Getting a good night’s sleep can be a challenge for many seniors like Bev Szandtner.
“I sleep erratically,” says Ms. Szandtner, 78. “Some nights are really good, and other nights are not so good; I will wake up at 2 or 3 or 4 a.m. and I won’t be able to get back to sleep.”
Ms. Szandtner, who is active and energetic, says she’s tried “a zillion things” and isn’t sure what makes her sleep well some nights and not others.
It’s been this way for years, Ms. Szandtner says, even before she retired a decade ago. She has spoken to her doctor but doesn’t want to take sleep medication, preferring instead to rely on natural methods such as meditation, doing puzzles and reading to help her relax at bedtime.
“I’m not really tired during the day. Maybe I don’t need the sleep,” she says.
Seniors more susceptible to sleep issues
About one-third of adults report insomnia symptoms, according to the Canadian Family Physician journal, and that number rises to 40 per cent among people 65 and older.
For many retirees, not having a job to go to every day can disrupt their routine and impact sleep patterns, says Jonathan Charest, a behavioural sleep medicine specialist.
Some retirees may also be less social, less physically active and spend more time indoors away from natural light. Many also take medications for age-related ailments.
“These are all factors that will lead to sleep disturbance,” says Dr. Charest, who is also director of athlete sleep services with the Centre for Sleep and Human Performance in Calgary.
A senior’s circadian rhythm – the natural, internal process that regulates the sleep-wake cycle – also changes, he says, which can mean they fall asleep earlier and get up earlier. It can also be harder for them to have a deep sleep.
Seeking help for ongoing sleep issues
Liz Minato, 79, says her sleep troubles started with rising anxiety levels during high school exams decades ago. Her issue is falling asleep or getting back to sleep if she wakes up in the middle of the night.
“That came to be the pattern of my life,” Ms. Minato says.
She turned to sleep medication for help, but felt she needed to do more. A few years ago, Ms. Minato talked to her doctor about the Sleep Medicine Clinic at London Health Sciences Centre – Victoria Hospital in London, Ont.
After more than a year on the waiting list, she was accepted into the clinic and says the strict program and sleep advice have made a world of difference.
For instance, Ms. Minato had to keep a detailed sleep journal and, initially, couldn’t go to bed before midnight and only when she felt sleepy. She had to rise at 6 a.m. every day. Daytime napping wasn’t allowed, and the bed was only for sleeping – not reading or watching TV. If she couldn’t sleep, or woke up during the night, she had to get out of bed and do a quiet activity until she was sleepy again.
“The whole idea is that you don’t go to bed until you’re very, very tired and it’s what I do now,” she says. “You’re training your brain that when you’re in bed, you sleep.”
Another rule: no dwelling on how much or little sleep she got.
Eventually, the doctor weaned her off sleep medications entirely and Ms. Minato says she now gets about six hours of sleep each night.
“I wish I had done something like this many years ago,” she says. “It’s been a blessing for me because insomnia really did affect the quality of my life.”
The sleep training Ms. Minato received is a form of cognitive behavioural therapy (CBT), a psychological treatment shown to be effective for a range of problems including depression and anxiety, post-traumatic stress disorder and insomnia.
“The most successful therapy for insomnia ... is not medication, it’s CBT,” says Julie Carrier, a psychology professor at the Université de Montréal who specializes in sleep and aging. She is also the scientific director of the Sleep On It campaign aimed at educating Canadians about sleep and sleep disorders.
A big part of CBT is to change people’s perception of sleep, Dr. Carrier says. For instance, she says it’s “normal” that, as we get older, we don’t sleep as long or sleep through the night without waking.
And similar to what Ms. Minato discovered, there are strategies for sleeping better, such as getting up if you can’t sleep in the middle of the night and doing something calming until you are ready to sleep again. Dr. Carrier also advises people not to oversleep if they haven’t had a good night’s rest because it won’t help them sleep better the next night.
Both Dr. Carrier and Dr. Charest recommend anyone who has trouble sleeping regularly, especially if it impacts how they function during the day, should discuss it with their doctor.
“Don’t wait; don’t lose too much sleep before consulting with a sleep physician or family doctor,” Mr. Charest says, noting that sleep is critical for people to maintain their mental and physical health.
“There’s a solution; there’s a reason why you’re losing sleep.”