The Sleep Crisis of Men & Women over 50

The world is in a sleep crisis as more than 1 in 3 American adults and more than 150 million people in the developing world find it difficult to get to sleep or to stay asleep for at least three nights a week for three months or more.

Finding it difficult to get to sleep or stay asleep?

With China and Barbados being 12 hours apart, I have found myself on a full almost 24 hour day schedule - working during the day in China and most of the night in Barbados time. After the dark circles appeared around my eyes and following several nights of two to four hours of sleep, I became very concerned about my sleeping habits.

Never before have I found it so difficult to get to sleep and to remain asleep. Now, the continual ‘ping’ of messages on my mobile awakens me and keeps me awake for most of the night. My concern reached a climax when I snapped at a student after he didn’t do well in a practice test - this had now become an urgent cause for more prayer and some internet research.

We are in a Crisis of a Lack of Sleep

The time when TV goes off does not exist anymore - in fact those born after the 90s would not have experienced a signing off or on of TV.

Not only does TV not sign off but our other electronic devices are also available on a 24 hour basis. From children to adults to the aged, we have extended our awake hours to coincide with this 24 hour access to communication and information way beyond business hours and daylight hours via our TVs and smart devices. But even before this, we had succumbed to the glam of working or partying through the night. We have trained our bodies to exist on four hours or less of sleep a night in an effort to accumulate wealth and high status.

Over 35% of Americans suffer from a chronic lack of sleep

It turns out that over 35% of Americans suffer from a chronic lack of sleep according to the Centers for Disease Control and Prevention . A chronic lack of sleep? This is defined as not getting enough sleep over an extended period of time and enough means according to the National Sleep Foundation 9 hours for children, 8 to 10 for teens and 7 to 9 hours for adults.

But sleep quantity is also influenced by our age - as we age, our sleep patterns change even in the absence of any health issues.

• For starters, we sleep less as we get older by about 30 minutes per decade of age.

• We sleep less in Stage 3 and 4 as we get older. Also, as we get older, REM sleep is reduced to about 15% of our night’s sleep. In fact, our sleep is lighter and deep (REM) sleep is less.

• We may get sleepier earlier and then wake up earlier.

However, it’s not only about quantity but also about quality.

Are you feeling refreshed when you awake in the morning? are you getting sleepy during the day? These may be signs that you are not getting an adequate number of sleeping hours or/and the right quality of sleep.

It’s not only how long you sleep but also HOW you sleep

"To sleep well, you need quantity and quality," said Dr. Alcibiades Rodriguez, assistant professor of neurology at NYU Langone Health.

So what is the right quality?

The right quality of sleep is sleeping long enough to get you through all the stages of sleep which are required for the healthy generation and restoration of your body.

In order for the body to undergo the full process of regeneration, we must be sleeping long enough.

There are 5 stages of sleep which serve a specific health purpose for our bodies and we must undergo each stage in order to gain from those benefits that lay (pun intended) within each stage.

Stages of sleep

Stage 1: Falling asleep

We should be in this stage for about 10% (13 to 17 minutes) of our normal sleep time and undergo this stage only once in a night of uninterrupted sleep.

In Stage 1, regular breathing and heartbeat with relaxed muscles occur; our eyes and body may twitch.

During this stage, if we are awoken, we can often think that we haven’t been sleeping at all (so that's what it is!!).

Also during this stage, regeneration of our body commences.

Stage 2: Light Sleep

We should be in this stage for about 50% of our normal sleep time and we can return to this stage many times in an ordinary night of sleep.

Our muscles are more relaxed and our eyes are not moving.

The process of regeneration of our body continues.

Stages 3 and 4: Deep sleep

We get to stage 3 after about 30 minutes and to stage 4 after 45 minutes. These stages comprise about 20% of our step time.

In these stages, it takes quite a bit of noise to awaken us because we are in a ‘hibernation’ type sleep.

Now is when we get the most rest from sleeping.

The regeneration of our body intensifies; Our body and muscles and immune system are restored and our brain begins to process and organize memories and experiences.

REM sleep: Dreaming

REM sleep happens after 80-100 minutes of falling sleep and comprises about 20 percent of our sleep.

Our breathing and heart rate accelerate but our muscles are still relaxed and approach a type of paralysis. However, Rapid Eye Movement (REM) starts.

This is the time that we dream (and when males experience erections!). Our very relaxed muscles prevent us from literally acting out our dreams.

Our brains during this stage are almost as active as when we are awake but it is actually processing our day-time experiences, organizing and storing our long-term memories whilst discarding unimportant ones.

Sleep cycles: Stage 2 through 4 to REM and back again

We may go through as many as three to five sleep cycles comprising the various stages in one night.

A full night’s sleep therefore begins with light sleep followed by deep sleep stages and then the REM stage. We spend the most time in light sleep which ensures that we get into the most restful part of our rest (REM sleep).

The first sleep cycle lasts for about 90 minutes

The second sleep cycle begins with a shorter deep sleep followed by a longer REM stage.

Cycle three begins again with shorter deep sleep and is followed by a longer (maybe as longs as 30 minutes) REM period.

If we sleep for only four hours or less each night, we are not sleeping long enough to allow our bodies to go through each cycle furthermore to go through them three or four times as required in order to be restored.

If we want restful sleep, we must sleep long enough to get from light and deep sleep into REM sleep and then start that cycle over again.

Sleep Sickness, Sleep Disorders and Sleep Deprivation

There are several sleep disorders ranging from insomnia to hypersomnias to sleep breathing disorders (eg. sleep apnea) to sleep movement disorders (eg. restless leg syndrome) and to Circadian Rhythm Sleep-Wake Disorders (eg. shift work sleep disorder). Other terms used to describe sleep disorders are Acute Sleep Deprivation and Chronic Sleep Deprivation.

Of these, insomnia is the most common sleep disorder and affects more people in the world.

Insomnia is when you find it difficult to get to sleep or to stay asleep for at least three nights a week for three months or more. At this stage, it is chronic insomnia which was experienced by more than 1 in 3 American adults in 2016. and by more than 150 million people in the developing world.

So are you suffering from sleep sickness? If we discount the changes in our sleep patterns due to aging, there are some symptoms that may guide us in determining whether we are suffering from insomnia or some form of sleep deprivation. These symptoms as listed by Medical News Today can tell us if we are getting the right quality of sleep. This was a wake-up call for me as I suffer from the first six of these:

1. Difficulty falling asleep at night.

2. Waking during the night.

3. Waking earlier than desired.

4. Still feeling tired after a night's sleep.

5. Daytime fatigue or sleepiness.

6. Worrying about sleeping.

7. Irritability, depression, or anxiety.

8. Poor concentration and focus.

9. Being uncoordinated, an increase in errors or accidents.

10. Tension headaches (feels like a tight band around head).

11. Difficulty socializing.

12. Gastrointestinal symptoms.

Are you suffering from some type of sleep sickness? There are now smart sleep trackers that can help you log your sleep including the quality of your sleep. Researchers recommend a few for example the FitBit Flex which is under $50 or the more expensive type, the Healbe GoBe2 which can run you into almost $200. You can also record in a journal things like how long you have 'slept', how you feel when you awake and when you start to feel sleepy all in an effort to self-diagnose and therefore to take action.

What is the fall out of accumulating sleep deficits?

The FitBit Flex, one of several smart sleep trackers

8 Diseases Caused by Sleep Deprivation

We know that one of the most wonderful things happened when the first man fell asleep - woman was created! But why did God create sleep? And further, why did He command us to rest for one day out of seven? It turns out that when we don't rest and when we accumulate sleep deficits, not so wonderful things happen and the body falls into a state of dis-ease.

Whilst we may adjust and adapt to the quality of sleep that we are getting, research shows that we do suffer more than we think from a lack of sleep even for a night or two furthermore for an extended period of time. So what is the fall out of sleep deprivation?

Here are seven dis-eases that can occur from sleep deprivation:

1. Weight gain

Insomnia impacts negatively on that part of our brain known as the hypothalamus - an impact that contributes to an increase in your appetite and also causes you to crave carbohydrates and sugary foods. We all know what that means - high intake in sugar can lead to weight gain and obesity.

The cycle of overeating and obesity is further exacerbated by a lack of exercise caused by the feeling of fatigue as a result of under-sleeping.

2. Type 2 Diabetes

The Sleep Foundation warns that too little sleep (four to six hours) puts your hormones in disarray causing your body to release less insulin, a hormone that regulates your blood sugar levels. Not going through deep sleep also prevents your body from maintaining optimal levels of insulin.

As if that was not enough, the increase in appetite caused by insomnia can also lead to obesity and we know the connection between obesity and type 2 diabetes.

3. Hypertension, stroke, coronary heart disease and irregular heartbeats

Cardiovascular diseases according to The Sleep Foundation are more commonly experienced by those suffering from sleep disorders. The necessary stages of sleep accomplish the regeneration of our bodies as was noted within our description of the various stages of sleep. This regeneration includes the healing and rebuilding of heart vessels, control of inflammation as well as the maintenance of optimal blood pressure levels. Not going through the stages of sleep within which these processes are performed increases our risk for developing cardiovascular disease.

Various studies have convinced heart experts of the connection between insomnia and cardiovascular disease. One study of 44,080 Taiwanese men and women over 10 years found a higher incidence of stroke and myocardial infarction in those diagnosed with insomnia than in their rest-full peers. In another 10 year study of 86,329 postmenopausal women, the risk of developing cardiovascular disease was higher amongst those with insomnia.

4. Depression

We often think that depression leads to sleep disturbance but recent research suggests that a lack of sleep may actually result in depression. This study found that persons suffering from insomnia are more likely to also suffer from depression than those who do not. In fact, they are 9.82 and 17.35 times as likely to have clinically significant depression and anxiety, respectively. The study also concluded that the degree of depression increased with an increase in the incidents of awakening from sleep.

5. Dementia & Alzheimer’s Disease

Dementia is a deterioration in memory and the ability to perform daily activities. According to the World Health Organization 50 million people in the world have dementia and 10 million new incidents of dementia occur every year. Alzheimer’s is the most common form of dementia and comprises 60-70% of dementia cases worldwide.

Statistics of the World Health Organization as of December, 2017 project that the number of people suffering with dementia will be 82 million in 2030 and 152 million in 2050.

Dementia and Alzheimer’s contribute to the rising cost of care of the elderly. In 2015, global societal cost of dementia was approximately US$ 818 billion, or 1.1% of global gross domestic product (GDP). Several risk factors for dementia are those also caused by insomnia or sleep deprivation such as diabetes, cognitive inactivity, depression, midlife hypertension in addition, risk factors are alcoholism, tobacco use and unhealthy diets.

How does insomnia cause dementia?

Studies have found that during sleep the brain clears up deposits of amyloid plaque and that a lack of deep sleep may impede this process. According to Ronald Petersen, director of the Mayo Clinic Alzheimer's Disease Research Center and the Mayo Clinic Study of Aging "If you're only making it to Stage 1 or Stage 2 and then you start choking or snoring or whatever and you wake yourself up and you do it again and again, you may not even be aware of it, but you...may be accumulating this bad amyloid in the brain rather than clearing it."

Assistant professor of psychiatry and human behavior at the University of California, Irvine School of Medicine, Bryce Mander concludes that various studies support the causal relationship between a lack of sleep and Alzheimer's disease.

"Sleep is critical for mental health, and (that) chronically disturbed sleep may facilitate the development of Alzheimer's disease or accelerate its progression."

6. Cognitive Impairment

Insomnia has also been linked to decreased productivity which is not surprising as a tired individual will not perform as well as one who is full of energy and verve. Researchers now believe that cognitive impairment and a lack of sleep fuel each other and that inadequate sleep presents a high risk factor for cognitive impairment and in the extreme, dementia.

If our bodies including our brains do not get a chance to regenerate itself, not only will we feel physically tired but we will also not have the brain power to do such things as multi-task, problem solve or focus on tasks.

Medical News Today states that our cognitive functioning is depleted by inadequate sleep and can cause us to:

• be moody/irritable/anxious

• have a negative outlook

• be harsher of others

• be impatient

• and even be superstitious

7. Acceleration of Aging

“This research shows for the first time, that poor sleep quality can accelerate signs of skin aging and weaken the skin’s ability to repair itself at night,”

Having a great night’s sleep can actually maximize the functioning of our skin and therefore minimize the formation of wrinkles. In a ground-breaking study commissioned by The Estée Lauder Companies, physician-scientists at University Hospitals (UH) Case Medical Center came upon the connection between wrinkles and insomnia. The study (involving 60 pre-menopausal women between the ages of 30 and 49, with 30 women suffering from some sort of sleep deficiency) showed that the skin of those with poor sleep quality did not recover as well from sun-induced DNA damage or environmental toxins. Essentially, women who slept well recovered more efficiently from stressors to the skin.

“This research shows for the first time, that poor sleep quality can accelerate signs of skin aging and weaken the skin’s ability to repair itself at night,” said Dr. Daniel Yarosh, a senior vice president at Estée Lauder

8. Reduction in sex drive

Another big plus of having a good night’s rest is an improvement in your sexual health. Researchers in a new study published in The Journal of Sexual Medicine found that participants’ (171 healthy women) levels of desire, genital response and sexual activity correlated positively with the number of hours of sleep. This research provides a clue to improving the low sex drive in menopausal women since it concluded that women who had more hours of sleep experienced greater vaginal arousal and that the likelihood of a couple having sex increased by as much as 14% for each additional hour of sleep.

"These findings suggest that acute sleep disturbance may contribute to sexual complaints and reduced sexual activity," The Journal of Sexual Medicine.

The less men sleep, the higher their perception of their partner’s willingness to have sex.

In still another study in 2013 (this time by the journal Sleep) on the connection between sleep quality and sexual health, it was found that each night of sleep deprivation increased men’s perception that their partner wanted sex. However after having a good night’s rest, both men and women assessed the sexual intent of women as being significantly lower than that of men.

10 Tips on How to get a Good Night’s Sleep

Several tips abound on how to improve your sleep quality. But like all health issues, one must know one’s body as well as seek expert advice if necessary. Here are just a few tips which I have found to be very helpful.

1. Reduce Blue Light

With sleep deprivation being prevalent not only among the aged but also young people, the common denominator is found to be exposure to blue light technology which is emitted from electronic devices during what should be sleeping time. This exposure reduces the production of the hormone melatonin that regulates the sleep awake cycle.

So if you want to maximize sleep quality, do not sleep with your smartphone or laptop or at least adjust them to a yellow night-mode light after a certain time.

2. Have a digital curfew

Ideally stop using all electronic devices about an hour before your bedtime. This gives your body and mind time to prepare for sleep by reducing hyperactivity.

3. Stop checking your messages

Do not awaken to look at your electronic device. Looking at your cell phone, the clock, watching television disturbs your sleep cycle and forces you to start Stage 1 sleep and reduces the likelihood of entering into deep sleep rest. If hearing the message notifications on your phone will awaken you, turn off all notifications or turn off your electronic devices.

4. Exercise

Doing exercise will make you tired and more likely to sleep well. It may be best to finish exercise at least two to three hours before bedtime so that you get to wind down and not be hyper just before going to bed.

5. Read instead of using your cell phone

Reading a non-blue light device like the Kindle Paperwhite or ideally a good old fashioned paper book may help you to fall asleep on those nights when sleep seems to evade you.

Listening to soothing audios for example the audio bible or calming music may also do the trick.

Free Audio Bible App

6. Avoid stimulants before bedtime

Have your last cup of coffee and dinner at least three hours before bedtime. This will help our body to wind down to be ready for sleep instead of winding up.

7. Only sleep or have sex in your bed

Doing work or studying in bed will tell the body that it is not time to sleep. Move your office to another space and reserve your bed as a restful, peaceful, stress-free and no blue light zone.

8. Reduce day-time napping

Somehow avoid sleeping during the day and reserve sleep for regular and full hours at night.

9. Have regular bedtime hours

Go to bed at the same time every night and awaken at the same time each morning even on weekends. This allows the body to regulate itself into a proper sleep cycle which allows for all the sleep stages to take place.

10. Do not be anxious

Rid your mind of all thoughts that may cause stress and anxiety and focus your mind on whatever is true, noble, pure, right, lovely and admirable while in bed. This will make it much easier to fall asleep.

Life is in the control of God - put your trust and security in the hands of the One who controls your breathing and ability to awaken.

“In peace I will both lie down and sleep; for you alone, O Lord, make me dwell in safety.” (Psalm 4:8)