Do you often wake up at night, Tips to get Sleep again
Do you often wake up at night and can’t get back to sleep, and then end up tossing and turning? Are you fatigued the next day? Worse, do you dread the thought of hitting the hay for fear of the nightly struggle to get a good night’s sleep? It is estimated that seven out of 10 adults have trouble sleeping and suffer from some form of insomnia – the inability to fall asleep or stay asleep. Women tend to report insomnia more often than men, but sleeplessness is unhealthy and disruptive in both sexes. If your sleeplessness persists for several days, you may have chronic insomnia.
How sleep patterns change with aging
Total sleep per night in your 20s: 7.5 hours Deep Sleep (Stage 3): 20% Total sleep per night in your 70s: 6.0 hours Deep Sleep (Stage 3): 9% Over a night of slumber, we cycle repeatedly through four stages of sleep: Stage 1 (drowsy), Stage 2 (light sleep), Stage 3 (deep sleep), and REM sleep. With aging, the average person may enjoy less time in Stage 3, the deepest and most restorative kind of sleep, and feel fatigued the next day.
Sleeping less and less
It’s myth that you need less sleep as you get older, although you may end up sleeping less for other reasons. Our ability to return to sleep may become impaired as we get older, particularly in the last third of the night.
Older people spend less time in the deep and most restful stage of sleep, partly because of changes in the brain. Other sleep disturbers include benign prostate enlargement, which can make you wake more often to urinate. Impaired nighttime breathing, or obstructive sleep apnea, is more common in men. And many men and women are beset by aches and pains caused by common conditions like arthritis and back pain. Awakenings make for more fragmented sleep, causing fatigue, daytime drowsiness, forgetfulness, anxiety, and even depression.
What’s keeping you awake?
Decoding all the possible causes of insomnia starts with your doctor taking a medical history. The idea is to rule out treatable causes of chronic insomnia.
One self-help step recommended to everyone is to make sure poor sleep habits and other lifestyle factors aren’t derailing your nightly journey to dreamland (see ‘8 Steps to put sleep trouble at rest’). Drinking caffeinated beverages or eating full meals too late in the day are easily addressed sleep busters.
Drugs have their limits
Over-the-counter sleep aids usually contain antihistamines – the drug in cold remedies that unstuffy your nose. These may help you fall asleep, but they won’t necessarily keep you asleep. For serious sleep problems, the over-the-counter products don’t help much. What’s more taking too many, too often, can be harmful. Prescription sleeping pills like zolpidem (called hyponotics) help many people with serious, persistent insomnia. But all sleep aids should be used at the lowest effective dose to prevent a hangover of drowsiness the next day that could cause accidents or falls.
Bed room makeover
Hue’s good White walls may have a clear look, but they reflect light; the sparkle can cause headaches and the light wake you good before you are rested. Experiment with a darker color (or an off white) with a matte finish.
Snore no more Researchers at Florida Hospital in Kissimmee found that the Sona Pillow decreased or eliminated snoring in nearly all 22 study participants. And sleep interruptions fell from 17 per hour to fewer than 5.
Clear the air Ease breathing trouble – chronic stuffy nose, asthma – with a HEPA air filter. Try a single-room purifier. The EPA reports that these reduce certain indoor air pollutants.
Light alarm An 80-week Finnish study found that quality of sleep improved after just 6 days with an alarm that gradually increases light intensity to wake you.
Turn off the TV Basking in the glow of the TV or computer screen for as little as 1 hour before bedtime is enough to upset your circadian rhythm, delaying sleep – and may increase risk of disease. Need another reason to move the tube? One study found that a TV in the bedroom decreases sexual desire by about 50%.
Plug in a night-light. Bright evening light kicks your body into wake-up mode and there’s evidence it may raise your risk of several types of cancer. Because red wavelengths are the most innocuous, use a crimson bulb.
The case for therapy
Unrelieved insomnia can be devastating to your health and quality of life. A counseling approach called cognitive behavioral therapy (CBT) has been shown to help many to recover their 40 winks. Research suggests that for many insomniacs, CBT works better than sleeping pills in the long term. In a recent study, published in the Journal of the American Medical Association, 160 adults with chronic insomnia were treated with cognitive behavioral therapy alone or in combination with zolpidem for approximately six weeks to seven months. Cognitive behavioral therapy worked well on its own – and led to even better sleep improvements (although the difference was small) over seven months when zolpidem was used initially but then discontinued after six weeks.
The most telling sign of a candidate for CBT is a pattern of negative thoughts and feelings about sleep. This leads to a vicious cycle of anxiety in which worrying about sleeplessness worsens and sustains the sleeplessness. CBT is really very effective for people who have developed an anxiety disorder about sleeplessness. Insomniaphobes dread the bed. They may feel hopeless about being able to sleep normally again. They start to blame negative emotions during the day on lack of sleep. They may have unrealistic expectations for how quickly they will fall asleep and how long they should stay asleep. They expect to experience insomnia – then they do.
Counterintuitively, the first step in CBT for insomnia is sleep restriction! It requires you to adopt a sleeping period with a set time for going to bed and a set time to get up – no matter what. The sleep time is initially a little short, which gradually increases fatigue at night and strengthens your internal sleep drive. Sleep restriction trains the body to be ready to sleep when you get to bed.
Gradually, the sleeping period is increased to establish a normal and restful sleep pattern. Along with this, sessions with the therapist help to instill a more accurate and positive attitude toward sleep.
One obstacle to making CBT work is that it requires you to complete the counseling programme, which takes commitment. Even if you are not a full-blown insomniaphobe, CBT teaches that sleep is essentially a mindbody issue. Recognizing and resolving the physical ailments, problem behaviors, and negative attitudes are the keys to better sleep.
8 steps to put sleep trouble to rest
Simple tricks you can try to get your 8 hour zzzzs
Get into a Pattern naturally. If your schedule permits, wake up naturally without an alarm clock, and go to bed at night only when you feel sleepy – not because it’s “time for bed.” Pay attention to when you feel tired and to when you typically wake up.
Exercise at the right times. Exercise not only improves overall health but also makes it easier to fall asleep. When you are physically active, your body temperature rises, leading to a natural drop about five to six hours later. Since sleeping is associated with falling body temperatures, afternoon exercise makes it easier to fall asleep at night – but activity right before bed can make the body too warm and alert for sleep.
Go outside at least 30 minutes a day. Even in overcast weather, exposure to natural light (without sunglasses, which block the sun’s full spectrum) helps regulate your body’s levels of melatonin, a hormone that plays an integral role in sleep rhythm.
Don’t go overboard with dinner. Heavy meals can cause heartburn or stomach trouble that may interrupt sleep and lots of fluids mean more nightly trips to the bathroom. Try to finish dinner at least three hours before bed; if you get hungry again, just have a light snack, like a banana or cereal.
Avoid alcohol and caffeine before bed. Although alcohol may make you feel sleepier, even one drink up to four hours before bed can prevent the body from entering the most restful stages of the sleep cycle. And the body takes about six hours to exclude just half the caffeine in a cup of coffee, so it’s best to stick to avoid caffeine (coffee, tea, cola, and chocolate) after noon. It can cause shallow sleep or awakenings.
Try not to nap. Excessive napping during the day may make it harder to fall asleep at night. If you must nap, try to limit it to an hour around the same time every day – and do not nap after 3 P.M.
Keep your bedroom quiet, dark, and a little cool. If that doesn’t do the trick, sometimes simple changes to your sleep environment, like blackout curtains, earplugs, or a more comfortable mattress (even high-quality mattresses should be replaced every 10 years), can make a big difference.
Use your bed just for sleeping and intimacy. If you can’t fall asleep after about 20 minutes, don’t stay in bed and try to force it. Thinking too hard about the “mission at hand” can drum up anxiety that may keep you alert. The best thing to do is get out of bed (preferably, out of the bedroom) and relax with a book or some soft music until you feel like nodding off. Avoid watching TV in bed. The goal is to train your mind to associate your bed just with sleep.
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