Our Aging Body: Sleep
In Search of a Good Night's Sleep
We would all benefit from learning more about the wonders of the human body. Wellness always begins with our lifestyles: what we eat, how we move, and how we navigate the complexities of modern living. Aging is part of our lifespan - there is only one escape! I became curious about what happens to our bodies as we age and what strategies we can employ, given our access to wisdom, common sense, technology, and scientific information. Each month, I will feature an article on the aging human body. I am not a medical professional, and that’s a good thing because I write to be understood.
I suspect that most of us don’t think much about the physical act of sleeping except when we can’t. We stare at the clock, wondering why we can’t sleep, perhaps willing ourselves to sleep. If our insomnia continues, we begin to worry about how well we will function once we start our day.
Many people assume that changing sleep patterns and insomnia are natural parts of aging. In actuality, older adults need the same amount of quality sleep as younger adults. Research indicates that older people sleep less deeply, wake up frequently at night, and have difficulty falling asleep. Sleep deprivation can increase confusion, slow reaction time, and impact overall alertness. Diagnosing the cause of sleep deprivation is not always easy.
Many factors can affect an older person’s ability to sleep deeply:
Physical pain or discomfort
Anxiety, stress, grief, or depression
Pharmaceutical drugs and over-the-counter drugs
B vitamins, stimulant herbs, antihistamines, dietary supplements
Diet, eating patterns, or nutritional deficiencies
Digestive problems (e.g., bloating, reflux)
Lack of exercise
Lengthy naps during the day
Increased need to urinate
Reduced melatonin production
Irregular hormonal fluctuations
Alcohol overindulgence
Lack of natural light exposure
Overstimulation from television or computer
Sleep disorders
Intrusive light or noise (e.g., snoring, loud music)
Restless leg syndrome, fibromyalgia
Room temperature
Irregular sleep habits
Sleep apnea
Sleeping is a complicated and essential activity that is critical to the health of our body's systems. Decades of research confirm that the quality of our sleep habits can have adverse long-term health effects. Chronic sleep deprivation can contribute to the following health issues:
Reduced energy and daytime sleepiness
Impaired cognitive functions contributing to the potential for accidents
Weight gain and increased risk of obesity
Glucose intolerance and increased risk of diabetes
Hormonal imbalances
Anxiety, depression, and mood swings
High blood pressure and increased risk of heart cardiovascular disease
Weakened immune function
Sleep Architecture
We often measure our sleep quality by hours, with seven to nine hours recommended for a “good night’s sleep.” But our bodies and research remind us that quality is also measured by the cycles of sleep stages that occur when we are asleep.
Our sleep processes, called sleep architecture in the science world, consist of stages of different kinds of sleep that are repeated throughout the night. Each stage contributes to our body’s ability to rest and restore. Ideally, we should experience four to six cycles of these stages in a sleep session.
Each sleep cycle consists of four stages: the first three are non-rapid eye movements (REM), and the fourth is rapid eye movement. The third stage is where we experience deep sleep; if we are disturbed while in this stage, we often feel groggy or confused. (I recently woke in this stage after being asleep less than two hours and asked what day it was.) Deep sleep is where our body systems recover and restore. Research suggests that the third stage also contributes to our creativity and ability to remember.
During the fourth stage, REM sleep, our brains are busy—at times as active as when awake. Most of our muscles are temporarily paralyzed in this stage, and we experience vivid dreams. Recently published research discovered that our brains flush metabolic waste while sleeping. This waste is created because the brain uses energy to function. Excess metabolic waste can contribute to neurodegeneration, which can lead to neurological diseases like Alzheimer's.
As we age, the amount of time we spend in each stage changes, notably reducing the time spent in deep sleep stages. Older people report waking more frequently, resulting in less restful sleep sessions.
Circadian Rhythms
The brain contains a collection of 20,000 cells that control our internal clock, commonly called circadian rhythms. These rhythms schedule hormone releases, affect our digestive and immune systems, and help regulate our blood pressure, appetite, and energy.
As we age, our circadian rhythms lose some functionality. Here’s the fascinating part: these cells gather information about light through our eyes, guiding our 24-hour daily circadian rhythm. Exposure to outdoor daylight is one of the best ways to maintain circadian rhythms. Unfortunately, many older people don’t spend enough time outdoors to reap daylight’s benefits. (Looking out a window doesn’t count.)
Another age-related change to our internal clocks is called phase advance. Our circadian rhythms move forward a bit, and we feel tired earlier in the afternoon and wake earlier in the morning. (I am a member of the 4:30 am wide awake club.)
Aging weakens our ability to adjust to schedule changes, and we take longer to recover. Many of us experience this when the clocks change to daylight saving time and traveling across time zones. (Legislators: Please eliminate daylight saving time!)
Hormone of Darkness
Melatonin is a hormone produced by our pineal gland, and as daylight moves to nighttime darkness, it is naturally secreted into our bodies. Its primary job is to prepare our bodies for a good night’s sleep.
Guess what? Melatonin production naturally declines as we age. (Are you seeing a pattern?) Like many synthetically made dietary supplements, melatonin was hyped as a natural sleeping aid, and sales of it in the US increased by 150% between 2016 and 2020. I am cautious about dietary supplements primarily because they are not regulated for quality and effectiveness. My training and education in herbalism have taught me to begin with our lifestyles to see what changes we can make to improve our wellness, in this case, our sleep quality. (There’s a simple way to support your natural melatonin production…see below.)
The Sleep Industrial Complex
Sleep science research overwhelmingly confirms that sleep is critical to our overall health. A good night’s sleep is as essential as a healthy diet and daily exercise. Millions of people in the US have reported that their sleep quality has declined over the last five decades. Many cultural reasons have contributed to that decline, but instead of looking at those reasons as potential sources of the problem, the billion-dollar “sleep industrial complex” was created. During the latter half of the 20th century, sleeplessness became medicalized, and another retail market offering expensive quick fixes to help us sleep was born. In a 2007 New York Times article titled “The Sleep Industrial Complex,” the author examined the development of the competitive market for sleeplessness. Below is a list of some products sold to help us sleep better:
“Intelligent” mattresses
Dietary supplements sold
Pharmaceutical sleep drugs
Sleep-tracking devices
Sleep clinics (over 2500 in the US)
Self-help books
Photo-therapy devices
Blue-light blockers for nighttime screen use
Air ionizers
Meditation and sleep-inducing apps
Zen alarm clocks
Baby sleep aids
Lifestyle Habits for Quality Sleep
If your sleep patterns have changed and you are experiencing too many nights of sleeplessness or poor sleep quality, start by reviewing your lifestyle. Many people have developed habits that contribute to their insomnia.
Technology has altered and benefited our modern lives in incredible ways. But not without consequences. Historians have noted that artificial lighting dramatically changed human behaviors. The last 75 years brought the “Age of Screens,” and science tells us we spend far too much time looking at screens and less time outdoors.
To prepare your body for sleep, stop using phone and computer screens 90 minutes before going to bed. Turn off notifications. Don’t keep your phone in the bedroom. The blue light from these screens suppresses melatonin production. (The internet will still be there in the morning.) And TVs in bedrooms? Same thing.
Avoid alcohol, nicotine, and caffeine. Even a small amount can disrupt sleep, specifically the REM stage.
What and when you eat affects your sleep. Eating healthy, whole foods is far more conducive to sleep quality than processed junk food. Stop eating several hours before your usual bedtime. Spicy or rich food can also create digestive issues like bloating and reflux.
Exercise every day, preferably in the morning. Avoid exercising at least four hours before bedtime. Strength training benefits healthy sleep, so commit to it two to three times weekly. Research shows that regular exercise increases the quality of sleep. (In my research for my series of essays on aging, daily exercise is the #1 lifestyle factor that offers benefits in every aspect of our wellness.)
Spend at least 30 minutes outdoors, ideally in the early morning. The outdoor light will help with melatonin production and secretion.
Create a sleep sanctuary: a comfortable bed and no cellphones or computers. Open a window for fresh air circulation and strive for total darkness. Use black-out curtains or an eye mask if light from neighbors’ houses and street lights can be seen.
Excess body weight can affect your sleep quality and cause sleep apnea (a sleep disorder that affects breathing during sleep).
Commit to a regular sleeping schedule by going to bed at the same time each night and rising at the same time each morning.
Short naps can be beneficial, but longer than 20 minutes can affect your nighttime sleep.
Develop an evening ritual to prepare your body and mind for quality sleep. Turn off screens, meditate, do some gentle yoga stretches, read something light, drink herbal tea, wear comfortable clothing, and sit in the dark or candlelight to activate melatonin production.
If insomnia or poor sleep patterns persist, older people should discuss their concerns with a health practitioner. Increasing exercise and movement during the day, spending at least 30 minutes outdoors, avoiding overstimulation late at night, eliminating long naps, and reducing alcohol and caffeine can significantly improve sleep patterns. Developing healthy sleep habits (and habitats) requires commitment.
Herbs as Sleep Aids
Sedative herbs like valerian, California poppy, hops, passionflower, and chamomile can help with occasional insomnia and anxiety Matching an herb's specific uses to specific indications of a health complaint will be more effective when addressing insomnia and anxiety.
Chamomile tea has a long history of being used to calm nerves and upset tummies. Drink one or two cups after your evening meal. Or consider taking chamomile capsules: A recent study of 60 older adults who took chamomile capsules twice a day concluded that chamomile could significantly improve sleep quality.
Tinctures (herbs extracted in alcohol) can be an effective sleeping aid without increasing the need to urinate later in the night. Passionflower, valerian, hops, and valerian extracts are dosed by drops and are not recommended for use during the day or pregnancy. Research each herb or work with an herbalist to determine whether these potent herbs are a good choice.
Note: If using pharmaceutical drugs, over-the-counter (OTC) sleep aids, or dietary supplements, always check possible interactions with a pharmacist or health practitioner before using herbs on a therapeutic basis.
Additional Resources
The National Sleep Foundation is an independent non-profit dedicated to improving overall health and well-being by advancing sleep health. Short articles on improving sleep quality.
https://www.sleepfoundation.org
A source of easy-to-read and accessible information about sleep. They are affiliated with many of the sleep products industry.
100+ Sleep Statistics: How Well Do Americans Sleep?
https://www.sleepfoundation.org/how-sleep-works/sleep-facts-statistics
TED Educational Series: Sleeping with Science
Two seasons of short informational videos with sleep scientist Matthew Walker.
https://www.ted.com/series/sleeping_with_science#season_2
At Day’s Close: Night in Times Past by A. Roger Ekirch
The book is a scholarly review of nighttime in Western society before the Industrial Revolution. It will make you appreciate your private, secure, warm homes and improved health and hygiene!
Segmented Sleep
https://www.bbc.com/future/article/20220107-the-lost-medieval-habit-of-biphasic-sleep
In Part Four of his book, Ekrich reveals a history of segmented sleep: Europeans often woke in the middle of the night for “an hour or more of quiet wakefulness.” This article offers details.
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Good information, well researched, balanced--thanks, Sue.
One herb that is at least anecdotally connected to good sleep is cannabis, particularly the "indica" strain. One edible a few hours before bedtime, and I enjoy a good sleep. This is particularly important for me, because I do have a sleep disorder: REM Sleep Behavior Disorder. My brain fails to shut down my muscles, so I can act out a dream--swing a leg or an arm, shout out loud in well-articulated profanity, even crawl across the floor. While cannabis does not completely stop this from occurring, it helps. But, as your article states, there is no single magical pill to take; a good night's sleep depends on multiple good habits.