We hear so many things that can impact our health as those over the age of 45 become more concerned about their health and how it impacts aging. So should you lose sleep thinking about sleep? As people get past age 45 and reach the "fragile 50’s", sleep and health issues become more common.

Yes, people are living longer. With that comes all the issues that have an impact on the quality of life as we age. Sleep … lack of it and poor quality of sleep, can have huge impact on our well-being.

WebMD says more than half of men and women over the age of 65 complain of at least one sleep problem. Many aging people experience insomnia and other sleep disorders on a regular basis.

Our sleep patterns tend to change as we age. Most people find that aging causes them to have a harder time falling asleep. They awaken more often during the night and earlier in the morning. Some people are more prone to falls which can cause Long Term Care issues with older people.

Total sleep time stays the same or is slightly decreased (6.5 to 7 hours per night). It may be harder to fall asleep and you may spend more total time in bed. The transition between sleep and waking up is often abrupt, which makes older people feel like they are a lighter sleeper than when they were younger.

Less time is spent in deep, dreamless sleep. Older people average three or four awakenings each night. They are also more aware of being awake.

Older people wake up more often because they spend less time deep sleep. Other causes include needing to get up and urinate (nocturia), anxiety, and discomfort or pain from chronic illnesses.

Is it the aging process itself that causes issues with sleep? An article in the New York Times suggests it is not aging but health issues and medications to treat those issues which may be a major cause.

“The more disorders older adults have, the worse they sleep,” said Sonia Ancoli-Israel, a professor of psychiatry and a sleep researcher at the University of California, San Diego quoted in the NY Times article. “If you look at older adults who are very healthy, they rarely have sleep problems.”

Pain and pain medications are examples which can disrupt sleep. The AARP listed on their website, www.aarp.org, the top ten medications which cause sleep issues:

1.Alpha-blockers – These medications are used to treat things like high blood pressure (hypertension), benign prostatic hyperplasia (BPH) and Raynaud's disease. Examples: alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin) and tamsulosin (Flomax).

2.Beta-blockers – They are used to treat hypertension (high blood pressure) and arrhythmias (abnormal heart rhythms), angina, migraines, and tremors. atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), propranolol (Inderal), sotalol (Betapace), timolol (Timoptic) and some other drugs whose chemical names end with "-olol."

3.Corticosteroids – These type of medications are used to treat conditions like inflammation of the blood vessels and muscles as well as rheumatoid arthritis, lupus, Sjögren's syndrome, gout and allergic reactions. Examples: cortisone, methylprednisolone (Medrol), prednisone (sold under many brand names, such as Deltasone and Sterapred) and triamcinolone.

4.SSRI antidepressants - SSRIs (selective serotonin-reuptake inhibitors) are used to treat symptoms of moderate to severe depression. Examples: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).

5.ACE inhibitors - Angiotensin-converting enzyme (ACE) inhibitors are used to treat high blood pressure, congestive heart failure and other conditions. Examples: benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace) and trandolapril (Mavik).

6.Angiotensin II-receptor blockers (ARBs) – They are used to treat coronary artery disease or heart failure in patients who can't tolerate ACE inhibitors or who have type 2 diabetes or kidney disease from diabetes. Examples are: candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).

7.Cholinesterase inhibitors – These are commonly used to treat memory loss and mental changes in individuals with Alzheimer's disease and other types of dementia. Examples include: donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon).

8.Second-generation (nonsedating) H1 antagonists - H1 antagonists, which are in a class of drugs commonly known as antihistamines, inhibit the body's production of histamine — the chemical that's released when you have an allergic reaction. Second-generation H1 antagonists, also known as nonsedating antihistamines, do not have the same side effects as first-generation antihistamines, such as diphenhydramine (Benadryl), which suppress the central nervous system, causing severe drowsiness. Examples of second-generation H1 antagonists include: azelastine (Astelin) nasal spray, cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), levocetirizine (Xyzal) and loratadine (Claritin).

9.Glucosamine and chondroitin – These are dietary supplements that are used to relieve joint pain, improve joint function and lessen inflammation. (Both are found naturally in the human body.) Many arthritis supplements contain glucosamine and chondroitin, both of which are regulated by the Food and Drug Administration as a food rather than a drug.

10.Statins – These drugs are used to treat high cholesterol. Examples include: atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor) and simvastatin (Zocor).

Better sleep means better health, however health issues, especially those that develop once we hit our ‘fragile 50’s, cause sleep issues which makes our overall health issues worse.

You can take measures to help you sleep and improve your quality of life:

1. A light bedtime snack may be helpful. Many people find that warm milk increases sleepiness, because it contains a natural, sedative-like amino acid.

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2. Avoid stimulants such as caffeine (found in coffee, tea, cola drinks, and chocolate) for at least 3 or 4 hours before bed.

3. DO NOT take naps during the day.

4. Exercise (moderately) in the afternoon.

5. Avoid too much stimulation, such as violent TV shows or computer games, before sleep. Practice relaxation techniques at bedtime.

6. Try to go to bed at the same time every night and wake at the same time each morning.

7. Use the bed only for sleep or sexual activity.

8. Avoid tobacco products, especially before sleep.

9. Ask your provider if any of the medicines you take may affect your sleep.

If you cannot fall asleep after 20 minutes, get out of bed and do a quiet activity, such as reading or listening to music.

When you feel sleepy, get back in bed and try again. If you still cannot fall asleep in 20 minutes, repeat the process.

Drinking alcohol at bedtime may make you sleepy. However, it is best to avoid alcohol, because it can make you wake up later in the night.

Paying attention to your overall health as you pass age 45 and making appropriate retirement planning to address the physical, emotional and financial issues that come with aging, health and long term health care will also make you sleep better.

Thing to make sure you do:

1. See your doctor on a regular basis.

2. Contribute to your employer’s 401k or 403b plan.

3. If you have an HSA (health savings account) contribute the maximum allowed.

4. Pay attention to the investments in your retirement accounts and make sure they are balanced based on your age.

5. Obtain Long Term Care Insurance in your 40’s or 50’s when you are healthy and premiums are very affordable.

6. Sign a medical and financial power-of-attorney and let your family know of your wishes.

Good luck as you age and enjoy life!

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