I can't fall asleep. Then, I toss and turn all night, and by morning I'm exhausted. I'm often sleepy during the day. Are my medications doing this to me, or is this just part of getting old?
Insomnia is more common as we age, but there are concrete steps you can take to improve your sleep.
First, look at your "sleep hygiene." This refers to the habits and environment you have developed in your sleep pattern. Common components of healthy sleep hygiene include the following:
Try to go to sleep and wake up at the same time each day.
Don't get in the habit of spending more than 30 minutes in bed not sleeping. For example, don't watch TV, read books, eat, or "toss and turn" in bed. If you can't sleep, get out of bed and do something productive.
Avoid caffeine, alcohol and tobacco.
Limit liquids near bedtime to avoid trips to the restroom at night.
Exercise daily. This helps correct a disordered sleep cycle.
Many older adults don't get more than 30 minutes of sunlight outdoors per day. Sunlight helps our bodies' clocks tell time and when you've been exposed to plenty of sunlight throughout the day, you can sleep better at night.
Second, ask your doctor if medications you are taking might affect your sleep. Medications that can affect sleep include Sudafed, Lasix, beta blockers, theophylline, bronchodilators, some antidepressants and steroids. If you are on these medicines, realize that they may not be the problem; this is just a possibility. You are likely on these medicines for an important reason, so don't stop taking them without checking with your doctor first.
Third, there are serious sleep disorders that can interfere with sleep and thus cause daytime drowsiness. The most common one is "sleep apnea." This is where someone actually stops breathing for periods of time throughout the night. It is not uncommon for people with sleep apnea to stop breathing, for example, for 10 to 30 seconds more than 50 times an hour. They stop breathing either because their brain forgets to tell them to breathe, or more commonly, because the soft tissues in the back of the throat collapse and block the air passways. Obesity is a chief cause, but not the only cause of this disorder. Often the spouse is more aware than the patient of the gaps in breathing and loud snoring that characterize this disorder.
Recently sleep apnea has become better publicized as a disorder. You may even know someone who wears a special nose piece or mask at night attached to a machine that pushes air into the lungs. These machines, called "nasal CPAP" for continuous positive airway pressure can improve sleep dramatically for sleep apnea sufferers.
Weight loss can improve sleep apnea as well. Dentists can often fabricate mouthpieces that, when worn while sleeping, help splint the tongue and throat's soft tissues out of the way.
To formally diagnose sleep disorders, your doctor has to send you to a sleep lab. This involves an overnight stay, usually at a hospital, where your breathing, heart rate, brainwaves, and movements while sleeping are all recorded. A report is then generated and sent to your doctor describing which sort of sleep disorder, if any, you suffer from.
If you practice the good sleep hygiene listed above and rule out any serious sleep disorder, then your doctor can try a short-term sleeping pill.
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