Health

Z's Are Tops

Tired of being up all night? Here’s news to put you to sleep.

You know the drill: Work all day, work a little more into the night, crash on the couch, drag yourself into bed, and, hello!, you’re wide awake. Insomnia may be a common problem for the over-40 crowd — as is its sister dilemma, frequent waking — but neither should be considered a normal part of aging. Roughly one-third of adults in midlife experience occasional bouts of insomnia, and 10 percent have what’s deemed chronic insomnia, according to David Neubauer, M.D., an associate professor of psychiatry at Johns Hopkins University School of Medicine who’s studied and written about sleeplessness. Women going through perimenopause and menopause also frequently experience a spike in sleep disturbances.

“The problem with not sleeping well,” he says, “is that too many people simply accept it. They don’t take it seriously, but it most definitely is impacting their lives in bigger-picture, long-term ways that they may not realize.”

Lack of sleep undermines your efforts to lose or maintain weight, for example. It makes it harder for you to prioritize exercise because you’re so darned exhausted. Poor Z's make you irritable and that much more likely to forget where you left your keys. You’ll also have a heightened sensitivity to pain. Inadequate sleep hampers your productivity at work and leaves you with little energy to enjoy your time with friends and family. Insomnia may even put you at a greater risk of developing high blood pressure (or compounding already high blood pressure).

“Your body needs that deep sleep to function properly,” says Dr. Neubauer. “When people talk about wanting to improve their health and well-being, if they’re not addressing their sleep along with their eating and exercise habits, they’re not going to meet their goals. Proper rest will enhance your good efforts toward improving your health. Our society needs to place a higher value on sleep — not just getting enough sleep each night, but getting quality sleep each night.”

Easier said than done? Not necessarily. Instead of counting sheep, commit to these strategies to get the shut-eye you’re craving.

Assess and address your health status. “Good health and good sleep is a two-way street,” explains Dr. Neubauer. Not only does persistent insomnia contribute to the health issues mentioned above, but if you’re overweight, not exercising, eating more bad foods than good, or have a chronic condition like diabetes, heart disease, or even back pain that you’re not managing well, your chances of having trouble falling asleep are higher. He encourages adults in their 40s, 50s, and 60s to stay on top of their annual checkups and have meaningful conversations with their doctors about how well they’re sleeping.

Figure out how much sleep you really need. Generally speaking, adults need a good seven to eight hours of shut-eye for prime functioning the next day. But Dr. Neubauer points out that sleep needs are individualized. Your goal is to get enough sleep so that you wake up feeling rested. To do that, start with the time you need to wake up so that you’re on time for work or to get your household up-and-at-‘em. Count back 7.5 hours and that’s when you need to turn in for the night. If you wake up shortly before your alarm rings, you’ve found your sweet spot for sleep. If you wake up much earlier, you can go to bed a little later. On the other hand, if you still need your alarm, you’ll need to go to bed earlier. Work with 15-minute increments until you find the time when you can consider your alarm a backup, not a necessity.

Create a pre-sleep routine. The medical world calls this “sleep hygiene.” What it means is you need a bedtime routine that promotes a sense of tiredness. If you routinely fall asleep watching a TV show only to go to bed and find you’re wide awake, for example, you have a poor bedtime routine. A better idea would be to make use of that Netflix account and watch those later-evening shows on a different day at an earlier hour. For those who count on those hours before bedtime to get more work done, give yourself a firm cut-off time. Your body needs at least 30 minutes to properly unwind and prep for sleep. “When you start to feel sleepy, that’s the time to head to bed, not just put on your pajamas,” says Dr. Neubauer.

If you’re awake in bed, get up. You should be asleep within roughly 20 minutes of hitting the pillow. So if you’re still fighting your brain (Shut down, already!) you’re better off getting out of bed and engaging in a quiet activity until you start to feel sleepy again. Similarly, if you wake up at 2 or 3 in the morning and find yourself tossing and turning, stop the madness and get up. When you’re up, it’s important to keep the lights dim — so no dusting or online shopping.

“You’re not doing yourself any favors by staying in bed simply because it’s the middle of the night. You’re likely making yourself so stressed about the sleep you’re not getting that even if you do drift off you won’t get to that deep sleep,” he says.

In fact, several centuries ago, people made good use of the time when they’d awaken in the middle of the night. Notations from 16th-century English and French physicians refer to patients who chose to study or make love during the hour or two between “first sleep” and “second sleep.” There also are several literary references, including in Chaucer’s Canterbury Tales, to the two sleep periods as being common occurrences. More recently, when researchers at the National Institute of Mental Health deprived study participants of artificial light, they found that individuals naturally fell asleep around 8 p.m., woke around midnight, and then drifted off again a few hours later.

“In a sleep doctor’s ideal world, we’d all go to sleep relatively soon after sundown and wake up at sunrise,” says Dr. Neubauer. “In reality, we need to set a good stage for better rest, not fight our natural urges to fall asleep, but also not fight ourselves during those times when we can’t sleep.”

Know when to seek help. The occasional night of tossing and turning won’t hurt you, but if it’s a nightly battle, or if you begin to struggle with daytime fatigue, Dr. Neubauer says it’s time to call your doctor to get at the root of what’s preventing you from sleeping well. “Persistent insomnia can cross the threshold and become a mood disorder,” he says. Plus it increases your risk for physical health problems (see above). “But beyond the health consequences, sleeplessness just shouldn’t be a given. There’s help.”