By Kimberly Goad, AARP March 2023
Tips for getting the deep, refreshing slumber you need, and for getting back to sleep when you wake in the wee hours. Don’t believe the short sleepers. Those one-percenters — Martha Stewart and Elon Musk, among them — all claim to get by just fine on less than six hours of sleep a night. But sleep is meant to repair and restore, and research shows that unless you’re among the 1 percent with the “short sleeper” gene, you need at least seven hours a night to make that happen. No surprise, many of us — 1 in 3 — aren’t logging that many hours, and if we are, we aren’t doing so consistently or without waking throughout the night. That’s especially true as we age and begin to experience a shift in how we cycle through the different stages of sleep — what sleep experts call “sleep architecture.”
“As we get older, our sleep becomes more shallow and broken up, and the amount of deep sleep decreases somewhat,” explains Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona College of Medicine Tucson. “This may be due to more sleep disrupters and medical issues interfering with our ability to get deep sleep, or it may just be a natural part of aging. We also tend to get more interruptions to sleep, for longer periods of time, as we get older.”
Whatever the exact reason, the cumulative effect goes way beyond simply feeling tired and foggy-headed the next day. Research shows that chronic sleep deprivation accelerates the aging process. According to a recent study in the Journal of Experimental Medicine, chronic insufficient sleep can negatively affect immune cells, which may lead to inflammatory disorders and heart disease. The study also found that catching up on sleep — say, on the weekends — doesn’t reverse the damage. Another study, published in PLOS Medicine, analyzed the impact of sleep duration on the health of almost 8,000 men and women at the ages of 50, 60 and 70. Researchers looked at the relationship between how long each participant slept, mortality and whether they had been diagnosed with two or more chronic diseases — such as heart disease, cancer or diabetes — over the course of 30 years. People who reported getting five hours of sleep or less at age 50 were 30 percent more likely to be diagnosed with at least two chronic diseases over 30 years, compared to people who slept for up to seven hours.
But that doesn’t mean staying healthy is contingent upon sleeping through the night without ever waking up. Uninterrupted sleep isn’t realistic, says Chris Winter, M.D., a neurologist, sleep expert and author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It.
Although we may not realize it, “humans wake up during the night a lot — probably 15 times every hour, and this number tends to grow as we age,” says Winter, who works with professional athletes to help them improve their sleep habits. “Waking up once or twice during the night does not mean your sleep is ruined. Every NBA player I work with wakes up once or twice to go to the bathroom at night, and they still score 15 points the next day and grab four rebounds.”
We go right back to sleep after most of those short awakenings, but sometimes we wake up and stay awake. So it isn’t the waking up that’s (necessarily) the problem. It’s the going back to sleep that can be tricky. Keep reading for tips on how to improve your chances of making that happen.
1. Set a regular bedtime (and stick with it)
Your chances of getting a good night’s sleep begin the night before. That’s right. The most important thing you can do in the name of getting a good night’s sleep is to go to bed and wake up at the same time every day, even on weekends.
What experts call good sleep hygiene “incorporates many different aspects, beginning with keeping to regular bedtimes and wake times, regardless of how the day went,” says Jing Wang, M.D., associate professor of medicine at the Icahn School of Medicine at Mount Sinai. Also important: “Protect the bedroom for sleep or sex only,” she adds. “You want to create a relaxing environment — quiet, cool and dark.” To that end, lower the thermostat slightly, close the blinds and “take the clock out of the bedroom or cover it so you don’t see it.” It’s a matter of heated debate among animal lovers, but having pets in your bed can disturb sleep.
2. Avoid long naps
Nothing wrong with a daytime nap. Research suggests it can improve overall well-being in a number of ways. The secret is to keep naps short, ideally 20 minutes and no longer than 30. Otherwise, they can interfere with nighttime sleeping.
“Naps are like sleep snacks,” says Grandner. “A light snack in the middle of the day can be great for health and give an energy boost. But constant, excessive snacking might be a sign of a problematic diet. It’s the same with naps. Planned naps in the middle of the day can be very helpful. But unplanned naps due to sleep deprivation may not solve the problem of poor nighttime sleep.”
Mounting research shows a strong relationship between sleep and physical activity, whether it’s a walk around the block or an all-out sweat session at the gym. Each plays a role in the success of the other. “Exercise is the one thing that truly improves sleep quality and quantity,” says Winter.
4. Avoid fluids after the early p.m.
Nocturia — otherwise known as waking during the night to pee — is incredibly common among older people. Research suggests half of adults ages 50 to 79 make two or more trips to the bathroom per night. The reasons? Age-related changes in the urinary system along with a variety of hormonal changes. Research shows that hypertension, cardiovascular disease, diabetes, sleep apnea and obesity also play a significant role. The solution? Reduce fluid intake in the mid and late evening, especially of caffeinated beverages and alcohol, which can act as diuretics. Pelvic floor exercises may also help.
5. Power down
It isn’t just that the TV series you’re streaming is stimulating or the games on your phone keep your brain buzzing. The blue light that’s emitted from these and other electronic devices is like a calling card for insomnia, boosting mood and alertness by slowing the production of melatonin — the sleep hormone — in the body. Turn off all tech “at the very least an hour, ideally two to three hours,” before you slip between the sheets, Wang says.
6. Get out of bed
You’ve counted sheep, dogs, cats, the number of times your grandkids watched Paddington during their weekend stay, and still you can’t fall back to sleep. “Awakenings are often followed by a period of unavoidable wakefulness — our mind or body is just too activated to return to sleep,” says Grandner. “The best thing to do is get out of bed and do something else to pass the time until the mind and body are ready to try again. Lingering in bed often backfires and creates stress around sleep.”
But that’s not to say a bout of insomnia is license to grab your phone off the nightstand and go googling. The American Association of Sleep Medicine gives the green light to anything that isn’t stimulating, whether it’s knitting, drawing or reading. If you have no choice but to log on to your computer or pick up your phone, keep a pair of blue-light-blocking glasses handy, and be sure the lenses are orange or red. A study published in 2022 in the Journal of Biological and Medical Rhythm Research looked at 50 pairs of blue-light-blocking glasses and found that the orange and red lenses blocked virtually all the light that impacts circadian rhythms and sleep. “Blue-light-blocking glasses are great to use during middle-of-the-night wakings,” says Grandner, lead author of the study.
If none of the above helps and “your sleep problems are interfering with your ability to function or are contributing to health or mental health problems, seek out a sleep specialist to see if you might have a sleep disorder,” Grandner suggests. “Sleep disorders are highly treatable — most don’t even require sleeping pills or other medications.”
Is melatonin a good idea?
You could be forgiven for thinking of melatonin as a sleeping pill, given its proximity to over-the-counter medications and supplements at the pharmacy. Melatonin is actually a hormone produced naturally by the body. Its production ramps up at night, promoting sleep and helping to orient your circadian rhythm, the body’s sleep-wake cycle. The melatonin that comes in a bottle is a synthetic version of that hormone.
The question is: Are melatonin supplements — whether regular or extended release — effective for middle-of-the-night awakenings? “In general, we do not recommend taking melatonin, but may consider it depending on a patient’s individual situation,” says Wang, echoing the findings of a review of studies recently published in Clinical Interventions in Aging. “Because it is a nonprescription medication, we worry about inadvertent inappropriate dosing/timing, so we prefer to discuss individualized plan for use.” For more about this popular supplement, see Melatonin for Sleep, Does It Work and Is It Safe?