(This is the twenty-second in a series of health articles that are designed to help you gain a deeper appreciation for God’s amazing handiwork of the human body and a better understanding of how it works and how it can be better maintained by simple methods. George McDaniel is my father-in-law, and has been a registered nurse for many years, which, along with much research, has taught him many useful health principles. I pray that you are being blessed by these articles. Editor)
Rest – Part 3
According to the National Sleep Foundation (NSF) 2001 Sleep in America poll, 63% of adults do not get the recommended eight hours of sleep needed for good health, safety and optimum performance. While the NSF poll reports that Americans spend less time sleeping and more time working, that isn’t the only reason why sleepless nights strike as we grow older. The fact is, middle-aged and elderly people tend to spend less time in deeper sleep than younger people. By age 60 or 70 many adults experience a decline in the amount of time spent in the deepest sleep, called delta sleep.
Also, older people are more likely to suffer age-related medical problems that may disrupt sleep and specific sleep disorders that delay, shorten or interrupt sleep. Some of these disorders include arthritis, osteoporosis, heartburn, back pain, cancer, Parkinson’s disease, Alzheimer’s disease, incontinence, snoring and sleep apnea.
Another thing that can keep one awake is a decline in the level of certain hormones, particularly melatonin. Melatonin is made by the pineal gland, which is located in the brain to the rear of the hypothalamus. It has many nerve connections to the retina in the eye. Exposure to bright light during the day, particularly before noon, sets the stage for release of melatonin at night. Melatonin is not released until it gets dark, but exposure to bright light earlier in the day stimulates its production. The pineal gland often becomes calcified in later life, which may be another reason why older people have difficulty sleeping.
The reason why exposure to bright light early in the day is more beneficial than later in the day is due to the following fact: Located at the top of the retina is a small speck of a protein substance called melanopsin. When bright light strikes the melanopsin it resets the body clock. This happens every day. People who spend all their time under artificial light, or for any other reason don’t get the early morning light exposure, can suffer from more than just difficulty sleeping. The basic biorhythms of the body can be altered and can result in sickness and premature death.
Studies show that older people, who have a low melatonin level and have sleep problems, sleep better if they take a melatonin supplement at bedtime. It has been found that 1 mg. of melatonin taken in the evening improves all aspects of sleep. The most common available dosage is 3 mg. per tablet or capsule. The larger amount doesn’t work as well for some people.
In a study in Israel, 34 older people who were taking benzodiazepine sleeping pills agreed to taper off or stop taking the benzodiazapines and substitute melatonin for it. In six months, of the 24 people who completed the program by stopping the benzodiazepines and taking melatonin, 19 maintained good sleep. Melatonin also helped in a study done with blind people, who often have sleep problems because they can’t partake of the daily cycles of light and dark that regulate the body’s biological clock. Most of the participants of this study experienced normal sleep patterns with melatonin. Melatonin, as with other hormones, has more than one function. It improves gastrointestinal function, reduces the incidence and severity of gastric ulcers, improves immune function, and many other things.
Before anyone begins taking melatonin supplements, it would be better to try natural methods to increase one’s own production of melatonin. This would include several hours daily of exposure to bright outdoor sunlight, particularly in the first half of the day. Don’t sit in front of a TV or computer screen late in the evening. It would be good to omit this completely for at least two hours before bedtime. Also, make sure the sleeping room is completely dark. Even a very small amount of light can interrupt the production of melatonin.
Another hormone problem that can cause insomnia is the decrease in estrogen and progesterone in women at menopause, occurring approximately from ages 45 to 60. During the perimenopause, menopause and postmenopausal time the decrease in hormone levels can cause insomnia, lighter sleep, poor quality of sleep and frequent nocturnal awakening. Night sweats associated with perimenopause and menopause can cause sleep problems, too. It can result in women missing enough of the most restful, deep state of sleep. There are therapies for this. Anyone who needs them should consult with an experienced practitioner to determine the best approach.
Listed below are some suggestions to help improve the quality of your sleep:
- Be sure the bedroom is totally dark. Even a little light from a street or yard light, or the moon, can be a negative influence. Cover or remove electric clocks, telephones that glow, or any other device that emits light.
- Avoid caffeine. If you do use it, don’t take it for at least three hours prior to bedtime.
- Avoid alcohol. As with caffeine, if you use it, don’t take it for at least three hours before bedtime. Alcohol interrupts sleep patterns.
- Don’t watch TV or use the computer for at least two hours before bedtime.
- Don’t eat a protein meal before going to bed. If you must have a snack, limit it to a light snack of complex carbohydrates. It is better to sleep on an empty stomach. The process of digestion requires the use of a lot of energy, which interferes with sound sleep. Of course, if you have a medical need for a bedtime snack, then it is best to follow the doctor’s orders. (This brings up the subject of hypoglycemia, diabetes, and insulin resistance, which needs to be covered in another article.)
- Try to maintain a regular bedtime and regular awakening.
- Keep the temperature of the bedroom comfortable. In winter a humidifier may be necessary.
- Be sure you have a comfortable pillow and mattress. Try to sleep on your side rather than on your back or abdomen.
- Exercise regularly. Even walking 30 to 45 minutes three times a week may help to improve deep, slow wave sleep. People who exercise have fewer awakenings, fall asleep faster and spend more time in deep sleep.
- If you need help getting to or staying asleep, use only natural, herbal sleep aids. Do not use prescription or over-the-counter remedies. These often cause liver or kidney damage and may become habit forming. Some herbs that have been found useful for aiding sleep are: chamomile, valerian, passion flower, lemon balm and hops.
- Listening to relaxing music can sometimes relax one enough to go to sleep.
- Sleep is also improved by psychological arousal during the day because it helps one to stay up long enough to build up sufficient sleep debt, making sleep more efficient and facilitating relaxation at the end of the day. It is particularly beneficial to remain socially active or to seek out exciting activities in old age. If life is dull, one tends to sleep longer (if one can), go to bed earlier and take more naps than needed during the day. Naps are not always bad. If naps are scheduled into the day as part of the normal sleep pattern, and one takes care not to rid himself of too much sleep debt, a short nap can improve alertness without decreasing the day’s total sleep debt much. In other words, a short nap can keep one feeling good without keeping him from falling asleep at night.
As one gets older, sleep health, like other aspects of one’s health, requires more attention and work. One can’t just assume any longer that he will fall asleep at the end of the day and stay asleep. As one gets older, he has to watch what he eats and get the right kind of exercise. One also has to manage his sleep. This means planning how to accumulate and pay off sleep debt; sleeping enough to enjoy a vital day, but not sleeping so much that it is hard to fall asleep at night.
If one fails to get the sleep he needs, he may end up decreasing memory, impairing immune functions, disabling mood and squeezing the fun out of life. Age-related sleep disorders are not normal if something can be done about them.