8 Ways for Seniors to Sleep Better Tonight

aging ruins your sleep but the good news is there is something that you can do about it so in this video I'm going to walk you through the specific things that you should do to get a great night's sleep as we all get older hey everyone Dr Michael Bruce the sleep doctor here a few weeks ago I released a video on how aging negatively impacts your sleep and a lot of you asked the question about what can you actually do about it so I thought I would discuss the three of my main sources of sleep problems that I see in people who age and and what you could do about it on this video here from my house now the reason your sleep gets worse as you age is usually the result of several different factors but they seem to fall into three main categories one is your habits the next is your biology and then the third are some possible medical issues that can be available and don't forget it could be habits before bed during the day during the night you never quite know let's start by talking about something that happens with most people as they age which is Tech technically called phase advancement but what I call Grandma and Grandpa want to eat dinner at 4:30 that's because their melatonin production has advanced meaning it's happening earlier in the time frame that it usually happens so there's their tummies are rumbling because they think it's actually later than it is this happens very very frequently in fact in most people it seems to happen um and it's supposed to happen the signs and symptoms of this phase advancement usually tend to be things like people are getting up a little bit earlier they can perform tasks uh a little bit better in the morning they start to get really sleepy later in the afternoon or may even fall asleep uh on the couch type of thing remember this is due to a change in melatonin as we age there is a physical slowdown of melatonin production for many people once they hit age 55 and above um so that in that particular situation it might make sense to take a melatonin supplement to help boost your production now I want to be clear about this um not everybody out there needs a melatone supplement you would want to talk with your doctor see if you have some of these symptoms and if you do then you would want to start at a very low dose of Melatonin like a half of a milligram and see take it about 90 minutes before you wanted to go to bed and see if that could be helpful for you because the reason that you're wanting to eat earlier and go to bed earlier is because your melatonin is actually turning on too early so by taking this pill a little bit later at night you can teach your system to do a little bit later what this also represents for folks out there who've taken my Chrono quiz is what we call Chrono longevity for example if you were a bear you might turn into a lion for example or if you're a person who isn't an early bird or a night owl you might turn into an early bird those are the type of things that we see happening so remember as you age your circadian rhythms will shift later but to understand your circadian rhythm it will help you to know when you're at your most productive during the day and when to go to bed to get the best quality sleep s over at sleep.com we have the quiz that can help you determine your chronotype so it's a wonderful tool that I've designed to give you practical tips for getting your best sleep and being your best throughout your day now let's talk about some of those habits uh that we all have a tendency to have as we get older that unfortunately we really haven't dropped I got to hit the big one hard it's caffeine right so one of the things that a lot of people don't really think about especially if you've been a caffeine Drinker for a significant period of time is simply it doesn't have as big an effect on you anymore so you keep loading it on but just because you don't feel the effect does not mean that it is not affecting your biology um there have been a lot of studies to report that we are more sensitive to caffeine internally as we age and another study indicated that adults over 65 take 33% longer to metabolize caffeine so you really should be slowing down or stopping much earlier in the daytime and a lot of people from a habitual standpoint they like to order coffee with their meal right and so if you're having dinner at 5:00 or 4:30 and you have a cup of coffee it's not only taking you 33% longer to get that out of your system but it's certainly going to affect your sleep okay Dr Bruce you've you've convinced me what do I do about it so there's a technique called caffeine fading now I'll be honest with you I used to be at one point in time a fairly not heavy coffee drinker but I would say I might have three maybe four in a day type of thing uh and and so what I decided to do was a technique called caffeine fading so you take your last cup of caffeine for the day and you make it half caffeinated and half Decap you do that for one week then you have that last cup and it's completely Deca for one week and you start moving yourself so each week you basically remove a cup a half a cup of caffeinated coffee and add a half a cup of decaffeinated coffee you still get your coffee you still have the ritual you still have all the taste you still have all the smells but what you don't have is a problem with caffeine later on another big activity that a lot of us do as we get older is we have a little bit more time on our hands or maybe we're not as stressed so guess what we take what I call unscheduled naps so it it's not it's not because we want to it's just because maybe we're bored or hanging out but we will experience a natural small temperature increase between 1 and 300 p.m. in the afternoon when that happens it's a signal to our brain to release a little itty bitty teeny tiny bit of melatonin so this is the reason why everybody between one and three have a tendency to get sleepy but if you're inactive let's say that you're a senior and you've already had your walk for the day and it's 2 o'clock in the afternoon and you're sitting on the couch watching TV you have a very high chance of taking a nap what happens if you take a nap well remember there's two systems in the brain for Sleep one is called Sleep Drive the other is called Sleep Rhythm if you nap you will actually have an effect on both sleep drive and potentially sleep Rhythm so if at all possible what you really want to do is avoid the nap now between 1 and three your body is going to naturally get sleepy but if you can just go outside and get some direct sunlight that actually turns off the Melatonin faucet in your brain and really makes for a much better afternoon I'm going to digress for a second and tell you a story about a patient of mine um 63 63y old male um and um he would religiously take a nap after lunch but here's what was interesting is his nap would sometime last for an hour 2 hours something like that so one of the things that we always wonder about when people are napping a lot during the day is are they getting good sleep quality at night so one of the things that I had him do was do a home sleep test and guess what he had a mild form of sleep apnea that none of us had really thought about or detected because he didn't have a lot of symptoms other than the napping and once we're able to figure that out we fix his apne at night no longer a need for nap during the daytime much more active and be able to do what he wants to do by the way I am a big fan of naps but you've got to do them correctly so go over to my YouTube channel it is filled with great advice on things like getting the best naps setting up the best bedtime routine even how to get the right supplements for your sleep I publish anywhere from one to two videos a week so be sure to hit the Subscribe button so you can get notified whenever a new video arrives next we're going to go from Habits to biology what biologically speaking could be affecting your ability to sleep as we get older well one of the big things is there's a natural increase in EEG which is brain wave arousals as we age I I mentioned it in one of my last videos the one I was talking about earlier but remember sleep becomes what we call fragmented as we age so we basically go from Wake to stage one to stage two to wake up stage one to stage two to wake up and we start to miss out on some of that deep restorative refreshing sleep that slow wave sleep really has a tendency to decrease also what we see is our proportion of stage one increases got to be honest with you stage one doesn't do a whole lot stage three and four or slow wave sleep that's the physically restorative sleep that we're looking for so one of the things that we always want to do is be aware that just naturally our brain is not going to have nearly as much oomph or power as it would have when we were younger so there's some things that we can do about it also I wanted to let you know that the American Academy of sleep medicine has found that these aging changes are so proficient we actually change the way we score sleep studies based on your age so if you're 55 plus like me guess what we're going to actually score your study a little bit differently because the biological changes are so prevalent all right now what do you do about it well the big thing to do you can't change your biology right is to limit the environmental impacts that could make your Awakenings worse such as well number one you don't need any light in the room so if you can keep the lights as low as possible still have a nightlight if you need to get up to use the restroom I don't want you to fall in the complete darkness if you can keep your room nice and chilly but not don't make it so cold that you need to put on your winter coat to go to bed if you can block out as much noise as possible that seems to work well uh for most elderly patients I'll be honest with you as I'm getting older my hearing is not so great so the noise doesn't seem to bother me nearly as much another biggie that a lot of people really don't think about is consider replacing your mattress um I was surprised when I did this I actually discovered that a lot of older people have been sleeping on their mattress for a very long time and here's the thing as we get older our physical bodies change much more rapidly so if let's say you waited I don't know 7 8 n years before you got a mat in your 20s that was probably okay but in our 50s got to be honest with you you can't wait that long I don't know about you guys but I wake up with I think a new pain or ache every month or so um and so trying to to you know kind of mitigate that and understand it is going to be important if you have not replaced your mattress in I'd say probably six to seven years it's probably a really good idea to look at that because that could have a major impact on your ability to stay asleep remember your biology is keeping you in a lighter stage of of sleep if you've got a crappy mattress it's just going to keep waking you up and waking you up what I tell people all the time is you want to look for something that has a lot of cushion and a lot of pressure relief personally I also like for my seniors to have really good Edge support because personally I sit on the edge of my bed when I wake up in the morning to kind of Catch My Breath and kind of get oriented I know a lot of people my age do and we don't want people to slip off the end of the bed so do yourself that favor you want something with Edge support you want something with really good comfort as well as some extra support in the center another thing that disrupts sleep as we age is the prevalence of yeah you guessed it medical conditions honestly some of the most interesting and most prevalent common medical issues in the Aging population are things like high blood pressure nearly 60% diabetes 27% depression 16% dementia 12% obesity now at 42% these all of these medical issues do have potential effects on your sleep obesity as an example could be leading to snoring and sleep apnea which will bring you into a lighter stage of sleep so when you think about medical issues and and I've listed quite a few the goal here is to get the medical issue treated first because in many cases that's primary and the Sleep Disorder could be secondary and potentially go away even if you don't have one of the medical disorders that I just discussed what if of course you could have an undiagnosed sleep disorder I mean that's certainly a possibility as we get older we certainly see a lot of this occurring specifically we see a lot of obstructive sleep apnea which is caused by that narrowing of our Airway in our throat which usually leads to disrupted breathing throughout the night snoring is One symptom of sleep apnea but don't forget sleep apnea can lead to gasping and choking in the middle of the night again fragmenting your sleep making you wake up to breathe the current biggest best treatment so far is something called a seap machine these are considered to be the gold standards primarily because they seem to um work about 99% % of the time uh but they're not so much fun to wear sometimes many people get used to it but then sometimes people will need an oral appliance which is like a mouth guard which replaces CPAP there are quite a few different things out there so I don't want people to get discouraged and say h got to go get a sleep study I know they're going to stick a seap on me I certainly don't want that don't worry so much let's figure out what's going on to make you have these sleep disruptions and then we can figure out what what might save them other uh Sleep disorders that I have a tendency to see in many of my senior population which is the one I'm entering into quickly is restless leg syndrome and something called periodic limb movements of sleep so restless leg syndrome is this weird as soon as you lie down you get this creepy crawly feeling on your legs and the only thing that makes it go away is if you get up and you walk around if you get up and you walk around and it doesn't go away that's probably peripheral neuropathy and something you should talk with your neurologist about but if it does get up and go away it's probably restless leg syndrome now here's what's interesting about restless leg syndrome is often times that's a preed thing so when you're lying down and still awake it occurs but it can cause significant insomnia and cause significant sleep disruptions it sort of has a cousin or maybe a a sibling called periodic limb movements of sleep now periodic limb movements is where your legs twitch like this all night long or your arms twitch or something like that you'd think it wouldn't be that big of a deal but in fact it actually moves you from a deeper stage of sleep to a lighter stage of sleep once again as we get older we're already in lighter stages of sleep so we really don't need to get any lighter so if your bed partner has noticed this kicking of the covers all night long or something along those lines it's probably a sign that you may have periodic limb movements or restless leg syndrome unfortunately there's no specific cure for restless legs and periodic limb movements but assessing some of the underlying factors can actually help uh mitigate some of the problems we would look at your current medications we would check your iron levels make sure that you're getting enough exercise and movement throughout the day which as we get older can sometimes be difficult older people have a tendency to take a lot of medications for other medical situations and those medications could include things like anti-depressants antihistamines anticho all of these can make sleep worse and a lot of times the doctors are so focused on one area like depression that they're not necessarily looking at sleep now I want to be clear clear I'm not here to make a distinction between depression and sleep but what I can say is there are some anti-depressants that are very stimulating uh I had one patient where we asked their doctor if we could remove the uh the medication which was called Wellbutrin from a nighttime dosage to a morning dose and as soon as we did that magically they were able to fall back to sleep so it's not so much getting off the medications but understanding the medications that you're on to be able to see if they're making your sleep quality any worse and if they are maybe you change the dosage timing maybe you change the dose maybe you change the med I want to be super clear though you don't do this you do this with a permission of your doctor and under your doctor's care um it's really important for people to understand that because people should not just be changing the dosage or the timing of their medication without letting their prescribing physician know now I want to talk about insomnia because it's something I hear very often from my patients uh I was recently reading a study that indicated that 550% of older adults report some symptoms of insomnia like trouble falling asleep or staying asleep daytime sleepiness other factors like irritability memory issues things like magnesium and melatonin supplements have been found to be somewhat helpful but I want to be clear here if you feel like you've got insomnia it's probably makes a lot of sense to come see a sleep specialist like myself or a gerontologist somebody who works with people in that age range because it definitely seems to um help those folks out at night magnesium a lot of people ask me questions about there's one study to show that magnesium seems to help elderly people with a magnesium deficiency who have insomnia so if you think you fall into that category it might make sense also melatonin can be helpful but again the dosage here and the timing is very very important also many people don't know this but melatonin affects medication let me repeat that melatonin affects medication it affects FS anti-depressants hypertensives uh it affects even antis psychotics so one of the things to remember is if you're going to start melatonin tell your doctors because they need to know and understand because it could have a pretty big effect on them um as we've seen there are very real biological factors that are going to change as we age but there are also some pretty complicated medical issues that all of us elderly uh complicate our sleep right so one thing you might not be thinking about is your medication list um a lot of people don't even know that many of the migraine medications have caffeine even some of the medications for central nervous system like benzodiazapines anti-seizure meds um also cardiac medications like beta blockers and even pulmonary medications like theophine all of these can be so stimulating that they can have a big effect on your sleep so if you start a medication or your doctor starts you on a medication and all of a sudden you notice that your sleep is disrupted tell them like call them up and say hey my sleep is really messed up is there anything that we can do nine times out of 10 they've heard this before and they've got an idea or something that will make intuitive sense for you to be able to hopefully mitigate that situation my Elder patients have also found a I found that they take a lot of supplements over the- counter sleep aids and things like that but I'm going to be very clear about something okay there are a lot of elderly out there that have historically said you know what Dr Bruce I take one of those PM medications Tylenol PM Advil PM whatever the PM is actually bened um that's all it is it's called dyen hydramine and it is what's called an anti-cholinergic medication there is now data to suggest and this has been around for a while that daily use of these PMs can absolutely lead to dementia so this is not something to be playing with if you are consistently using an OTC sleep aid I would say you probably want to talk to your doctor and find out number one could you be a candidate for maybe cognitive behavioral therapy which has been shown to be more effective than sleep aids or could you maybe need an actual prescription because your situation is temporary or time time constraint there are a lot of different ways that you can go about doing this so I don't want you to think hey it's either supplements or I'm on the heavy drugs but you really want to talk to your to your uh prescribing physician because a lot of these otc's can be more dangerous than you think while OTC sleep aids work only in the short term you can actually have more long-term success by taking vitamins and sub sometimes supplements one that I recommend to a lot of my aging patients is vitamin d as in dog now there's a lot to consider before taking any supplements so I want you to check out the video on vitamin D right here that we've got next because I take my vitamin D every single day taking it can not only improve your sleep as your age but there are some great benefits for your daytime as well this is Dr Michael Bruce the sleep doctor and I'm excited to have given you hopefully some great solutions for sleep as you age

Channel: Sleep Doctor

Views: 316,590

Keywords: TSD, The Sleep Doctor, Dr. Michael J. Breus, Sleep Medicine, age, aging, aging gracefully, geriatric care, sleep issues, aging issues, old age, sleep tips, how to sleep better, how to sleep better at night, fall asleep fast

Id: _bGHaWnr4Vo

Length: 19min 55sec (1195 seconds)

Published: Wed Jun 05 2024