4 Simple Rules for Better Sleep
This sounds way too good to be true: a quick, effective solution to the insomnia
that plagues an estimated 15 to 30 percent of older adults — without drugs,
without even needing to consult a doctor.
A University of Pittsburgh team, testing its method on 79 seniors with chronic
insomnia (average age: 72), reported very encouraging results. The treatment
required just two short sessions with a nurse-practitioner, plus two brief
follow-up phone calls, over the course of a month.
Afterward, the researchers reported two-thirds of those treated reported measurable
improvement in sleep, compared with 25 percent of those in a control group. 55
percent of those treated no longer had insomnia at all. And six months later,
three-quarters of those tested had maintained or improved their better sleep
So what was this potential wonder non-drug? It’s a change in what you do, not in what you take.
So the researchers distilled those principles into four simple rules, came up with
a workbook and sleep diaries to help patients follow them, and trained a
nurse-practitioner to explain the regimen and the physiology behind it.
Insomnia, like other sleep disorders, can take a serious toll on health. It’s associated
with depression, falls and fractures, with higher mortality — and its
prevalence increases with age.
Doctors take insomnia seriously and prescribe medications to help patients sleep.
But sedatives can create problems. In older patients, sleep drugs can cause daytime
drowsiness and impair memory, and they’re also associated with falls.
The British Medical Journal in 2005, concluded that while the drugs improved sleep,
their effects were small and the hazards significant. “In people over 60, the
benefits of these drugs may not justify the increased risk,” the researchers
Drug FREE Sleep
An intervention not involving drugs would therefore be a great boon “In an
ideal health care system, one would wish for behavioural treatment for insomnia
to be widely available because of the data supporting its success,” not to
mention the cost savings from reduced drug use and fewer side effects and injuries,
Thomas C. Neylan, a psychiatrist at the University of California, San
Francisco, wrote in a commentary accompanying the study.
So why isn’t this method commonly prescribed.
The idea is to stick to a schedule that maximizes your “sleep efficiency” — the
amount of time in bed you spend sleeping, instead of tossing and hoping that
sleep will descend.
The four rules:
1 Reduce the time spent in bed.
2 Get up at the same time every day.
3 Don’t go to bed until you feel sleepy.
4 Don’t stay in bed if you’re not sleeping.
The nurse instructing patients in the technique uses diagrams and examples,
describes the physiology involved, cautions that people may feel tired and
sleep-deprived for the first few weeks but usually go on to deeper, more
restful sleep that comes more quickly. Still, that’s about all that needs to be
said — not much. In the study, three brochures given to the control group
contained a lot of the same information, but just reading about better sleep
habits didn’t do the trick.
However obvious the strategy may sound, the reality is, people gravitate toward the
exact opposite behaviour. It’s common to see older adults spend 10 or 12 hours
in bed in order to get five hours of sleep. It’s very frustrating. But it’s also frustrating to think that a potentially safe and effective answer to a widespread problem might once more fail to make its way out of an academic journal and into physicians’ offices
and people’s bedrooms
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