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L.J. Rohan

L.J. Rohan

Gerontologist

The Life-Changing Sleep Secret!

I was born a night owl, loving the quiet of the late evening hours, when all the chores are done, commitments completed, the house nicely buttoned up for the night, and I have time for myself. In my younger decades I could easily stay up until 12 midnight or 1 AM, and wake up at a reasonable hour, refreshed. In the last few years, a strange shift has occurred. Even if I got the needed number of hours of sleep, when I go to bed at midnight, or later, the next day I’m tired and lack my usual pep-a-de-do. I can no longer deny the change.

It began in my early fifties and has slowly, and truly, become my new reality. I fought it for years, but now at almost sixty-one I can no longer stay up late, night after night, and expect to fire on enough cylinders to get through my To-Do list, much less anything on my Want-To-Do list the next day.

Going to bed earlier changed my life. I never thought this would happen, but as a gerontologist, I know retiring earlier to feel more competent is a part of aging well; a fact I wanted to ignore.

life changing sleep secrets

While research tells us losing our protective armor of hormones at menopause can also play a part in sleep-related issues– from small to great on a sliding scale depending on the individual woman– that isn’t my issue. Drilling into the science, I find as we get older, we experience a shift in our various circadian rhythms. Our circadian rhythms works as our body’s twenty-four-hour internal clock. Quietly, under the radar, they carry out key functions and processes. It is my circadian rhythm governing my sleep-wake cycle that downshifted when I wasn’t looking.

Much of the more conventional research ties an imbalance with sleep to our light/dark exposure, but I still wake up at virtually the same time I always did; it’s the time I turn off the light that makes the difference.

A few years ago, Dr. Julia Shekleton and her team at the Division of Sleep Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, in their ground-breaking article in the Journal of Clinical Sleep Medicine, identified why this phenomenon occurs. They called it the Wake Maintenance Zone.

We know the experience of the Wake Maintaince Zone more commonly as “getting a second wind.” Dr. Shekleton tells us the onset of our second wind usually occurs right before our body switches to “getting ready for sleep” mode by secreting melatonin—the hormone released by our brain that makes us feel sleepy. Looking at the circadian 24-hour clock, our brain begins releasing melatonin around 9 PM to our body’s clock even if you are traveling through several time zones. Additionally, in many women, but not all, melatonin declines more sharply at mid-life, which causes many women (and men) to struggle with getting enough restful sleep.

When our second wind kicks in, we get a seemingly “burst” of energy for two or three hours more, making sleep virtually impossible. By the time this second wind winds down, we are out of sync with our natural circadian sleep/wake rhythm, and so lose precious restorative sleep time. As Dr. Shekleton found, the next day our cognitive function suffers, and we feel tired, even if we slept in to try and make up for getting to sleep later the night before. And, if our stress level is high, our cortisol levels will take an uptick at night, just as we want to float off to slumber land, and further sabotage our ability to get restful sleep.

From my perspective as a gerontologist, what I find is working for me, and is helping my clients, is to turn off the light while we are still in the first phases of melatonin secretion—somewhere before 11 PM.  Research tells us this is the magic hour of demarcation, after which our body begins other processes that seem to also feed a second wind. More research is needed, but I know going to bed earlier than my usual time, makes this night owl a much happier, more energetic, and definitely pleasanter person to be around. 

Until next time…Be Vibrant!

The Life-Changing Sleep Secret!

The National Sleep Foundation Senior Health website recommends for adults 65 and older, 7-8 hours of sleep per night for better cognition, mental, and physical health. Seniors, especially women, suffer from sleep deprivation due to trouble falling asleep. Additionally, women often sleep less deeply, and have less slow brain wave activity (REM)—that body-restoring and rebuilding phase of sleep. We also wake up more often throughout the night, creating daytime tiredness and the perchance for napping. Sleep issues affect as many as 25% of senior women.

The Nurses’ Health Studies, among the largest studies into the risk factors for major chronic diseases in women was begun in 1976, and is ongoing. The studies have compiled data on more than a quarter of a million women. Using the benchmark of seven hours of sleep per night, the NHS found: Shorter and longer sleepers were less physical active, and had higher body mass indices. Less than five-hour sleepers scored significantly lower on cognitive tests. The shortest sleepers experienced the worst cognitive decline later in life. Just two hours a night less over time was enough to accelerate this decline.

Overlaying directly with the NHS, Daniel Polesel PhD., at Federale Universidad de Sao Paulo found Obstructive Sleep Apnea Syndrome (OSAS) is prevalent in postmenopausal women, especially in “late postmenopause,” noting OSAS in women increases significantly after menopause. For moderate and severe OSAS, the researchers found our waist circumference in both early and late postmenopause to be the main factors for sleep apnea. Dr. Polesel noted that late postmenopause may potentially exacerbate the presence of sleep disturbances and that reducing our waist measurement may be an important way to help manage OSAS.

A huge study—2,789 women, reported the addition of bedwetting (nocturnal enuresis-NE) along with OSAS. The symptoms associated with NE include: obesity, snoring, poor sleep quality, sleep fragmentation, daytime sleepiness, and hypertension. Each additional OSAS risk factor significantly increased the odds of having NE in comparison with women with no risk factors. What is the cause behind this sensitive, underdiagnosed issue? We experience apnea-associated changes in the air pressure in our lungs which leads to increased urine output. To further mess with our shut-eye, NE may be a surrogate condition for nocturia, a condition causing us to wake up during the night because we have to urinate. As we get older, many of us urinate more frequently, especially at night. In general, women, and men, over 60 do not usually urinate more than twice a night. “Patients with severe nocturia may get up five or six times to go to the bathroom,” said, Dr. Robert S. Rosenberg, a pulmonologist and medical director of the Sleep Disorders Center of Prescott Valley and Flagstaff, Arizona. “Sleep apnea triggers the frequent urination.” If you wake up to pee more than twice, give your doctor a call.

 Another cause of disruptive, fragmented, less restorative sleep? Post-menopausal hormone levels. It’s often called hormonal insomnia or progesterone insomnia. At all stages of a woman’s life, the hormone progesterone affects brain function. When in balance, it produces a sense of calmness, and its sedating and anti-anxiety qualities help promote rejuvenating sleep. Progesterone and sleep are tightly connected as our brains are highly sensitive to progesterone. As we know, our progesterone levels drop drastically after menopause.

All of us on the other side of fifty-five, know the multitude of ways menopause affects sleep. Bio-identical hormone replacement therapy is one option to tame those symptoms, if started within one year of entering post-menopause. This therapy received bad press fifteen years ago, and, many of us threw our hormones in the trash, stomped on them for good measure, and then incinerated them. However, once cooler heads prevailed, and the smoke had cleared from all those fires, subsequent research drilled into the flawed Women’s Health Initiative Study and proved bio-identical hormones–those biologically identical to the hormones our bodies produce, are a safe and effective way to even out hormone depletion and keep a woman’s body firing on all cylinders. Whew.

Another hormone, dehydroepiandrosterone, or DHEA, also helps maintain normal sleep patterns. DHEA peaks when we are young and carefree, and then begins to decline.  By the time we reach seventy, our DHEA levels may be less than one-fifth of what we had at age twenty.

Our thyroid glands also have an impact on every system in our body. Thyroid levels affect our energy levels, mental focus and functions, sleep cycles, and more. About 25% of women develop thyroid problems by the time they reach their early forties.

To add another bug in the bathwater, stress and high cortisol levels wrecks sleep. At night, just as we need to wind down, cortisol levels rise. We then feel more alert and awake at bedtime, making sleeping impossible. This cycle of exhaustion repeats itself, never allowing us to get the restorative sleep that would help bring our levels back to normal. Also, a lack of sleep raises our cortisol levels even more. Cortisol is made in the adrenal cortex from progesterone. The small amount of progesterone being produced (and that is a micro-dot amount compared to our pre-menopause days) creates cortisol, which allows little or no progesterone to come to our sleep aid.

But, there is hope on the horizon, and in the coming weeks I will share some proven ways to sail off to the land on Nod.

Until next time…Be Vibrant!