By JUDD MATSUNAGA, ESQ.
If you haven’t “slept like a baby” since you were a baby, this article is for you. An uninterrupted night of peaceful slumber can make all the difference in how you feel the next day. Not only that, but mounting evidence shows that getting a good night’s sleep on a regular basis is vital to your health and well-being.
Did you know that about 35% of Americans sleep less than the recommended seven hours each night. According to a Special Report from Harvard Medical School, “Improving Sleep,” insufficient sleep can increase your susceptibility to depression, weight gain, and even the common cold. A growing number of studies have linked long-term sleep deficits with significant health problems:
Diabetes: People who sleep just five to six hours a day are twice as likely to be diagnosed with prediabetes and Type 2 diabetes compared with people who sleep seven to eight hours a day, according to a 2021 review in the Journal of Endocrinology.
High blood pressure: Shorter sleep times were linked to a higher risk of high blood pressure. People with very short sleep times (four or fewer hours per night) were twice as likely to have high blood pressure compared with those who slept seven hours nightly.
Dementia: A growing body of research suggests that sleep disturbances may increase the risk of developing dementia. Experts believe that sleep helps clear the brain of amyloid, the protein thought to damage nerve cells in Alzheimer’s.
Weight gain: Numerous studies have linked inadequate sleep with obesity. Researchers found that lack of sufficient sleep tends to disrupt hormones that control hunger and appetite, causing you to eat hundreds of extra calories per day — in particular, quickly digested carbohydrates. Excess weight, in turn, increases the risk of several health problems.
Depression: A study found that, compared with normal sleepers, people who reported a history of insomnia were four times as likely to develop major depression within the next three years. And two studies found that sleep problems often developed before a diagnosis of major depression and (to a lesser extent) anxiety.
Viral infections: People who’d slept less than six hours per night were four times as likely to get sick as those who’d slept at least seven hours per night. Other research found a link between shorter sleep duration and lower antibody response to the flu vaccine.
Most adults need seven or more hours of sleep to function at their best. In older adults, falling asleep takes longer, and the shallow quality of sleep results in dozens of awakenings during the night. Because of the frequent fragmentation of sleep, it can take longer in bed to get the same amount of sleep.
Two of the most common medical conditions that affect people’s ability to sleep are (1) sleep apnea and (2) nocturia.
Sleep apnea is a serious health condition in which breathing stops or becomes shallower hundreds of times each night. Sleep apnea can double a person’s risk of suffering a stroke over a seven-year period. Sleep apnea also wreaks havoc on the cardiovascular system because the heart must work harder every time the person rouses to open the airway, increasing heart rate, blood pressure, and stress hormones.
Today, one in four men suffers from obstructive sleep apnea (OSA), the most common form of sleep apnea. With OSA, the tongue or throat tissues block the airway and you cannot breathe.
A potentially life-threatening lack of oxygen and buildup of carbon dioxide, as well as increasing efforts to breathe, cause you to wake and gasp loudly for air until blood oxygen levels return to normal.
Untreated, sleep apnea can have devastating consequences. The relentless daytime fatigue that often results may destroy careers, break up marriages, and lead to automobile and workplace accidents. It can even be life-threatening, contributing to the development of high blood pressure, heart failure, and strokes.
Treatment for OSA often includes lifestyle changes, which may improve but usually don’t fully resolve the condition. For people with mild to moderate OSA, therapies such as dental devices and positional aids may be reasonable alternatives. However, the gold standard (and most commonly used) treatment is positive airway pressure (PAP). Less common treatments include a variety of surgical procedures.
Another common cause of sleep loss for seniors is the need to get up frequently to urinate during the night, called “nocturia.” Nocturia is a common cause of sleep loss, especially among older adults. It affects nearly two-thirds of adults ages 55 to 84 at least a few nights per week. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times.
Nocturia becomes more common with age. As you grow older, your body’s ability to concentrate urine (that is, to remove water from the fluid going into the kidneys) decreases, causing you to produce a higher volume of urine. Also, the bladder tends to lose holding capacity, leading to more frequent emptying. Older people are also more likely to suffer from medical problems affecting the bladder.
Nocturia has numerous possible other causes, including some of the disorders mentioned in this report (heart failure, diabetes), other medical conditions (urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), and medication (especially diuretics). Some cases are caused or worsened by excessive fluid intake after dinner, especially drinks containing alcohol or caffeine.
Surveys suggest that although two-thirds of Americans have sleep problems at some time in their lives, most of them suffer in silence. They enjoy life less, are less productive, and endure more illnesses and accidents at home, on the job, and on the road. The American Academy of Sleep Medicine recommends seeking medical advice if sleep deprivation has compromised your daytime functioning for more than a month.
Don’t hesitate to ask for help when you’re sleeping badly following a death in the family or other stressful event. A physician may suggest the short-term use of a sedative to help you sleep at night. This may help you cope better during the day and prevent the development of a long-term sleep disorder. However, sleep medications are not necessarily the best option.
According to a National Sleep Foundation survey, most primary care physicians do not routinely ask their patients about sleep. Doctors trained in the U.S. receive roughly three hours of instruction on this topic during four years of medical school. So it’s in your best interest to ask your primary care provider for a referral to a sleep specialist to get an evaluation and treatment for a sleep problem.
If sleep problems are not that serious, the Harvard Special Report makes the following suggestions to help you sleep better at night:
● If older people are unable to get all the required sleep at night, they often supplement nighttime sleep with daytime naps. This can be a successful strategy for accumulating sufficient total sleep over a 24-hour period. However, if you find that you need a nap, it’s best to take one midday nap, rather than several brief ones scattered throughout the day and evening.
● Replace bright lights with lower-wattage bulbs or install dimmer switches that allow you to keep the lights low at night. Also, if you need to block early-morning sunlight, consider light-blocking curtains or shades. Bright bathroom lights can be an issue, too, especially since most people use the bathroom right before retiring (and often in the middle of the night). But you don’t want to stumble if you can’t see. As long as it’s safe to do so, consider using night lights to light the way to and in your bathroom.
● Screening out blue light: Electronic devices such as televisions, laptops, and cellphones emit blue light. Nighttime exposure to blue light, the shortest of the visible wavelengths, suppresses the brain’s production of sleep-inducing melatonin. Blue-light exposure tends to suppress REM sleep as well. That means using a blue-light-emitting device close to bedtime — whether you’re reading a book on a tablet or binging your favorite TV series on a laptop — can make it harder for you to fall asleep.
● Keep comfortable. A bedroom that’s too hot or too cold may interfere with sleep. Most people sleep best in a slightly cool room (around 65° F). Replace your mattress and pillows if they’re worn or uncomfortable. If aching joints are keeping you awake, ask your doctor about pain relievers. Some people say they are more comfortable sleeping on “memory foam” mattresses and pillows.
● Try relaxation rituals. Worrying about a problem or a long to-do list can be a recipe for insomnia. Well before you turn in, try writing down your worries and make a list of tasks you want to remember. This “worry journal” may help move these distracting thoughts from your mind. Closer to bedtime, try comforting rituals that may help lull you to sleep, e.g., listen to soft, calming music, take a warm bath, do some easy stretches, and/or read a book or magazine by soft light.
In conclusion, getting sufficient sleep will keep you healthier. You don’t have to toss and turn. Once you crawl between the sheets, use the above relaxation techniques, such as deep breathing or progressive muscle relaxation, so you can have all the health benefits restful sleep affords. Use whatever works so you can get to sleep without counting sheep.
Finally, for all Rafu readers interested in a drug-free approach to treating insomnia, I have created an audio clip that is currently available online. Simply search “ELS theta wave music” on YouTube. You’ll find a 15-minute induction (to stop the excess chatter in your mind), followed by an hour of theta wave deep relaxation music. I listen to it every night. It works!!!
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.