Sleep matters                                                    

            Humans have evolved to require about 8 hours of sleep a night. Getting much less not only makes us more tired and less productive the next day, which is pretty obvious, but it also contributes to anxiety, depression and poor mental performance. Becoming overweight or obese is another consequence of regularly getting too little sleep, perhaps because some of that time awake is spent in nervous eating.

            Seniors complain about not sleeping well but it’s not because of aging. Although it’s true that we need less sleep as we get older it isn’t really much less, probably about half an hour, on average. After the age of about 60 many of us have acquired a chronic illness that disturbs a normal sleep pattern. Both men and women are more likely to make an extra bathroom call during the night, men because of an enlarged prostate and women because of several disorders that affect the bladder. Seniors often nap during the day, borrowing from the time usually spent sleeping at night.

            Obesity is a significant risk factor for sleep apnea, a condition that causes multiple episodes throughout the night of semi-awakening and poor oxygen supply. The high prevalence of sleep apnea is reflected in the many TV and Internet ads for devices that allegedly relieve this problem.

            Many if not most Medicare-eligible persons take at least one prescription medication and some of these interfere with sleep. Drugs that lower blood pressure or relieve the symptoms of chronic congestive heart failure cause an increase in urinary output and the bladder capacity of most persons is too small to allow for a full night’s sleep.

            Prescription drugs that help us to sleep have their own side effects including daytime drowsiness and alcohol-like hangovers. These lead to increasing risk of motor vehicle accidents and falls. The former can be fatal; the latter lead to falls and hip fractures.

            Drugs that are prescribed for sleep are not meant to be taken forever, but only for about four weeks. Few patients or physicians adhere to that recommendation. A better solution is to take a few simple steps that will improve sleep. Make your evening meal a light one, and not too late. Aim for a bedtime of about 10 p.m., thus avoiding the anxiety-producing late night news. Avoid coffee, even decaf, and chocolate after noon. Exercise at least 30 minutes every day, more on most days.