Christopher Silas Neal
Jane Brody on health and aging.
I
regret that for most of my adult life, I treated sleep as more a luxury
than a necessity.
There was always something more to do before I
crawled under the covers and turned out the light. I realize belatedly
that I might have been more productive — and a lot nicer to live with —
if I had given sleep its proper due.
By failing to acknowledge
chronic sleep deprivation, I dozed during countless cultural events, and
on two occasions I fell asleep while driving, barely escaping disaster.
I have since reordered my priorities and learned to avoid distractions
and activities that can keep me from getting the sleep my body and mind
really need.
About 70 million Americans sleep poorly or not nearly long enough to achieve
the full physical, emotional and cognitive benefits sleep can bestow.
There are myriad reasons, ranging from self-inflicted disruptions to
those that are seemingly unavoidable. But there are also potential
solutions to most of the factors that can interfere with sleep.
For the
sake of your health and longevity, I urge you to give them a try.
How
much sleep do you need? Sleep requirements depend on age. Newborns
sleep 16 to 18 hours a day, preschoolers need 11 to 12 hours, and
elementary school children need 10 hours. Adolescents should get 9 to 10
hours, though most teenagers sleep only about seven hours.
Given
the opportunity to sleep as long as they want, most adults average about
eight hours a night. There are individual differences, of course, but
the usual range is between seven and nine hours.
Getting less than the
amount of sleep you need during the school or workweek builds up a sleep
debt that cannot be fully erased by “sleeping in” on the weekend. This
pattern can also mess up your biological clock, making it hard to get up
on Monday morning.
It was long ago shown that a midafternoon nap
of about 20 minutes can improve alertness and productivity and reduce
mistakes among sleep-deprived workers, yet few employers offer a midday
lie-down or provide a place for one.
Age also affects the quality
of sleep and the amount of time spent in the various stages of sleep.
These include REM, or rapid-eye-movement sleep (often called dream
sleep), and three types of non-REM sleep: the light sleep of Stage 1,
followed by the more relaxed sleep of Stage 2 and the most restorative
deep sleep of Stage 3.
Young children spend most of the night in
deep sleep, which is why they can often sleep through loud noise, bright
light and being carried from car to bed.
But with age, the time
spent in deep sleep diminishes and any number of disturbances can cause
awakenings. For women going through menopause, for example, sleep is
often interrupted by hot flashes.
Even if there are no external
disturbances, elderly people may be awakened many times during the night
by the discomforts of illness or pain, the side effects of medication
or the need to urinate.
Poor sleep among the elderly may in part
account for problems with memory and concentration, depressed mood and
daytime sleepiness. I often see gray heads nodding off at events, even
during matinees.
If noise or light disturbs your sleep, you can
counter them with a white-noise machine and light-blocking shades.
Keep
the room cool and avoid weighty covers.
Two years ago, I summarized
factors that commonly interfere with a good night’s sleep, but a quick review, followed by some valuable new tips that have helped me, may help you too.
EXERCISE Physical
activity leaves you tired, but if you do your workout within two or
three hours of bedtime, you may be too revved up to fall asleep easily.
MEDICATION Many
drugs, both prescription and over-the-counter, contain stimulating
chemicals like pseudoephedrine and caffeine, commonly found in
decongestants and painkillers. Beta-blockers, used to treat certain
heart conditions and high blood pressure, may be disruptive as well. Ask
your doctor if you can use an alternative drug.
FOOD AND DRINK
Eating a big meal close to bedtime can be a problem, especially if you
are prone to indigestion.
Drinking a caffeinated beverage late in the
day can disturb the sleep of anyone who has not developed a tolerance to
caffeine by drinking too much of it.
Caffeine’s stimulating effects can
last for six to eight hours and make it hard to fall asleep or cause
middle-of-the-night wakefulness.
Alcohol may help you fall asleep,
but when its effects wear off hours later, you may wake up and be
unable to get back to sleep. (I and others I know find wine especially
problematic and avoid drinking it with dinner.)
STRESS Anxiety,
excessive stress and difficulty shutting out worries trigger the
release of body chemicals that act as stimulants.
Try a relaxing bedtime
ritual like a hot bath, meditation or progressive muscle relaxation,
starting at the toes and working up to your head.
Or, odd though it may
seem, try reading something dull.
If things you must remember or
do the next day keep popping into your head, put a pad and pen next to
the bed, write them down and then do your best to forget about them
until morning.
OTHER TIPS Years ago I mentioned
that leg cramps were waking me up well before the alarm, and readers
responded with myriad solutions, from bedtime stretches to magnesium
supplements. What has worked best: drinking about eight ounces of tonic
water (diet version) every day.
Tonic water contains modest amounts of
quinine, which used to be sold over-the-counter to reduce leg cramps.
Another
innocuous sleep aid that has proved miraculous for me is a nightly
supplement of melatonin, which the body naturally produces after dark.
The pineal gland in the brain is inactive during the day, but after
sundown it starts spewing melatonin into the bloodstream.
With a
supplement on board, I fall asleep quickly, and if I awaken during the
night, I return to sleep easily. A three-milligram supplement near
bedtime is considered harmless and may help you as well, though it
should not be given to children without consulting a doctor.
If hot flashes are your current problem, ask your doctor about trying the prescription drug gabapentin.
Fuente: The New York Times. 24 de junio 2013/personal health