Are you getting enough sleep


Woman sleeping

Like good diet and exercise, sleep is a critical component to overall health. For adults age 50 and older, it is best to get between 7 and 9 hours of uninterrupted sleep per night, according to the National Sleep Foundation.

To pave the way for better sleep, follow these simple yet effective healthy sleep tips, including:

  • Stick to a sleep schedule, even on weekends.
  • Practice a relaxing bedtime ritual.
  • Exercise daily.
  • Evaluate your bedroom to ensure ideal temperature, sound and light.
  • Sleep on a comfortable mattress and pillow.
  • Beware of hidden sleep stealers, like alcohol and caffeine.
  • Turn off electronics before bed.


If you or a family member are experiencing symptoms such as sleepiness during the day or when you expect to be awake and alert, snoring, leg cramps or tingling, gasping or difficulty breathing during sleep, prolonged insomnia or another symptom that is preventing you from sleeping well, you should consult your primary-care physician or find a sleep professional to determine the underlying cause.

You may also try using the National Sleep Foundation Sleep Diary to track your sleep habits over a one- or two-week period and bring the results to your physician.

Most importantly, make sleep a priority. You must schedule sleep like any other daily activity, so put it on your “to-do list” and cross it off every night. But don’t make it the thing you do only after everything else is done — stop doing other things so you get the sleep you need.

Sleep can be divided into two types: REM sleep and non-REM sleep. Non-REM sleep has four stages of increasingly deep sleep. Stage 1 sleep is the lightest, while stage 4 is the deepest.

During normal sleep, you cycle through these types and stages of sleep. But if your sleep is repeatedly interrupted and you cannot cycle normally through sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while awake. Sleepiness puts you at greater risk for car wrecks and other accidents.

If you have trouble getting to sleep or sleeping through the night, you may have one of the following sleep problems:

Circadian Rhythm Disorders

Typically, people sleep at night — thanks not only to the conventions of the 9-to-5 workday but also to the close interaction between natural sleep and alertness rhythms, which are driven by an internal “clock.” It’s located just above the nerves leaving the back of the eyes. Light and exercise reset the clock and can move it forward or backward. Abnormalities related to this clock are called circadian rhythm disorders

These disorders include jet lag, adjustments to shift work, over-sleeping and under-sleeping. Circadian rhythm disorders are an important but less common cause of insomnia.


People who have insomnia don’t feel as if they get enough sleep at night. They may have trouble falling asleep or may wake up frequently during the night or early in the morning. Insomnia is a problem if it affects your daytime activities. Insomnia has many possible causes, including stress, anxiety, depression, poor sleep habits, circadian rhythm disorders and taking certain medications.

Insomnia may be temporary and stem from a simple cause, such as jet lag. Short-term insomnia may also be caused by an illness, a stressful event, or drinking too much coffee, for example. Many medications have insomnia as a side effect.

Long-term insomnia may be caused by stress, depression or anxiety. People can also become conditioned to insomnia: They associate bedtime with difficulty, expect to have trouble sleeping (and thus do), and become irritable (which can cause more insomnia). This cycle can be maintained for several years.


Snoring is when the air you inhale rattles over the relaxed tissues of the throat. Snoring can be a problem simply because of the noise. It may also be a marker of more serious sleep apnea.

When you fall asleep, many muscles in your body relax. If muscles in the throat relax too much, your breathing may be blocked and you may snore. Sometimes, snoring is caused by allergies, asthma, or nasal deformities that make breathing difficult.

Sleep Apnea

Sleep apnea occurs when the upper airway becomes completely or partially blocked, interrupting regular breathing for short periods of time, which then wakes you up. It can cause severe daytime sleepiness. If left untreated, severe sleep apnea may be associated with high blood pressure and the risk of stroke and heart attack.

Apnea means “no airflow.” Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age, any weight and either sex. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.

Drops in blood oxygen during sleep — once thought to be the cause of waking up due to obstructive sleep apnea — may or may not be present. Most likely, awakening occurs with the body’s increased effort required to overcome the obstruction of the airway.

Drinking alcohol can make obstructive sleep apnea worse because it relaxes muscles that maintain an open airway.

A rare form of sleep apnea called “central sleep apnea” occurs when signals from the brain to your muscles decrease or stop for a short time. You may not snore if you have central sleep apnea.


Narcolepsy is a brain disorder that causes excessive daytime sleepiness. There is sometimes a genetic component but most patients have no family history of the problem. Though dramatic and uncontrolled “sleep attacks” have been the best-known feature of narcolepsy, in reality many patients do not have sleep attacks. Instead, they experience constant sleepiness during the day.

The cause of narcolepsy is not clear. Genetic and environmental factors likely play a role, although the data on genetic factors is still speculative and not well studied. There are some rare nerve disorders that may be linked to narcolepsy.

Restless Legs Syndrome

Restless legs syndrome is discomfort in the legs and feet primarily at night. Sufferers feel an urge to move their legs and feet to get temporary relief, often with excessive, rhythmic or cyclic leg movements during sleep. This can delay sleep onset and cause brief awakening during sleep. Restless legs syndrome is a common problem among middle-aged and older adults.

There are many possible causes of restless legs syndrome, including kidney failure, nerve disorders, vitamin and iron deficiencies, pregnancy and some medications (such as antidepressants). Recent studies have shown a strong genetic link and researchers have been able to isolate a gene that may be responsible for at least 40% of all cases of the disorder.


Nightmares are frightening dreams that arise during REM sleep. They can be caused by stress, anxiety and some drugs. Often, there is no clear cause. Nightmares can be triggered by a frightening or stressful event, a fever or illness, or use of some medications or alcohol.

Night Terrors and Sleepwalking

Both night terrors and sleepwalking arise during non-REM sleep. A night terror can be dramatic, but the sufferer may be unable to explain the fear. Sleepwalkers can perform a range of activities — some potentially dangerous, like leaving the house — while they continue to sleep.

Night terrors are most common in pre-school children, but they also can affect adults who are experiencing emotional or psychological problems.

Other Factors in Sleep:

— Old age. People over age 60 may not sleep as deeply as younger people. Sleep apnea is also more common among older people.

— Lifestyle. People who drink coffee, smoke cigarettes or drink alcohol are more likely to have sleep problems than people who do not.

— Medication. Many drugs can cause sleeplessness. Others can cause daytime fatigue.

— Depression and anxiety. Insomnia is a common symptom of depression and anxiety.

— Heart failure and lung problems. Some people find it difficult to sleep at night because they become breathless when they lie down. This can be a symptom of heart failure or a problem with the lungs.

People who suffer from sleep disorders should discuss this thoroughly with their primary-care physicians. Many of these problems can be easily solved while others prove to be more difficult. Once your treatment begins, it is important to stick to the regime. If you need help doing what your doctor orders and with sticking to the program, remember that integrated health coaches who hold certificates from Duke University are specifically trained to work with you until you reach those goals.

Lisa Burbage

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