Friday, March 9, 2012

"To sleep, perchance to dream..." by my Uncle Gene

"Sleep, that knits up the ravelled sleeve of care." Sleep has been much in the news lately, and what I have heard at two recent seminars may be of interest to you. First of all, Dr. Suzanne Salamon, who writes for the Harvard Health Letter, said: "Sleeping pills, in general, are problematic for older people. They lead to grogginess the next day and may contribute to cognitive problems, poor balance and falls." So, do older people have more problems getting to sleep and staying asleep? And if so, Why? Turns out, there has been some recent research on circadian rhythms, the daily ups and downs of energy our bodies experience. These rhythms are stimulated by how much light, and what kind of light we are getting. As we age, we do not process the blue part of the light spectrum as well. By the time you are fifty, you are only processing 50% of the light needed to fully stimulate your circadian rhythms, and, by the time you are 75, only 17%. Bottom line: unless you are very lucky, as you get older, you will not sleep as well.

Well, is that really a problem? Wouldn't it be great to have more active hours? More hours awake are only valuable if you feel you can be enjoyably active during those hours. There are some things to be concerned about, if your sleep has deteriorated. Poor sleep does raise blood pressure and blood sugar, and not only makes people less efficient in what they do, it also detracts from taking delight in what might otherwise be pleasurable pursuits.  What constitutes poor sleep? Basically, not getting as much as you feel you need. How many hours of sleep do you really need? The need  varies from person to person, but most people "need" at least six hours of sleep, and seven to eight hours  seems to be ideal. The first three hours of sleep produce physiological restoration, the next three, some degree of mental restoration. You do go through four "sleep cycles" during the night, reaching R.E.M. sleep, or "Rapid Eye Movement," and then you repeat the cycle, which may last about ninety minutes. Your first dreams of the night may last only a few seconds, the last one may last for ten minutes! Most people actually "wake up" four or five times a night, but unless you get up, you probably don't remember your instants of wakefulness. 

What can you do to get a good night's sleep? There is a lot of evidence that regular exercisers sleep better than non-exercisers, and those who exercise earlier in the day sleep better than those who exercise later in the day. Several doctors suggest that watching the news at bedtime is not a good idea: it is mostly bad news, and you should calm down, relax, meditate, or take a warm bath, or a little bit of warm milk, rather than get yourself excited or upset by what TV has to show you. It takes most people five to twenty minutes to fall asleep. Some people insist that an alcoholic "nightcap" helps them sleep, but the research indicates that while alcohol may make you drowsy, it does not promote sound sleep. What about sleeping pills? The doctors who work with insomniacs acknowledge that pills may help temporarily, but persistently caution against the prolonged use of sleeping pills, including OTC medications like Tylenol PM. One doctor speculated that the ingredient in most of these drugs would not be cleared by the FDA, if it were tested by current standards. 

In research studies, even drinking one cup of regular coffee leaves caffeine in the system seven hours later. "Four cups in the morning is equivalent to having one cup at 10 pm." Some people who insist that coffee does not bother them, find out that switching to Decaf really makes a difference. Some people seem to benefit from taking melatonin, which is a hormone secreted by the pineal gland, and that does have something to do with circadian rhythms. However, as with all "supplements," getting the good stuff and getting the right dosage is not easy. One other factor that seems to correlate with older people having sleep problems: as you get older, the level of cortisol in your system, increases. Cortisol is a stress hormone, and stresses that were once easily dismissed can have a greater effect on people as they age. ("It takes less to stress us out as we get older.") Which brings me to the last corrective for sleep problems: CBT, or "Cognitive Behavioral Therapy." Even a couple sessions have proved beneficial to people having serious problems sleeping. To find an expert in CBT, you may have to contact a nearby sleep clinic, or talk to your medical professional. Sleep, as Shakespeare said, is the "balm of hurt minds," so having gotten this off my mind, I think I will go take a brief nap, in the hope of being fully restored to my youthful energies...

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