If somnolence (also known as sleepiness) is what eludes you, then it’s time to start taking the problem more seriously.
Sleep issues often can be underdiagnosed because people think it’s just part of getting older, and they don’t raise their concerns with a doctor. That’s the word from a local sleep expert who’s made a career out of helping people fall — and stay asleep.
THE AGE FACTOR
“Don’t give up hope,” says Dr. Dennis Auckley, Director of MetroHealth’s Center for Sleep Medicine and associate professor of sleep medicine at Case Western Reserve University.
He cautions those suffering from sleep challenges to distinguish between the many causes of disruption, some of which are natural.
“Sleep architecture changes with age,” he says. “A person may sleep the same amount as in the past but they’re in a lighter stage when they aren’t dreaming and can be awakened easily, leading to the perception that they are not sleeping as well. It’s just normal physiology.”
Sleeping is an activity that consumes one third of our lives. It’s hard to ignore the role it plays, so disruption to it requires serious consideration.
SLEEPLESSNESS CAUSES
Two common causes of sleep disruption include apnea and menopause symptoms of hot flashes and hormone imbalance. Up to 18 percent of people 55 -70 suffer from apnea, and among those, three to five percent require therapy.
Snoring, a byproduct of apnea or its own issue, eventually becomes widespread as people get older. By age 50, 60 percent of men and 40 percent of women snore. By age 60, 55 percent of people snore, Dr. Kingman Strohl, Director of Sleep Medicine at University Hospitals Case Medical Center and a professor of medicine at Case Western Reserve University says.
The most common treatments for both apnea and snoring include weight loss, oral appliances, a CPAP (continuous positive airway pressure) device, increasing fitness levels and positional therapy such as sleeping on your side.
Regarding menopause, the loss of progesterone and estrogen, which are factors in brain health, are causes of disruption along with hot flashes. Also, as a general part of aging, “molecules in the brain that put you to sleep and wake you up are not as coordinated as they once were,” he says.
Dr. Strohl’s approach to addressing and diagnosing the problem begins with a sleep inventory, paying particular attention to medications since some promote wakefulness or sleepiness. Those include antidepressants, steroids, blood pressure medicine, beta blockers, antihistamines, pain medicine and sedatives which can lead to daytime tiredness.
Dr. Auckley notes that restless leg syndrome is not uncommon, but under-diagnosed and disturbs the falling asleep process in 5-10 percent of the population. “It’s treatable with medicine.”
ALCOHOL, CAFFEINE MAY BE CULPRITS
Many behaviors can lead to sleep disruption too, says Dr. Strohl.
Alcohol consumption is a “devious one,” he says, because it helps people fall asleep but after it’s metabolized, “arousal comes roaring back.” He also notes that caffeine can be a culprit since it’s metabolized three to four times slower after age 50.
In cases where sleep disruption is “event initiated,” such as with anxiety from the death of a loved one, a health diagnosis or other forms of stress, “insomnia is probably appropriate,” Dr. Strohl says.
“The statistics on sleep disrup- tion reflect that women complain more, but not by much. Over people’s lifetime, very few don’t have complaints,” Dr. Strohl adds. At any one time in the adult population, 30 percent will suffer from poor, disrupted or inadequate msleep, and between ages 40-85, 70 percent will have occasional bouts of it. Five to 10 percent will require a doctor’s help.
NOW WHAT?
How long should it take for a person to fall asleep, and how much sleep should be enough for a person to feel good?
Dr. Strohl says 20-25 minutes is typically how long it takes, although, “many expect it to take two minutes, and if it takes 30 minutes, they complain.” Generally, six- to seven- and a half hours of sleep should be enough to feel refreshed.
Sleep stages follow a biological sequence of events, he adds, that first involve local brain regions, beginning with the frontal cortex, then cascading to the back of the brain and creating retrograde amnesia where a person can recall none of the process of falling asleep.
Reading is the best medicine to enhance the process of falling asleep, Dr. Strohl says. It forces the mind to focus on something other than stressful events, and it’s a cue to relax.
His best advice for a good night’s sleep? Keep a log or a sleep inventory for two or three weeks to help you or your physician determine what’s keeping you up at night and then make changes on your own or seek help from a professional.
As we age, we may not “sleep like a baby” anymore, but a change in habits — and in some instances medicine or machines — can put a good night’s sleep within reach. Sweet dreams.
