Sassy Moment 17 – Sleepy Messes

Good morning ladies, grab a cup of coffee, pull up a chair and listen in, this is the sassy moments podcast.  Moment #17 Messy sleep. 

How’s your sleep ladies?  Mine ranges from not dreadful to really dreadful.  Naps are impossible for me – it takes me 2 hours to fall asleep for a 20 minute nap.  I’ve been that way for as long as I can remember and medical training with its sleepless nights didn’t improve the situation.  The more I read about the importance of sleep and it’s far reaching impact on our brain health I shudder.  “What have I done?”  So many years of sleep deprivation.  My sleep is a mess.

To be fair, our need for sleep, as dictated by our circadian rhythm, changes as we age.  This is most apparent with kids.  Babies sleep most of the day.  Toddlers are more wakeful but still need a midmorning and often a mid-afternoon nap or there might be hell to pay.  As teens, sleep is completely wonky and they are awake until the middle of the night and asleep until noon or later.  

As adults we ignore our circadian rhythms, we skimp on our sleep as the pressures and stresses of life squeeze sleep to a minimum.  As I experienced through my medical training and practice, sleep is the first casualty of career and family demands.  

In his book Why We Sleep, Mathew Walker explores the notion that in the latter decades of life we need less sleep.  While it may be true that older individuals get less sleep, it’s a myth that they ‘need’ less sleep.  

As with toddlers and teens, our circadian rhythm continues to change as we age, and is regulated by the hormone melatonin – our sleep hormone, which is influenced by natural light, and thanks to Thomas Edison, artificial light.  Unfortunately, artificial evening light interferes with the release of melatonin and messes with our sleep patterns.

In contrast to teens who stay up late and sleep in late, with advancing age, we prefer to go to bed early and get up early.  That’s because our melatonin levels peak earlier in the evening as we age.  But not wanting to miss out on evening activities, we ignore the sleepy-time signal and end up dozing off in our chair, which in turn messes with our night time sleep and we mistakenly conclude we have insomnia, which messes with our sleep pattern the following day. 

In addition, as we age our sleep is more fragmented – mostly because we have weak ‘old lady’ bladders.  We need to get up and pee, which breaks up our sleep.  To make matters even worse, because of our old lady bladder sleep interruptions, our sleep is inefficient.  Sleep efficiency is defined by the amount of sleep you actually get versus the amount of sleep you are trying to get.  If you spend 8 hours in bed and sleep for 8 hours your sleep efficiency is 100%.  If you are awake for 90 minutes over the course of the night your sleep efficiency drops to 70%.  

This is bad news because sleep experts recommend a sleep efficiency of 90% or higher to support optimal health.  Poor sleep efficiency has been linked to higher rates of depression, fatigue and forgetfulness and ultimately mortality!  

So sleep is utterly crucial to aging well.  What a sleepy mess!  What can be done?  

Just knowing that these changes are coming can be helpful.  Fortunately many are most notable in the 7th and 8th decades, so there is time to intervene.  Here are some ideas.

Tune in to your sleep patterns, listen to your body.  Pay attention to your sleep wake cycles.  Increase natural light early in the day – just 10 – 15 minutes outside (cloudy or not) turns down melatonin and limit artificial light late in the evening, turning up melatonin.   Don’t drink a lot of water before bed… might as well try to limit the need to pee in the middle of the night.  And for that matter, careful with that wind down glass of wine – alcohol makes you need to pee. 

Sleep efficiency?  It’s not so easy to manipulate.  For me – no naps – not that they ever worked in the past.  I get up when I wake up for the first time after 5am.  This means I am waking up in accordance with my sleep wake – cycle.   Nowadays, I wake around 530 – 600am.  Since my nightly sleep goal is 8 hours, I calculate backward and settle into bed ~ 930 – 10pm.  

When I am able to do these things – 10 – 15 minutes of morning sunlight, no naps, limit evening artificial light and limit evening water intake my sleep is much less fragmented, I fall asleep with less difficulty, and I wake up rested, ready to go.  

By no means perfect and a work in progress, this works for me now, at 60 something, it might not at 80 something.  Time will tell, but I will be paying attention and adjusting accordingly.    

Talk again soon.

Live Life, Love Life, Always…