Restless Days, Sleepless Nights …

I thought last night would never end.  I went to bed at my usual time, read for about 20 minutes, turned off the light and fell asleep.  Two hours later, I woke up because my hips and knees hurt.  I took a couple of Tylenol and went back to sleep.  Two hours later I woke up because I had to pee.  Took care of that, went back to bed and fell asleep.  Two hours later I woke up with the covers all askew, my body in a sweat, and my back hurting.  Got up, re-arranged the bed, got back in and tried to fall asleep.  Did not succeed for a while, so tried reading.  Then I had to go to the bathroom again.  Finally fell asleep and woke up to the sun shining in my bedroom window convinced that I had overslept.

I never used to have problems sleeping.  It was just something that happened without question or interruption between the hours of 10:00 pm and 6:00 am.  It wasn’t until I went through menopause that this changed.  Having survived the hormonal challenges of night sweats and racing thoughts, I had thought I was home free.  Based on several months of evidence to the contrary, I now am learning what it is like to navigate nocturnal interruptions for bladder, pain, and restlessness.

How Much Sleep Do We Need?

Quality sleep is essential to brain health at any age.  This is especially true for those of us in elderhood.  Maybe like me, you were taught that eight hours of sleep a night was the standard.  Turns out that this is the “average”.  Some of us need less and some of us need more.  To confound that information, we don’t all need to get it at once.  I know people who sleep 3-4 hours at a time, then get up and do things and then go back to bed for another 3-4 hours.  This is just perfect for them!  For others, sleeping steadily through the night for 8-10 hours is typical.

Factors that affect how well I sleep include what and when I eat and drink.  If I don’t drink enough water during the day, I am dehydrated at night.  If I drink too much water during the day, I spend extra time in the bathroom at night.  If I drink alcohol or lots of fruit juice (basically sugar water), then I am up all night peeing. If I eat lots of carbs and sweets late in the evening, I am up during the night managing my digestion.  It is a balancing act based on my metabolism and my overall physical health.

How do metabolism and overall physical conditioning effect sleep?  In major ways.  If your digestive system is robust, your body will be eliminating toxins and absorbing nutrients as you sleep.  If your sleep is interrupted, this process will be interrupted.  When your body is weakened by illness, inflammation, dehydration, or disease, your brain will expend energy monitoring and responding to changes in these conditions as well as trying to do the restorative tasks of consolidating memories and tidying up neural pathways.

Why Do We Sleep?

So why do we need to sleep anyway?  You would think that would be a fairly easy question to answer, but surprisingly, it is not!  There are lots of different theories.  The brain needs to “clean house” and restore itself (recharging).  Sleep is an adaptive strategy for conserving energy and slowing metabolism.  Sleep is a strategy for not being eaten by other animals.  None of these is particularly satisfactory in its explanation.  The most researched of these three is the first one – where during sleep, the physical body is disconnected from the brain’s motor cortex allowing the brain to focus on consolidating memories and removing dead or poorly connected neural pathways.  While this is the dominant theory now, it does not answer a lot of questions.  Why?  Because sleep research is hard to do!

Think about it.  To research sleep, you need to watch people sleeping.  Watching hours of footage of people sleeping is only partially useful, because researchers don’t know what is going on inside of the subject’s brain.  So they hook them up to monitors.  The information obtained this way, gives us brain wave patterns, but little else.   They only way to find out what is going on is to wake the subject up and ask him or her, “what’s going on?”.

If any of you have had a sleep study done, you know that the sleep environment is anything but restful, what with the leads attached to your head, the unfamiliar and often uncomfortable bed, pillow, and environment.  Not to mention the knowledge that someone is watching you!  At least for me, this was not the optimal 8 hours of sleep I long for!  And, frankly, it was not representative of the quality of sleep I typically have.

Sleep Essentials

Still, research on sleep has uncovered certain essential elements.

First we all benefit from a regular sleep routine: Going to bed at the same time.  Making sure it is cool enough for good sleep.  Keeping lights off.  Not eating too late at night.

Second is cutting myself some slack.  If I don’t sleep well one night, that is OK.  I need to reassure myself that all the catastrophic thoughts I had at 4:00 am are just wild imaginings spinning around in my subconscious and aren’t actually accurate or predictive of what is happening.

Third is making sure that I exercise, drink enough water throughout the day, take my meds as prescribed and either don’t drink alcohol or use other substances except in moderation.

Sleep Partners

When my husband was alive, these things were sometimes challenging.  He needed a CPAP machine, and that thing hissed and blew all night long.  We shared a bed, but my body temp and his were on different ends of the thermometer.  If we had been filmed at night, you would have seen a tag team event of falling asleep, tossing and turning, getting up to pee, and returning to bed trying not to wake the other person.  After he died, his absence from the bed was just as hard to adjust to as having that damn CPAP machine going all the time.  It has taken me several years to get used to sleeping alone, as my body unconsciously continues to occupy only “my side” of the bed.

Some of you may have gone through similar experiences either with a sleep partner or with pets who share the bed.  All of these things can have an effect on the quality of our sleep.

Take Home Message

Here’s the take home message:  Ask yourself when you wake up, “Do I feel refreshed?  Do I have energy?”  If the answer is “Yes” to both, it really doesn’t matter how many hours you slept.  If your answer is “No”, then pay attention to the different things mentioned above and systematically see what needs changing.

Sweet dreams!

4 comments

  1. Loved this, Mary. So interesting and helpful. I’ve passed it on to my sleeping partner. Thank you!

    1. Since I was up at 4 a.m. this morning, regretting a recent real estate deal, this column hit home. I know there are many safe sleep aids available. One of them appears to be CBD-the part of marijuana that does not make you high. This according to a presentation yesterday at our local library that was aimed at us ‘agers.” The event was so popular that they had to turn people away, suggesting the interest in how CBD is seen to be useful in a whole range of health issues. Kudos to the Sonoma County Library for their sponsorship,too!

  2. “Sleep is a strategy for not being eaten by other animals.” Really???? I loved this post. No one else has described a fitful night so vividly (that I’ve read), or included just enough science (written equally vividly) to be really useful. I am glad you’re there–even from a distance, your thoughtful presence is always settles me.

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