refreshed. It can take a while to get used to CPAP therapy, but stick with it—it may be your first step on the road back to restful nights.

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