It is a common misperception that the quality of a person’s sleep decreases as they age. We have all had nights during which we did not sleep well (due to stress, not feeling well, a tooth ache, etc.) but this tends to only last one or two nights. Insomnia (trouble getting to and staying asleep) is a common complaint with older adults. They do not have a few nights of not sleeping well, but may experience difficulty with insomnia every night.
The negative effects on both a person’s physical and mental ability of not getting a good night’s sleep is well documented with a person’s cognition/memory being negatively affected by lack of sleep. A number of studies have shown that people who have persistent insomnia demonstrate significant decreased ability to learn new information, have decreased performance on cognitive assessment scales and are potentially at a greater risk for developing Alzheimer’s disease.
It is important to ask about sleep patterns/problems. The insomnia someone experiences may be long standing and the person has simply come to assume that poor sleep quality is normal for them and a normal part of the aging process. Implementation of a sleep hygiene program may have a positive effect on someone who suffers from insomnia with a subsequent improvement in cognition, memory and physical ability.
The following areas should be assessed:
- Medication review: Can a medication that may affect sleep quality be taken earlier in the day? Over the counter (OTC) medication should be assessed as many pain relievers; decongestants and cough/cold medicines can impair sleep and may actually be a stimulant.
- Does the person take a “nap’ during the day?
- Are they exercising late in the day/going for walks after dinner? These activities may actually cause the person to have increased energy.
- What are their eating/drinking patterns? How much caffeine or other liquids are consumed and when? Are big meals/deserts being eaten in the evening? Obviously caffeine is a stimulant and for a lot of people, so is alcohol.
- What activities does the person engage in during the two hours prior to going to bed?
- Do they read or watch TV in bed?
- What is the bedroom environment like? Noisy, bright lights from the outside, not comfortable?
A sleep hygiene program should consist of the following components:
- The bedroom should only be used for sleeping. There should be no snacking; listening to a radio or watching TV. If an e-reader is used, be aware that the blue spectrum of light is a stimulant.
- It is important to go to bed and arise at the same time each day.
- Avoid exercising within 3-4 hours of bedtime.
- Avoid eating and drinking of liquids after 6 PM.
- Avoid taking a hot bath/shower at least 90 minutes prior to going to bed
- Avoid alcohol for at least 2 hours before bedtime.
- Develop a routine/ritual that is performed prior to going to bed. This may include relaxation techniques, stretching, Yoga, reading, etc.
- If a person cannot fall asleep within 20-30 minutes of going to bed, they should get out of bed and try doing something relaxing before going back to bed.
- Make sure the bedroom is dark and does not allow outside light (street lighting/sunshine) to come in. The use of room darkening shades maybe needed.
Something as simple as improving a person’s sleep quality may have a huge domino effect on their cognition and memory ability and may actually eliminate issues associated with mild cognitive issues.