Health Awareness Campaigns for May

May is...

National Mental Health Month - Because sleep and mental health go hand in hand

National Asthma and Allergy Awareness Month - It's hard to sleep if you can't breathe

American Stroke Month  - Untreated sleep apnea can lead to this

Older Americans Month  - Our sleep needs change as we age

May 3-9: Children's Mental Health Awareness Week
Bad sleep habits start at a young age; so do sleep-related mental health problems

May 10-16: National Womens Health Week  - Women need more sleep than men

Sleep Awareness Events in December

December 1-5 is National Older Driver Safety Awareness Week
The American Occupational Therapy Association aims to promote a better understanding of the importance of older drivers making good decisions about transportation so they do not face barriers to independence. This includes reviewing health concerns like sleep disorders, which can lead to driving drowsy, a nationwide public health problem for people of all ages. Elderly drivers can benefit from looking at alternatives in community transportation, vehicle adaptations and family support if sleep concerns make it dangerous for them to drive. Click here to find ways to enable your elderly loved one's independence in the face of sleep health problems.

Sleep Hygiene Tip of the Week || Check out Grandpa's sleeping conditions

"Mark Twain, New Hampshire, 1905," by
The New York Times. Public domain.

Sleep health in the elderly can be compromised for any number of reason. Aging itself means less human growth hormone is released because elderly people experience fewer deep sleep stages in their golden years; these are the sleep stages when HGH is produced.

On top of that, chronic health conditions and their medications can disrupt sleep health.

Elderly people who continue with unhealthy lifestyle habits like abusing alcohol, smoking and poor eating habits can expect to see the consequences result in impairments in their sleep health.

In addition, many elderly folks deal more regularly with the loss of loved ones; bereavement itself can be hazardous to good sleep.

Some of these things can't be changed easily for elderly people by their loved ones. However, there are other things that families can do to help out grandparents who might not be practicing the best sleep hygiene (or who might not have the opportunity to do so).

Take a look at these options when you next visit your elderly loved ones, whether they live independently or reside in a nursing facility or retirement community where they have access to services.

1. Consider the quality of the actual mattress they are sleeping on. Do they need more support? Is their bed hard for them to get in and out of? Sometimes elderly people choose an uncomfortable couch for sleeping over an inaccessible bed. Neither option is acceptable. Also consider whether they need additional pillows, a wedge to help them sleep more upright or risers for the head of the bed; elevating a bed at the top can make sleeping much more comfortable. Sometimes elderly folks prefer a reclining chair to a bed; you might discuss this option. Finally, make sure they have comfortable, clean sheets and an adequate amount of blankets.

2. Look at the light sources in the room. The elderly do need additional nightlights in the evening so they can be safe walking from one room to the next. However, rooms with too much additional light (from house lights outside or streetlamps or traffic) can make it harder for them to fall asleep do to lack of melatonin production. Some facilities have regular visits from ambulances and aid cars in the evenings, and the added light from these vehicles can also disturb the sleep of residents. Consider adding appropriate window treatments and/or nightlights to fix lighting problems in your loved one's living quarters.

3. Listen for noise. Not all elderly people are hard of hearing. Many hear just fine, and that means they can hear their neighbors' television sets (especially if their neighbors are hard of hearing!), the traffic outside, the noise coming from nearby businesses during the evening. If they can use earplugs in a noisy environment, encourage them to do so. Setting up a white noise machine can also help block out noise at night so they can sleep better.

4. Ask if they are always cold or always hot. Sometimes, facilities and community housing have less than ideal temperature controls, especially if the structures are older. While it's not unusual for elderly people to have a very limited bracket of comfort when it comes to ambient temperature, sometimes it's a matter of adjusting thermostats, blocking drafts, using carefully placed fans or having layers of blankets on hand.  In addition, make sure to review medications regularly and consider their side effects and interactions if your elderly loved one is complaining about being too hot or cold all the time. Finally, keep in mind seasonal changes. What we as adults can tolerate can be far too extreme for our grandparents. Ultimately, a sleeping space that is too hot or too cold for them will be hard for them to sleep in.

Sleep Hygiene Tip of the Week || Think carefully before napping

"Rosie and Jennie Took a Cat-Nap."
Harry Whittier Frees, 1915. Public domain.

There's lots of contradictory advice out there about napping. Who should nap? Who shouldn't nap? When is a nap a good idea? A bad idea? What's a good nap length? Let's take these one at a time.

1. Who should nap?

• Naps are good for children as their developing bodies often need the added rest.
• The elderly often nap, and it's not a bad idea. They may have multiple health conditions that lead to daytime sleepiness, and they may also be taking numerous medications that cause them to feel drowsy. 
• Anyone who is sick with a virus or infection can benefit from napping. The body is working hard at the cellular level to manage healing; sleeping gives the body an added opportunity to repair itself.
• Anyone with a chronic health condition or a serious disease like cancer can benefit from a nap. 
• Postoperative patients can benefit from naps while they are in recovery and/or rehabilitation mode.

2. Who shouldn't nap?

• Don't get into the habit of napping if you are suffering from insomnia. It seems counterintuitive ("don't sleep if you can't sleep?"), but regular napping may actually lead to chronic insomnia. Try to get most of your sleep at night and only nap if you really can't avoid it. 
• If you suffer from depression, taking a nap may not help matters as it may continue to alter already disrupted sleep patterns that arise from the condition or via the pharmaceuticals used to treat depression.

3. When is a nap a good idea?

• If you are unexpectedly drowsy, a quick nap can give you the recharge you need. Often we feel drowsy in the early to mid-afternoon. As long as you don't oversleep, you can benefit from a nap at this time.
• If you work night or overnight shifts, a nap prior to working can add some sleep to your "bank" so your recovery time afterward can be easier.
• If you have been diagnosed with idiopathic hypersomnia or narcolepsy, planned naps can help offset these conditions. (Please don't diagnose yourself: get a confirmed diagnosis from a sleep health professional. Excessive daytime sleepiness can be caused by any number of health conditions, many of them not related to sleep.)

4. When is a nap a bad idea?

• If you tend to wake up groggy from naps, then you might not benefit from taking them right before you need to perform tasks that require alertness. 
• If you have insomnia, you might consider how often you nap, and for how long. Naps, if not absolutely necessary for function or healing, can actually reduce your sleep drive at night and make it harder to fall asleep or to get most of your sleep at night.
• It's after 3pm. Any naps after this time may very well disrupt your nighttime sleeping patterns.

5. What's a good nap length?

• Quick naps are best. Ten to 30 minutes should do the trick.

Other things to consider:

• If you use a device for your nighttime sleeping, such as supplemental O2 through a cannula, a PAP mask, nasal strips or an oral device, make sure and enlist these tools for naps, as well. They are yours to use to improve all sleep, not just the sleep you get at night.
• Eating a meal right before a nap could aggravate any heartburn or gastroesophageal reflux disease you may suffer from. You may wish to take a medication for this condition prior to napping.
• Always opt for a nap if you are driving a motor vehicle or operating heavy machinery and find you are extremely drowsy. Do not think you can "power through" extreme fatigue. Your sleep drive is a physiological process which can't be denied. 
• A warm room might be conducive to sleep onset, but you may not have a very long nap if you are overheated. If your sleeping environment is overwarm, try using a fan and blankets to moderate ambient temperature.
• Make sure you nap in an environment conducive to sleep (make sure it is dark and quiet, for example) or you might be frustrated by your failure to sleep.
• If you are regularly fatigued and need to nap daily, this could be a sign of an underlying health condition. Contact your doctor to discuss your options.