BY MELISSA ARMSTRONG, MD, MSC, FAAN
Many neurologic diseases such as Parkinson's disease and multiple sclerosis disrupt sleep. Sleep problems also can impact the brain: multiple research studies suggest, for example, that people with some types of sleep apnea, a condition in which breathing stops repeatedly through the night because of an obstruction of the airways, are at a higher risk of memory problems and dementia.
Aging also can affect sleep. Older people often take longer to fall asleep, sleep less deeply, and wake up more often. They may also fall asleep earlier in the evening and wake up early in the morning.
If sleep problems are affecting your daily life or your snoring affects you or your partner's sleep—often a sign of sleep apnea—talk to your doctor. Otherwise, consider making these changes to improve your sleep:
1. Decompress before bed. Prime your body for relaxation with restful activities like reading a favorite book or magazine, meditating, or soaking in the tub. Try to avoid checking your work email one last time or having an emotional conversation with a friend or your spouse or children.
2. Nap wisely. For people who have trouble sleeping, physicians often recommend avoiding naps entirely. I encourage my patients with Parkinson's disease who are too fatigued to make it through the day without resting to limit the number and duration of naps and resist napping in the afternoon or evening.
3. Skip the stimulants. Caffeine and nicotine can be too stimulating and make falling asleep difficult. It's best to avoid them close to bedtime. Alcohol can help people fall asleep more quickly, but it reduces deep sleep and also causes people to wake up during the night, having a negative impact overall. High-fat foods can disrupt sleep cycles, and late-night meals can lead to uncomfortable fullness and heartburn because digestion slows with sleep. Try to limit large meals to about four hours before bedtime.
4. Say no to the screen. Light from your smartphone and other electronic devices can disrupt sleep hormones, making it harder to fall asleep. Mental stimulation from emails and television programs can delay sleep, too, by making your mind active rather than preparing it to rest.
5. Soak up the sun. Sunlight helps regulate the sleep-wake cycle, which is particularly important as people get older. Research suggests that people exposed to more natural light during the day get more sleep at night. Doctors don't know the ideal amount of sunlight exposure each day. I tell my patients to try to work sun exposure into their daily routine, whether it involves sitting by a window or taking walks, or a combination.
6. Exercise regularly. Most research suggests that exercise helps improve sleep, though the reasons why are not completely clear, and the relationship between exercise and sleep is complex. Some research suggests that it may takes months before exercise begins to benefit sleep. So don't get discouraged if exercising doesn't improve your sleep right away. Exercise is also important for other health reasons, so starting a regular exercise program has multiple benefits.
These habits will not reverse sleep changes occurring with age or solve sleep disorders resulting from neurologic diseases, but they contribute to a holistic approach to improving sleep. And thankfully, the next time the clock changes this year, we can all look forward to an extra hour.
For more about sleep, see our Sleep Smarter feature in the April/May issue.
Dr. Armstrong is a movement disorders specialist at the University of Florida Health Center for Movement Disorders and Neurorestoration in Gainesville and a Fellow of the American Academy of Neurology (AAN). She's also involved in the AAN's evidence-based guideline program.
Illustration by Yvetta Fedorova