“About 50 to 70 million Americans have sleep disorders, and 1 in 3 adults do not regularly get the recommended amount of uninterrupted sleep they need to protect their health.”
National Institutes of Health
Eat well, move well, and be well are three pillars of Food & Fitness After 50.
This blog contains loads of information on eating well and moving well, but today’s post is about being well. Specifically, about sleep. This topic came up at my 8 am exercise class and a common lament was poor sleep.
I’ve been up since 4 o’clock because I couldn’t fall back to sleep.
I feel like a never get a good night’s sleep anymore.
I fall asleep quickly but can’t stay asleep.
If this sounds familiar you are not alone.
Couple the above quoted statistic from the NIH with COVID-19 and the sleep problems mount. A recent paper found the prevalence of sleep problems was high during the pandemic and affected about 40% of people in the general population.
Aging brings challenges to restorative sleep, too. Sleep time shortens and sleep patterns become more disturbed resulting in more time spent awake during the night and a harder time falling back to sleep. Reasons for this are not entirely clear, but most likely related to declining hormone levels and changes to our usual 24-hour rhythm.
Decreased testosterone in men and estrogen in women may influence sleep. As estrogen levels fall during the transition to menopause, 40 to 60% of women report trouble falling and staying asleep. And hot flashes also contribute to fragmented sleep. For some women, hot flashes affect sleep long after menopause.
Changes to our 24-hour master clock within the brain, called the superchiasmatic nucleus (SCN), also gets dysregulated with aging and with our modern lifestyles. In his fascinating book, Why We Sleep, Matthew Walker, professor of neuroscience at UC Berkeley, explains light, whether from the TV screen or LED-powdered smart phones, can fool the SCN into believing the sun hasn’t yet set. This suppresses the release of the hormone melatonin from tiny pinhead sized glands that sense daylight and begin the 24-hour cycle of wake/sleep. Melatonin increases as light exposure decreases and decreases when light levels increase. And melatonin naturally declines with age. (More on melatonin supplements in a bit!)
Remember, that not just waning hormones and night-time light exposure affect our sleep. Medications, whether prescription, over-the-counter drugs, or dietary supplements can all impact sleep. Forty percent of those of us over 65 take 5 or more medications. Common medications for blood pressure, heart disease, benign prostatic hypertrophy (BPH), allergies, and asthma can affect sleep, as well as corticosteroids and anti-depressants. The over-the-counter allergy and cold medicines that say, “non-drowsy” may be good for daytime alertness but can negatively affect sleep. Some dietary supplements can also affect sleep. CoQ10, St. John’s Wort, and red yeast rice have all been reported as causing poor sleep.
Don’t forget caffeine, the most widely consumed drug in the world! Some people notice more caffeine-sensitivity as they age and by now you probably know whether you are one of those people. Check your medications for caffeine (some headache remedies contain the drug) and don’t think coffee is the only beverage with caffeine. Tea and cocoa contain caffeine as do some foods. I switched to drinking decaf tea or herbal tea in the evening to avoid excess caffeine…I am definitely one of those caffeine-sensitive folks.
What can we do for better sleep? There isn’t one answer that will work for all people, but these tips can help you get the sleep you need.
Eating and Drinking
- We’ve already mentioned caffeine in coffee, tea, and some medications, but caffeine is also found in soft drinks, and not just colas. Lemon-lime, orange, and root beer drinks can also contain caffeine. Coffee-flavored ice cream and yogurt contain caffeine, as does anything with chocolate. Caffeine is a drug, so food and beverage makers do not have to list caffeine on the nutrition label. You will have to dig for information from manufacturer’s websites or nutrient-databases.
- Avoid energy drinks or shots. As the name implies, “energy” keeps you awake, and the most likely culprit is caffeine.
- Alcohol is another factor for poor sleep. Alcohol might mild sedate you, but it suppresses deep sleep. A night-cap is not a good idea for a restful night.
- Don’t go to bed too hungry or too full. Both can keep you tossing and turning.
Develop a sleep routine…just like a baby!
- Take time to wind down before going to bed. That might mean a warm bath, listening to soothing music, or meditation.
- Learn to recognize when you are sleepy and only go to bed when you can no longer keep your eyes opened.
- Stick to a schedule; try to go to bed and wake up at the same time; weekends, too!
In the bedroom
- Keep it cool. In his book, Dr. Walker says 65 degrees is the ideal temperature for sleep. That might not be possible unless you want to freeze-out your partner or other family members and it certainly isn’t good for your power bill, but keeping the room cool with a fan can help.
- Speaking of fans, the noise of a fan can also help with sleep. A white-noise machine helps some people, but for others, a fan does the trick.
- Keep it dark. Constant light from bedside clocks, TVs LED lights, or other sources of light can affect sleep. Keep a small flashlight by your bed to use for nighttime bathroom visits instead of a night-light in your bedroom.
- Turn off the screens…tablets, laptops, smart phones…the light from the screens suppresses melatonin. If you insist on having your phone in your bedroom, turn off notifications.
- Don’t watch the clock…turn the clock face to the wall and don’t fixate on the time.
- If you cannot sleep, get out of bed and read or listen to music until you are sleepy.
- People who routinely exercise report better sleep but avoid heavy exercise in the evening.
- Exercise for at least 30 minutes each day but not later than 2 to 3 hours before bedtime.
What about melatonin? Melatonin is a hormone but is sold as a dietary supplement. Supplementing with melatonin can help you fall asleep but not necessarily help you sleep longer. If you want to try it, here are some suggestions:
- Start with a low dose, 1 to 3 milligrams.
- Take it 30 to 60 minutes before sleep; if using a liquid form, try it 20 minutes before bed.
- Small doses do not appear to affect the natural production of melatonin, but it can interact with some prescription blood pressure and anti-anxiety medications.
- Use it as needed, but not every night.
If you still can’t sleep after trying these tips, it might be time to talk to your health care provider about your sleeplessness. Check out this free guide to good sleep by clicking here.
I wish you good sleep….just like dogs and cats sleep!
Chris Rosenbloom is a registered dietitian nutritionist and nutrition professor emerita at Georgia State University. She is the co-author of Food & Fitness After 50 and publishes this blog, Fit to Eat. Follow the blog by clicking here.