If you think good sleep hygiene means taking a bath before bedtime, read on. While cleanliness is admirable, there’s more to this type of hygiene than soap and water.

Good sleep hygiene involves all the things you do to get ready for sleep -- your bedtime routine. And it can mean the difference between spending the night staring at the ceiling and waking up exhausted, or getting a good night’s sleep and starting the day refreshed.

For seniors, it’s crucial to quality of life during the day, according to Amado Freire, M.D., MPH, division chief of pulmonary critical care and sleep medicine in the College of Medicine at the University of Tennessee Health Science Center.

“In the same way as they protect their health by controlling the blood pressure, the sugar and trying to do some exercise, sleep is an activity that is present in one-third of their life, and they should be protective of the quality of sleep,” Freire said. “You should take the time for adequate sleep recovery, because what you’re protecting is not really sleep but the brain function, and in seniors that’s important.”

Freire said key to protecting sleep is controlling the environment where you do it. That means lights out, no noise and no interruptions. It also means leaving Fido in his own bed.

“A lot of people who have pets are people who have sleep problems,” he said. “They should have a designated area for the pets, so the pet is not the reason why they are having sleep interruptions.”

Sleep can be illusive for any age group, he said. But for seniors, it can be even more so.

“There is something called the arousal threshold, and some seniors have a lower arousal threshold, so with a minimal amount of noise or motion or light, the arousal threshold is met, and they wake up,” Freire said. “That’s part of the brain development, as you get older, the arousal threshold changes. That’s why they have to be more protective of their sleep.”

That’s also why falling asleep in front of the TV is not a good thing. “If you’re going to sleep, you should go to your bedroom,” he said.

Freire said seniors with sleep issues should look to their sleep routine. Just as with children, seniors need bedtime rituals.

“If the expected time for bed is around 9 or 10 p.m., they should start an hour or an hour and a half before in a very well-defined routine.”

Brush your teeth, change into your pajamas, turn down the activities, no more computers and no more TV.

“So your brain is conditioned toward the process that the next thing we have to do is to go to sleep,” he said.

And just how much sleep is necessary? It varies, he said.

“The range is different and the requirements of sleep are not uniform among all humans,” Freire said.

There are people who sleep five or six hours, and they function perfectly during the day. There are people who need eight or nine hours in order to have adequate recovery for daily activities.

“What defines the adequacy of sleep time is the amount of function and the adequacy of function in the daytime,” he said. Freire does not recommend sleep aids, with the exception of melatonin, which has no side effects.

“But all the older sleep medications may have lag-time effects in the daytime on seniors especially, because they metabolize the medication less efficiently,” he said.

Cumulative effects may contribute to accidents and injuries.

Peggy Reisser is a media relations and communications specialist with the University of Tennessee Health Science Center (uthsc.edu).

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