Why is it harder to sleep when you get older?
Poor Sleep and Health Risks
For Smith and countless other seniors — people ages 60 and above — sleep disruptions associated with the pandemic are putting them at risk for an array of health problems, says Dr. Marri Horvat, a physician with the Sleep Disorders Center at Cleveland Clinic in Ohio.
Health problems associated with poor sleep include:
— Anxiety.
— Depression.
— Poor cognitive function, including problems with concentration, focus, and memory.
— Fatigue.
— Weight gain and obesity.
— Sleep apnea, a sleep disorder in which an individual’s breathing stops and starts while sleeping.
Sleep apnea, in turn, is associated with:
— Elevated risk for cardiovascular problems.
— High blood pressure.
— Stroke.
— Type 2 diabetes.
To treat sleep apnea, physicians typically prescribe patients a CPAP mask, which stands for continuous positive airway pressure mask. A CPAP machine sends a flow of pressurized air into the person’s mouth and nose as she her he sleeps. This helps keep the individual’s airways open to allow normal breathing.
Strategies for Better Sleep
While the pandemic has increased the prevalence of poor sleep among older adults, there are effective strategies that seniors can adopt to improve their sleep hygiene, Horvat says. Sleep hygiene refers to maintaining both daily routines and a bedroom environment that promotes consistent quality sleep.
Here are seven strategies people can adopt to improve their sleep quality and overall health:
— Avoid alcohol, caffeine, and nicotine for four to six hours before you go to bed.
— Use your bed only for sleep, intimacy, or sickness.
— Make sure you have the right mattress.
— Keep the bedroom dark.
— Have a “wind down” period each night before bedtime.
— Try yoga postures for loosening up the body before bedtime.
— Practice yogic breathing.
Avoid alcohol, caffeine, and nicotine for four to six hours before you go to bed
Not only does alcohol affect aging, but consuming alcohol — especially in excess — has been linked to poor sleep quality and duration. according to a paper published in 2022 by the Sleep Foundation. A normal sleep pattern includes four distinct stages. Consuming alcohol before bedtime could have a suppressive effect on REM sleep during the first two sleep cycles, which can diminish overall sleep quality, according to the paper. Dreams typically occur during REM sleep, which is restorative and important for cognition, learning, and memory.
Regarding caffeine, research published in the journal Sleep Medicine Reviews in 2017 suggests that caffeine “typically prolonged sleep latency, reduced total sleep time and sleep efficiency, and worsened perceived sleep quality.” Caffeine stimulates the central nervous system, which can create a rush of energy. It quickly boosts alertness in the brain. These effects can be detrimental to getting good sleep.
As for nicotine’s effect on sleep, research published in the journal Nicotine & Tobacco Research in 2016 suggests an association between nicotine addiction and disrupted sleep, says Steven A. Branstetter, an associate professor of behavioral health at Penn State University and a co-author of the study. Researchers found that one key marker of nicotine addiction — the tendency to smoke soon after waking, usually accompanied by waking earlier in the morning than desired — may be a key factor in the overall disruption of sleep in smokers, he says.
Use your bed only for sleep, intimacy, or sickness
Often, spending too much time in a bed outside of these reasons can lead to difficulty falling and/or staying asleep, Horvat says. “The more time you spend in bed watching television, playing on your phone, tossing and turning while trying to fall asleep and worrying, the more it morphs your bed into a cue for wakefulness rather than for sleep,” Horvat says. “Over time, pairing your bed with these sleep-disruptive behaviors can worsen your ability to fall and/or stay asleep.”
Make sure you have the right mattress
Using the right mattress can improve your sleep, and choosing the right one is a highly individual decision. In general, medium-firm mattresses are a good choice for many older adults. That’s because the medium firm is the minimum standard for good spine alignment and comfort. Before settling on a mattress, try various models with different levels of firmness. You can also try memory foam toppers, which go on top of a mattress, for additional comfort.
Keep the bedroom dark
Keeping your bedroom dark and free of white light from electronic devices helps promote good sleep, says Dr. Savitha Elam-Kootil, a board-certified sleep medicine expert and internist at Kaiser Permanente in Atlanta. If you need some dim light, an amber light is better than white light or blue light.
“White or blue light interferes with the secretion of the sleep hormone melatonin, more than amber light, which in turn affects sleep onset,” she says.
Adding blackout liners to your bedroom curtains can be helpful.
Have a “wind down” period each night before bedtime
Having a designated time every night to review your day and go over what you could and couldn’t control can be part of a relaxation practice that helps with sleep, Elam-Kootil says.
“Assure yourself that you did what you could for that moment to the best of your ability and hence you can’t ask yourself for more,” she adds. “Assure yourself that you deserve your rest because you need to be charged to similarly give your best for the next day.”
Relaxation practices can help your mind from feeling overly busy. Like a laptop with dozens of open tabs, Elam-Kootil explains to patients that mindfulness practices can help “close open tabs and pop-ups in their mind space,” which can prevent them from falling and staying asleep.
Try yoga postures for loosening up the body before bedtime
Practicing yoga can improve the sleep of older people with insomnia, research published in the journal Alternative Therapies in Health Medicine in 2014 suggests. Research published in the Indian Journal of Psychiatry in 2013 suggests that yoga improved the sleep and the quality of life of 120 older people in nine elderly group homes.
Elam-Kootil — who serves on the advisory board for MyYogaTeacher, an online yoga platform — recommends yoga nidra, a guided meditation practice that can lead to a kind of “yogic sleep” or state of deep restfulness, in which you have an awareness of relaxation. This is easy to practice at home via online courses or audio recordings.
“It helps people to sleep seven to nine hours daily,” Elam-Kootil says.
She recommends these three yoga poses:
— Child’s pose. You kneel on the yoga mat, bend forward and rest your torso on your thighs while extending your arms straight forward. Allow your forehead and hands to gently touch the mat. Hold the pose for one to two minutes.
— Butterfly pose. In this pose, you sit quasi-cross-legged but allow the soles of your feet to face and touch each other. For a minute, flutter your knees up and down so that your legs open like the wings of a butterfly.
— Supported wall stand. In this pose, you lie down on your back with your buttocks touching the wall while elongating your legs up the wall, perpendicular to your body, for one to two minutes.
Marlene Smith, the North Carolina retiree, initially began taking online yoga classes from MyYogaTeacher a few months into the pandemic to help alleviate her knee pain, but she discovered that practicing yoga daily and taking nighttime meditation courses have improved her sleep and overall health.
“Since starting meditation, I’ve been able to sleep better and get up bright-eyed and ready to go,” Smith says. “My quality of life has improved 100%.”
Practice yogic breathing
Yogic breathing, which is known as pranayama in Sanskrit, can help relax the body and mind by stimulating the parasympathetic nervous system.
“(This) counters and balances the sympathetic nervous system, which is in overdrive in people with insomnia,” Elam-Kootil says.
Elam-Kootil recommends these breathing techniques:
— Bhramari pranayama. This is a breathing technique in which you hum like a bee when you exhale. “It releases cerebral tension and helps to lower blood pressure and relax the central nervous system,” Elam-Kootil says. “I recommend practicing humming only while sitting upright, not while lying down, and repeat a few times.”
— Anuloma viloma pranayama, or alternate nostril breathing. This practice helps to balance the left and right sides of the brain, Elam-Kootil says. Slowly inhale through the left nostril, using the thumb of the right hand to keep the right nostril plugged. Hold your breath for five seconds while the right nostril remains plugged, then simultaneously release the right thumb and plug the left nostril with your right ring finger so you can slowly exhale through the right nostril. Repeat the slow inhale through the right nostril while using the right ring finger to keep the left nostril closed, holding the breath for several seconds. Then, slowly exhale via the left nostril by releasing the ring finger and using the right thumb to keep the right nostril closed. Repeat this pattern two to five times.