Sleep and Aging: Stay in the Rhythm of the Night

Published on August 4, 2021

How did you sleep last night? Well or poorly? Not enough or just enough? Like a baby or tossing and turning? It’s a simple, yet important, question.

Sleep, that precious phase when our neurological system quiets down and we slip into unconsciousness, is vital to our well-being, yet many of us fall short of our nightly requirement of vitamin Zzzz, especially as we get older.

It starts with the circadian rhythm.

We often hear of our circadian rhythm described as our body’s internal clock, as if we have a timepiece sitting on some imaginary mantle, keeping our bodily functions on a schedule. But a more accurate visualization might be to picture the body’s various organs and systems as musicians in an orchestra, playing in time with circadian rhythm.

This rhythm is present in all of the cells throughout your body. Each area represents a different section of the orchestra, playing its part to create the symphony that is your physical being. The conductor of the orchestra is a small group of hypothalamic nerve cells in the brain called the suprachiasmatic nucleus (SCN.) The SCN controls the timing of our sleep-wake cycles and coordinates the circadian rhythm throughout the brain and other organs.

 When you get older, the beat changes.

As we age, bidirectional changes occur between our circadian rhythm and bodily systems. The conductor may get off-tempo and the musicians may miss some notes. These changes affect metabolism, inflammation, body temperature, hormone levels, and sleep-wake cycles, all of which can affect our sleep patterns.

One such change is Advanced Sleep Phase Syndrome (ASPS,) a fancy way of saying that as we age our internal clock gets set back on a perpetual daylight savings time.

There’s a reason the early bird specials attract the mature crowd.

ASPS is a change in circadian rhythm that causes people to get tired earlier in the evenings and awaken earlier in the mornings. This is fine for those who can easily adapt to their body’s changing needs, but some people find it difficult to break from societal or familial norms. It’s hard to say goodnight at 8:00 p.m. when your favorite show is starting or the party is just ramping up!

Other Causes

Other reasons sleep may elude you as you age include sleep apnea, medications, stress, pain, restless leg syndrome, and frequent urination.

Sleep apnea occurs when your breathing pauses or becomes shallow during sleep. It is most often caused by excess weight but can be influenced by drugs or alcohol, medications, sinus congestion, and medical conditions including diabetes, Parkinson’s disease, high blood pressure, and heart disease.

Medications that can interfere with sleep include antidepressants, stimulants, decongestants, steroids, beta-blockers, statins, ACE inhibitors, nicotine replacements, and thyroid replacements.

Stress is a common deterrent to sleep. While we can’t avoid all stressors in our lives, we can learn to manage stress in healthy ways during our waking hours so our brains can rest at night. Meditation, exercise, and talking with friends, family or a mental health professional can help.

Pain, when you are trying to sleep, is, well, a real pain! Unfortunately, pain is often exacerbated by sleeping or trying to sleep, in uncomfortable positions. Taking pain medications, or sleep aids may seem like a good plan, but can often set up a vicious cycle. Work with your health care team to address the root cause instead of just masking the pain.

 Restless Leg Syndrome (RLS,) or Willis-Ekbom disease, can occur at any age, but often worsens as you get older. The cause of RLS is unknown, but it is thought to be related to changes in dopamine levels in the brain and is sometimes associated with other conditions, such as neurological damage from alcohol or drug abuse, iron deficiency, kidney failure, or spinal cord damage. There are medications available to help with RLS, but lifestyle or self-care practices such as exercise, warm baths, massage, and avoiding caffeine may also help.

Frequent urination, or nocturia, affects more than three-quarters of women over forty, and 80% of all elderly people. The main cause of nocturia is simply the excess production of urine at night. This can be the result of drinking a lot of fluids, or from decreased kidney function, diabetes, diuretic medications, alcohol, or caffeine. Decreased bladder capacity from frequent urinary tract infections may also play a role.

Interestingly, sleep disruptions may cause nocturia, instead of the other way around. In other words, when you are awakened, you realize you need to use the bathroom.

Your brain on sleep.

Disruptions to sleep are more than just irritating; they are detrimental to our overall health. The health impact on our sleep-deprived population is serious enough that the Centers for Disease Control have declared sleep disorders a public health epidemic.

Scientists studying Alzheimer’s disease and dementia are particularly interested in what happens in our brains as we sleep. While you are awake, a plaque called amyloid builds up in your brain. This plaque normally protects brain cells, but if too much plaque develops, brain cell function is compromised. During periods of deep sleep, the production of amyloid decreases, and the brain flushes out any excess.

Dr. Rudolph Tanzi, Professor of Neurology at Harvard Medical School, director of the Alzheimer’s Genome Project, and co-author with Deepak Chopra of Super Brain, calls deep sleep our “mental floss.”

A key to strong immune systems.

Our immune systems also benefit from quality sleep. When you are sleeping, your immune system releases proteins called cytokines. These proteins, which include interferon, interleukin, and other growth factors, are needed in increased amounts when you have an infection or inflammation, or when you’re under stress. Sleep deprivation decreases the production of cytokines.

Melatonin, the hormone that causes us to get sleepy, also plays an important role in the immune system, stimulating the production of immune cells and reducing inflammation. Interestingly, early in 2020, scientists looking for a cure for COVID-19 found a link between melatonin and the severity of COVID-19 cases. Physicians reported that patients taking melatonin had a less severe and shorter duration of symptoms. Some propose that melatonin may even prevent infection.

Read the full article here.

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