Sleep Through the Ages
Sleep is an integral part of life, but our slumber needs change as we age. The medical director of the Center for Sleep Disorders at Cooperman Barnabas Medical Center shares her insight and provides sleep tips.
Tired of being tired? All of us feel a little sleepy sometimes, because such is life. But getting nights and nights of consistently poor sleep can not only affect how you function during the day, but also your physical health. “Sleep is an imperative biological process—it’s nonnegotiable,” says Mangala A. Nadkarni, M.D., neurologist and medical director of the Center for Sleep Disorders at Cooperman Barnabas Medical Center (CBMC), who has been practicing sleep medicine for almost 30 years. And, she adds, for some people, poor sleep is a result of an underlying sleep disorder such as sleep apnea or narcolepsy.
At the Center for Sleep Disorders, Dr. Nadkarni and her team evaluate patients clinically who may be showing signs of a sleep disorder; sleep apnea often presents as excessive snoring as a result of tightened airways, while narcolepsy is when someone falls asleep during the day, such as behind the wheel. Depending on each patient’s history, Dr. Nadkarni may recommend a sleep study that’s performed either at-home overnight or during the day, respectively, to help assess the issue. “We also see patients who have a REM behavior disorder, where they’re sleep walking or acting out their dreams because they seem very real,” Dr. Nadkarni adds. “Sometimes these patients are referred by their primary care physicians, or they’re self-referred by a scared spouse!”
But even those of us who don’t necessarily have an underlying sleep condition—or a loud, snoring husband or wife—should know that sleep changes as we age, and not enough slumber can potentially lead to health issues. “With each decade, our sleep quality worsens somewhat—the deep sleep, or the REM stage of sleep which is responsible for cognitive performance, reduces by two percent every decade,” says Dr. Nadkarni. “All of us need enough sleep to function properly.”
Our 20s is when we have the most energy, and thus we can function with some sleep deprivation, but by age 30, 7-9 hours is ideal. The 30s is also when sleep apnea becomes more common, especially for men, since “the metabolism slows down and thus the risk of obesity increases, and this can lead to sleep apnea,” Dr. Nadkarni notes.
However, there is a caveat: “Even if you’re the same weight [as you were when you were younger], muscle tone decreases with age and your throat muscles drop behind your tongue, which narrows your airway and causes snoring,” says the doctor. “Thus, sleep apnea worsens as we get older.”
There are treatments for sleep apnea, though. One of the most common is an APAP machine, which can adjust flow of air according to the patient’s breathing and is a much more comfortable alternative to CPAP. “Alternatively, if someone has an overbite, a dental device can be an option,” says Dr. Nadkarni. For those with mild to moderate sleep apnea, your physician might recommend Inspire surgery, a minimally-invasive procedure to implant a device that goes under the right collarbone and has wires that stimulate the nerve and thus facilitate air to the back of the throat. “Sleep apnea is linked to high blood pressure, heart attack, heart failure, irregular heart rate, strokes and memory problems, so it’s important to address these symptoms,” the doc says.
Women have poorer sleep in their 30s due to iron deficiencies during menstruation which can cause restless leg syndrome, as well as due to pregnancy and childbearing. Women suffer poor sleep again in their late 40s and early 50s as they experience hot flashes and other menopausal symptoms.
So, what can you do to improve your sleep, now and as you age? What Dr. Nadkarni refers to as “sleep hygiene” involves; turning off electronics at least an hour before bed; limiting caffeine intake after 3 p.m.; not drinking alcohol less than three hours before bed; and avoiding hanging out in your bedroom all day (yes, that means don’t work in there either!). She adds that doing physical exercise during the day and eating well helps with sleep too.
“Sleep disorders are easily diagnosed and easily treatable, and doing so will help you live a long, healthy life,” Dr. Nadkarni concludes.
Are Your Kids at Risk?
Yes, even children as young as age three could be prone to sleep disorders, according to Dr. Nadkarni. Here are the facts:
• Children ages 3-5 with large adenoids and tonsils are at risk of sleep apnea.
• Elementary school-aged kids with ADHD or restless leg syndrome have a harder time falling asleep than their peers.
• Teens go to bed later and wake up later, and thus many have trouble paying attention in school since high school starts so early. “This is why so many districts are trying to change the start-time of high schools,” Dr. Nadkarni says.
To learn more about The Center for Sleep Disorders at Cooperman Barnabas Medical Center, call 973.322.9800 or go to rwjbh.org/cbmcsleep.