Patient Daily Living

Getting a Better Night's Sleep

Authored By: Helen Frank


We all know the value of a good night’s sleep, but, getting one is a different matter.  According to the National Sleep Foundation’s 2025 Sleep in America® Poll focused on exploring the powerful link between sleep health and an individual’s ability to flourish in life, key findings showed that 60% adults don’t get enough sleep, and 50% of adults have trouble staying asleep.  The American Academy of Sleep Medicine says that insomnia puts sufferers at increased risk depression, anxiety, substance abuse, motor vehicle accidents, Alzheimer’s disease and Type 2 diabetes.

It’s a common myth that older adults need less sleep because they are less active, and most adults benefit from getting 7-9 hours sleep per night. 

However, there are many factors that lead to sleep disturbances in older adults:

  • Increased waking during the night due to pain, or increased need to urinate. 
  • Disturbances caused by other people, and, even, pets.
  • Interference with deep sleep caused by medical conditions such as sleep apnea or heart disease.
  • Changes in circadian rhythm mean that our internal body clocks become less efficient, which can lead to intermittent waking and shorter sleep durations.
  • Changes to a long-established routine, including retirement, and not having to get up at a certain time, or moving home, can affect your body clock.
  • A bedroom that is too hot, cold, or too humid.  A cool temperature of around 67F is considered optimal for promoting restful sleep.
  • Watching exciting, violent, or suspenseful television programs can stimulate the brain, and make it difficult to relax or wind down.
  • Blue light exposure from electronic devices - smart phones, television screens, computers, suppress melatonin production, which is vital for regulating sleep.
  • Eating a heavy meal close to bedtime negatively impacts sleep, since high-fat and high-protein foods, in particular, can be difficult to digest, and can cause discomfort or heartburn.  Try to eat your dinner at least two hours before you go to bed.  Additionally, avoid alcohol, spicy and acidic foods, and caffeinated foods and drinks in the evening.
  • Going to bed hungry can also disturb your sleep, since your body releases the hormone ghrelin, which stimulates your appetite, and causes hunger pangs, which can make it difficult to fall asleep and stay asleep. Your blood sugar can also drop, leading to difficulty sleeping.
  • Anxiety, stress, and fear can keep you awake.  It’s a vicious circle, worrying can keep you awake, and lack of sleep can worsen the anxiety.  It’s not easy to tackle the root causes of worrying, but, it is necessary to try and address those worries over which you have some control.  Relaxation exercises before bed, may help.

It’s all too easy to reach for a medication or supplement to help you sleep, but, not all of them are created equal.  Some medications simply cause a state of sedation, which is not the same as natural sleep, nor as beneficial.  You need sleep to rest the brain and facilitate memory capacity, heal the body and repair tissue, produce vital hormones, and restore the body’s sense of equilibrium.   Benzodiazepines, commonly known as ‘Z drugs’ are a class of medications that can be prescribed to help with sleep.  They are powerful drugs and are recommended for short-term use only.  They depress the central nervous system and can reduce the time it takes to fall asleep sleep and increase the amount of time you stay asleep.  However, they must be used judiciously due to serious potential side effects and dependency risk.  It’s important to discuss your insomnia with your doctor and, if a medication is recommended, find one that is suitable for your individual needs, and compatible with other medications you may take.  You should also discuss with your doctor any over-the-counter medications or herbal supplements you are taking.  They can be useful, when combined with other strategies, but they can also be powerful, and affect the efficacy of other meds.

So, what can we do to give ourselves the best chance of a healthful night’s sleep?

  1. Establish a sleep routine – go to bed and get up at around the same time each day.  Don’t skip sleep during the week and plan to have a lie in at the weekend.  Catching up on lost sleep isn’t beneficial.
  2. Follow the 10-3-2-1 rule - Starting 10 hours before bedtime, avoid consuming caffeine. Three hours before bed, limit alcohol and food. Two hours before bed, try to relax and avoid mentally-stimulating tasks. One hour before bed stop using your electronic devices.
  3. Don’t go to bed hungry.  The best bedtime snacks combine protein, healthy fats, and fiber-rich carbohydrates, and include options like Greek yogurt with berries, whole grain crackers and cottage cheese, nuts and seeds, hummus and veggies, peanut butter and apple slices, low-sugar cereal, air-popped popcorn, or a hard-boiled egg.
  4. Limit daytime naps to no more than a total of an hour.
  5. Regular physical activity promotes sleep, but avoid it too close to bedtime.
  6. Relax during the evenings, and, particularly in the hour before bedtime.  Listen to soothing music, read a book, meditate and do some deep breathing exercises.
  7. Try to get some exposure to natural light each day.  If this is not possible, buy an artificial bright light device or bulbs.
  8. Create a relaxing sleep environment. A comfortable bed and pillow, and bed linens made of natural fibers are key.  Use blackout drapes, if necessary, to darken your bedroom, and regulate its temperature to around 67F.
  9. Try not to drink fluids, other than sips to take medication, two hours before bedtime, and go to the bathroom just before getting in to bed.  Hydration is important, but reducing fluid intake before bedtime is key to reducing nocturia (excessive nighttime urination).
  10. If you wake, and can’t get back to sleep, don’t lie awake thinking about not sleeping, read a book, until you feel tired again.

 


Authored By: Helen Frank