-Dr. Kathy Johnson, PhD CMC
Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. “sleep hygiene”) as outlined below.
Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don’t conflict with bedtime, and physically comfortable in a quiet and dimly lit place.
Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.
For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these “sleep hygiene” tips and habits are the first steps to take:
Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.
- Eat a big meal at lunchtime, and have a lighter dinner.
- Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
- Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
- Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
- Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
- Avoid television right before bed.
- Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
- Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.
If you don’t fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape. Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.