Conquering sleep issues

GETTING to sleep is a problem for everyone at times and this often becomes more of a problem as we age.

RPH sleep scientist Dr Kim Ward says it is important to seek medical advice for a possible sleep disorder if getting to sleep becomes a persistent problem.

At night, older people may take longer to get to sleep, wake up more often and spend less time in deep, refreshing sleep. They also have a higher risk of insomnia. More serious than occasional insomnia is obstructive sleep apnoea (OSA).

“Obstructive sleep apnoea is very common in middle to older age, and often presents as insomnia because every time the person falls asleep, the throat obstructs and causes an awakening, and this cycle can be repeated over and over,” said Dr Ward.

When the throat obstructs breathing stops for a short time – from 10 seconds up to a minute or more – and blood oxygen levels fall as a result. This interrupts sleep for a few seconds but this disrupts your snooze and can be repeated many times during the night.
Alcohol and sleeping tablets may make OSA worse.

Check your sleeping habits (below) and if OSA persists see your doctor.

For the best chance of getting a good night’s sleep follow the advice of the Sleep Health Foundation:

Your bedroom should be quiet, dark, comfortable and neither too hot nor too cold. Ban all electronic gear such as computers, TVs, mobile phones and clocks that you can see from the bed.

Try to go to bed at the same time every night and avoid food, caffeine, alcohol, exercise and computer games just before bedtime and don’t take long naps especially during the evening.

If you haven’t fallen asleep after about 30 minutes, don’t stay in bed. Get up, go to another room and do something quiet and restful in dim light like reading a book. Don’t use your computer, mobile or TV, because the light they emit can stimulate your mind and keep you awake.

When you start feeling tired, go back to bed. If you still can’t fall asleep, get up again.

Don’t worry if you have to repeat this several times.

Remember to get up at your regular wake-up time however little sleep you have had to avoid getting into a non-sleep routine.

Sleeping pills will send you to sleep but do not deal with the cause of sleep problems and they can be addictive. Moreover the longer you take them, the less they will work. This means they are really only a short term solution for a short term problem.

Over the counter sleeping pills include doxylamine which can be taken for up to 10 days and herbal remedies usually containing valerian or camomile for which there is little hard evidence of efficacy.

Melatonin, available only on prescription, may also work for some older people.

If these hints don’t help consider trying mindfulness meditation. This teaches you to manage your physical sensations, thoughts, and emotions in a non-critical way.

Join a class or download a mindfulness app. You can listen to the app at bedtime or take part in activities that encourage mindfulness, such as yoga, Pilates, walking or Tai Chi.

Another suggested mindfulness technique is 4-7-8 breathing. Breath in through your nose for four seconds, hold your breath for seven seconds, then exhale through your mouth for eight seconds. This is said to soothe you to sleep.

If all this fails to help you sleep you could try cognitive-behavioural therapy (CBT).

Research shows this is effective in the medium and long term especially for older adults. It reduces sleeping difficulties by 50 per cent on average.

There are effective online CBT programs online such as SHUTi (myshuti.com) that can be accessed from home.

If you are having ongoing trouble sleeping, persistent problems with mood, restlessness in bed, severe snoring or wakening unrefreshed, don’t assume it is a normal part of ageing.

See your doctor who may refer you to a sleep specialist or psychologist.