independent

Sunday 20 April 2014

The good sleep guide

Our sleep patterns change as we grow older. Photo: Getty Images.
Our sleep patterns change as we grow older. Photo: Getty Images.

It is no secret that our sleep patterns change as we grow older. Where once we might have enjoyed an unbroken eight hours every night, now we may wake intermittently, compensating with a little light napping during the day. Or, for the first time in our lives, we may have difficulty nodding off in the first place, our brains ticking over as we lie gazing at the ceiling.

Why ageing should affect sleep is unclear, though several theories exist. For some, the factors may be entirely physiological – our bodies have changed and, so, our relationship with rest has altered too. But lifestyle can have an impact as well – in retirement we may be more inclined towards a lie-in (not recommended by sleep experts). Or perhaps we are taking medication that interferes with the body's rhythms. In this respect everybody is different.

"We need sleep to maintain good health," says Dr Elaine Purcell of the Mater Hospital Sleep Disorder Clinic. "With age there is a general trend of sleep deteriorating, becoming more fragmented. You may have more awakenings at night, which can lead to napping in the day. Partly this is physical, partly behavioural.

"For instance, during their working life a person may have had a set routine of getting up at the same time every morning. After they retire, the routine can start to slip. They sleep in but may continue to go to bed at the same time. They grow frustrated that they cannot sleep. If they had the stuck with their life-long habits, matters would not have deteriorated. This is what we call 'sleep hygiene'. It is important that we try to maintain healthy practices.

"We all have a natural body clock. Some of us tend to be night owls. Others are morning larks. As we age, people veer towards morning lark. People can wake quite early. They may feel dissatisfied - (growing tired) in the evening may limit their ability to socialise. They often feel isolated."

The good news is you do not have to completely restructure your life. Here are some straightforward tips to assist with a decent night's rest.

1. Have a schedule

As with everything in life, your sleep will benefit if you set out a schedule and stick to it. Your body has a sleep-wake cycle that functions better with a consistent regime. This means going to bed and getting up at the same time – including weekends and holidays. Lie-ins and unusually late nights are to be avoided, as far as possible.

"There different types of sleep – the very deep sleep, called Rapid Eye Movement Sleep, is the kind we find restorative and refreshing," says Dr Purcell. "If you have a late night you may miss out on it."

2. Try to avoid eating late

A big meal before bedtime is not recommended, as you may feel bloated and have difficulty dropping off (in addition, by lying down, you making it more difficult for the acids in your stomach to break down the food). By the same token, don't go to bed hungry – the pangs will surely keep you awake. If you do need to eat, bananas and turkey slices are a good evening snack – they contain the amino acid called tryptophan. This assists the body in making the calming hormone serotonin.

"A heavy dinner might delay your ability to sleep," says Dr Purcell. "The general advice is to avoid eating for three hours before bedtime."

3. Coffee before bedtime is out – and so is tea

"We know caffeine can impact sleep," says Dr Purcell. "Even if the person does fall asleep,the presence of caffeine can reduce the depth and, thus, the quality of rest."

Unfortunately, tea contains almost as much caffeine as coffee – and so must be avoided just as strictly.

"The problem is that it takes about 12 hours to break down half the caffeine," she says. "So if you have a breakfast cup of tea, half of the caffeine will still be in your system by 9pm."

She recommends caffeine-free alternatives – "herbal tea, camomile, ginger tea . . . anything like that".

4. Say no to bedtime tipples

Alcohol may assist in nodding off. However, the quality of your sleep will be impaired and you may wake insufficiently refreshed.

"If people are not working they can fall into bad habits and have lots of night-caps," says Dr Purcell. "When alcohol is broken down by the liver, it turns into a stimulant. This interferes with REM sleep – so you will have less of that very important 'dreaming' sleep".

5. No napping

Who doesn't enjoy a quick post-luncheon rest? But by giving in to temptation you may enhance the risk of a sleepless night.

"It is a myth that people can do with less sleep as they grow older," says Dr Purcell. "Older people tend to sleep less well because they may be having cat-naps during the day. The goal is to sleep well at night so as to not require a nap."

6. Observe a bedtime ritual

Our bodies crave routine. If you observe a 'ritual' every night it will tell your brain that it is approaching shutdown time, thus making sleep easier. You might take a bath, listen to music or read a book.

7. But don't watch TV – or surf the net on your iPad

Staring at a screen stimulates the brain – thus interfering with the subtle mechanisms that induce sleep. This doesn't simply apply to staying up past midnight watching 'Apocalypse Now' in surround sound. An activity as innocuous as checking your email in bed can fire up your brain's neurons, so that they are still tingling when the lights are off and you're waiting to fall into a comfortable slumber.

8. Ensure you are comfortable

The smallest irritant can spoil our sleep. So check there are no creaky doors, leaking taps or uncomfortable bed-springs. In addition, ensure you are somewhere dark, quiet and of moderate temperature. Consider ear-plugs or shades to deal with background noise or light sources. And if you believe deficiencies in your mattress or pillow may be obstructing sleep, dispose of them – decent repose is more than worth the price of a replacement.

9. Make Sure You Are Tired

While a routine is essential, it's important you don't go to bed before you are good and ready. As a rule if it takes more than 20 minutes to nod off something is amiss. Rather than lying there tossing in frustration, get up, read a book, go to another room. Wait until tiredness is washing over you – your body's way of telling you it's time for some Zs.

10. Speak to your doctor about medication

"People can be prescribed a lot of medications as they get older," says Dr Purcell. "This is known as 'polypharmacy'. They are seeing different specialists who may not pay close attention (to the other medications the person is taking). These can interact and lead to day-time sleepiness. If you are nodding off, it may take away from night time sleep. Another side effect might be indigestion at night. If any of this makes you uncomfortable, bring it up with your prescribing doctor."

Irish Independent

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