The Seniors Health Network each month poses a question to health-care professionals. This month, Dr. Brendan Byrne, was asked:
I am a 78-year-old woman and my husband died last year. I’m getting used to living alone and have wonderful friends and a very supportive family. My only problem is that I’m having trouble sleeping at night. I can’t seem to fall asleep and then I wake up a number of times during the night. I don’t want to take sleeping pills but wondered if there is anything else I can do to improve my sleeping.
I’m glad that you’re doing so well adjusting to living alone and I think I can help you with your sleep. You are very wise to avoid sleeping pills as they frequently cause more problems than they solve.
A good night’s sleep is all about optimizing your behaviours and environment to fit your body’s natural rhythm.
First, avoid substances that will alter hormones and affect your sleep:
• Alcohol – as a general rule, when you aren’t sleeping well you should stop all drinking. Once you are sleeping well again you can resume light (one drink per day) alcohol intake.
• Caffeine – if you aren’t sleeping, stop all caffeine. Once your sleep has been restored, it’s OK to have some caffeine but stop after 12 p.m.
• Some medications – check with your doctor whether any of your medications/supplements (or the time you take them) could be affecting your sleep.
Next, optimize your daytime activities:
• Be active during the day as this will drive up adenosine, telling your body it needs rest.
• Get some exercise, but finish at least three hours prior to bedtime.
• Eat more during the day avoiding heavy meals late in the evening. Don’t eat anything within two hours of bedtime.
• Get some natural light during the day and avoid bright lights in the evening.
Next, optimize your environment for sleep:
• Keep your bedroom dark – black out curtains, eyeshades.
• Keep your bedroom quiet – “white noise” can help – humidifiers, fans or “white noise machines.”
• Keep your bedroom cool.
• Create a comfortable sleep environment – invest in your bed, your sheets, your pillow.
• Keep your electronics out of the bedroom.
• Your bed is only for sleeping (once you have re-established your sleep, you can try reading in bed again).
Optimize your sleep ritual:
• Two hours before bedtime, shut down the screens - TVs, computers and phones.
• 60 minutes before your bedtime begin a process to relax yourself – reading, light yoga, meditation followed by a sauna or hot bath.
What do you do if this doesn’t work?
• Go to bed at the same time every night.
• Get up at the same time every morning
• Since you are having trouble sleeping – do not nap.
Plan for a set amount of sleeping:
• Calculate the total amount that you are currently sleeping (albeit broken) and use this to set your new sleep hours.
• So if you are sleeping six hours in a broken fashion set your wake-up time exactly six hours after the time that you go to bed.
• Then go to bed and wake up at the set times – no exceptions – even if you have had three hours of sleep you need to get up and start your day. You will be tired during the day but resist all urges to nap, come bedtime that fatigue will help you get to sleep.
• Once you are sleeping soundly through that six hours, add 15 minutes to your sleep.
• When you find that you are sleeping through the night and waking refreshed your sleep has been restructured. Generally, the total amount of sleep needed will be between seven and eight hours per night.
Brendan Byrne has been a physician and digital pioneer for the past 25 years. He currently serves as Chief Innovation Officer for TELUS Health. He recently opened the Wellness Garage on Russell Avenue in White Rock.