In 2010, Spain hosted a sleeping (siesta) competition, its first ever. While some persons might find this hilarious or a waste of time, the aim was to encourage people to get recommended hours of rest and
also promote the habit of napping; a custom which is fast vanishing because of the pressures of modern life. Pedro Soria, a 62yr old man emerged winner and went home with a cheque of 1000 euro1… prior to the final game he had eaten a healthy lunch which we assume was at least 10minutes before he went to sleep.
Sleep is a naturally-occurring, reversible, periodic and recurring state in which consciousness and muscular activity is temporarily suspended or diminished, and responsiveness to outside stimuli is reduced2. Simply put, it can be described as a state of rest in which the body is not active and the mind is unconscious.
The benefits of sleep cannot be over emphasized3.
What are the benefits of Sleep?
- Sleep improves learning.
- Sleep is involved in healing and repair of the heart and blood vessels.
- Sleep helps for proper functioning throughout the day.
- Sleep supports healthy growth and development
- Sleep improves your mood and focus.
Lack of adequate amounts of sleep can lead to;
- High blood pressure
- Lack of alertness
- Heart attack
- Lower sex drive
- Increase in weight gain
While daytime naps are important, the most essential rest occurs at night when the human body begins to shut down in preparation for complete rest. When this night-time rest is habitually prevented from occurring, one can be said to be suffering from Insomnia.
In this article, we will be looking at insomnia; it’s symptoms as well as treatments.
Insomnia is a fairly common complaint in the elderly (> 60yrs). It can occur due to anxiety, discomfort from chronic illnesses or even increased trips to the toilet to urinate 4.
What is Insomnia?
Insomnia is defined as a repeated difficulty in falling asleep or staying asleep, even when a person has the chance to do so.
The individual usually experiences fatigue, low energy levels, difficulty concentrating and mood disturbances.
Symptoms associated with Insomnia
- Difficulty falling asleep
- Waking up and not being able to get back to sleep
- Frequent awakenings
- Waking up without feeling refreshed
- Tension Headaches
- Difficulty socializing
Types of Insomnia;
- Primary Insomnia: is said to occur when the lack of sleep cannot be linked to an existing cause i.e. medical, psychiatric, illicit use of drugs or medications. It includes various subtypes such as psychological, idiopathic, paradoxical and inadequate sleep hygiene6.
- Secondary Insomnia: This is as a result of an underlying condition; illness (stroke, heart disease), sleep disorders, use or abuse of certain substances7.
As one ages, sleep patterns change, with people falling asleep early in the evening and waking up in the wee/early hours of the morning. This is due to a change in the internal circadian rhythm, however it should not affect the number of hours of sleep.
Ogunbode et al, 2014, carried out a study on geriatric patients in Ibadan to assess the prevalence of Insomnia:
Women were reported to experience insomnia more than men. This could be attributed to:
- financial hardship which have been reported in older women.
There was also a higher rate of insomnia amongst persons not currently married, which include those who were separated or divorced.
Risk Factors of Insomnia in the Elderly9
Insomnia of primary origin cannot be linked to a precipitating factor, though some factors can incline the elderly to developing insomnia. These factors include;
- Loss of a loved one
- Illnesses such as stroke, heart disease
- Medications such as Selective serotonin reuptake inhibitors, Anticonvulsants, etc.
- Anxiety; E.g. inability to access retirement funds
- Menopause; Decreased estrogen contributes to hot flashes that lead to insomnia
- Social changes; retirement
- Unhealthy lifestyle choices such as excessive drinking, smoking
- Appetite suppressants
Effects from insomnia over time include:
- A diminished quality of life
- Slower reaction times
- Poor balance which can increase the risk of falling. Falls are already a leading cause of fatal injuries in the elderly.
- Poor memory and Increased risk for developing depression are outcomes in persons with insomnia.
- Insomnia can also increase the risk for developing diabetes, as sleep affects how well your body responds to the hormone insulin.
There are several approaches to fighting insomnia. An effective method will include a combination of good sleep habits with the following:
- Life Style Modification: Reduced consumption of or abstain from alcohol, tobacco, cannabis and also coffee. Persons who engage in such habits have a higher prevalence of developing insomnia.
- Increase in physical activity like jogging, brisk walking, swimming and cycling.
- Avoidance of excessive daytime naps.
- Leave the bed when you are unable to sleep for more than 30 minutes.
- Create a comfortable sleep environment; soft and clean beddings, cool temperature, dimly lit room.
- Limit use of electronic devices when it’s close to bedtime.
- Restrict the bedroom to activities of rest and sex, this helps attune the brain to sleep.
- Reduce your intake of fluids after 7pm, as this will decrease the frequency of urinating during sleep at night.
- Increase intake of foods rich in Calcium & Magnesium, these play a role in deep sleep and also help with insomnia. E.g. include banana, bone, shelled fish (crabs, snails, periwinkles, lobsters), Walnuts, Avocado, Almonds, milk, Yogurt, Sardine, Cheese.
- The neurotransmitters; serotonin and melatonin regulate sleep patterns in the body and tryptophan (amino acid) has a huge role in their production. Foods with high content of tryptophan are Egg, turkey, tofu, fish.
- If you are on a routine drug regimen, seek counsel/advice from your pharmacist on the likelihood of any of the drugs causing or triggering insomnia.
Sleep and rest are central to our body’s performance and our general well-being, so it is important that we get enough of both to enable our bodies and minds work at optimal levels. Take steps to consult your doctor for a proper assessment of possible underlying medical cause for your insomnia and do not self-medicate with over the counter medications.
Try not to worry too much, put that phone down, eat well and rest!
- https://www.theguardian.com/world/2010/oct/24/ecuadorean-wins-spain-first-siesta-contest Accessed : 18th April, 2018
- https://www.howsleepworks.com/what_definition.html Accessed:18th April, 2018
- https://www.nhlbi.nih.gov/node/4605 Accessed : 18th April,2018
- National Sleep foundation
- American Academy of Sleep Medicine
- Gureje,Oge et al. ”The Natural History of Insomnia in the Ibadan Study of Ageing”. Sleep 34.7(2011):965-973. PMC.Web.12 Apr.2018
- Ogundele A.et al, Insomnia & Dysfunctional beliefs about sleep among elderly persons.
- Montogomery and J. Lilly, “ Insomnia in the elderly”
- https://www.insomnia.net/natural-remedies/l-tryptophan/ Accessed 18th April,2018.