The Mended Hearts, Inc.
Hearts of Jersey Chapter #179
Hearts of Jersey Chapter #179
December 2009
As the meeting opened, Sheila Turkel pointed out that the chapter needed volunteers and the treasurer was in the room ready to accept membership applications. She also mentioned the upcoming Celebration of the Heart on December 11. The speaker in January, she hoped, would be Dr. Edlin, to tell us about the 64-slice CAT scan machine. Till then, a Happy Thanksgiving and a wonderful holiday to all.
Sheila then introduced the speaker, Debra Shar, a Registered Nurse supervisor for Meridian Health Senior Services, and the topic: sleep deprivation and how to get a better night’s sleep. According to the latest news, she said, over fifty percent of us are sleep deprived.
Debra avoided a monotone delivery, talking in a style that went from emphatic challenge to a rushed, hushed throwaway. She held our attention and gave us a lot of interesting and useful information.
Sleep keeps your heart healthy, she said. Blood vessels are most relaxed in the evening, lowering blood pressure. They constrict about three or four o’clock in the morning, raising blood pressure, and that’s when heart attacks and strokes are most common. Lack of sleep is associated with increased blood pressure, higher cholesterol levels, and increased stress, all risk factors for heart disease.
Insomnia - having difficulty getting to sleep and staying asleep - is a big problem. You can’t catch up on sleep deprivation. On average, people need about seven to nine hours of sleep each night.
A good night’s sleep gives you more energy. It makes you feel more alert and refreshed. It improves your memory. Insomnia is not part of the normal aging process; neither is forgetfulness due to lack of sleep. If you have these conditions see your doctor.
Sleep can decrease inflammation. Too much body fat around your abdomen can increase the risk of heart attack, stroke, diabetes - and inflammation, including gout, arthritis, and other conditions that cause pain and discomfort - and interfere with sleep.
Lack of sleep increases stress hormones. Adrenaline is secreted when you have a “fight or flight” reaction: your heart starts thumping, you sweat - that’s the effect of adrenaline. Anger, or an emergency that makes you nervous, can have the same effect. Cortisol is a hormone that is released when you’re always stressed out, and (among other effects) it can make you gain weight. Go on, blame your weight gain on cortisol.
Sleep deprivation can lead to daytime drowsiness. The worst time is about two o’clock in the afternoon, when you could fall asleep in the middle of a program. Mental alertness and motor functions decrease. Weeks of sleep deprivation can cause hallucinations. Don’t get behind the wheel of a car when you’re sleep deprived. Your reactions are slowed, and you could fall asleep at the wheel.
Mood disturbances include sadness, anxiety and depression. Crankiness and impatience can affect interpersonal relations.
Lack of sleep can lead to weight gain by upsetting the balance of two hormones: grelin and leptin. Grelin, the “hunger hormone,” stimulates hunger. People who are apt to be overweight have a higher level of grelin, while thin people have a higher level of leptin. People who have had gastric bypass have more leptin.
A short nap - twenty minutes to half an hour - can be refreshing and make you more alert and productive. Longer naps can interfere with nighttime sleep: set an alarm clock if you have to.
Five stages of sleep have been identified, and we cycle through them about every ninety minutes, in the same order. Most dreaming occurs in the second half of the night when REM sleep lasts longer:
Babies sleep mostly in REM sleep. We lose that as we get older, and our doctor prescribes sleeping pills. You should take them no longer than a couple of weeks. Some people take them for years and they stop working.
Things that keep us from sleeping: frequent urination, (or if you don’t drink water at bedtime, dehydration), pain and discomfort (see your doctor), medication (don’t take your diuretic at bedtime!), restless leg syndrome, anxiety and stress (write things down before going to bed so you don’t have to think about them).
Drugs can interfere with sleep: Alcohol may help you fall asleep but then it wakes you up with dehydration and frequent urination. Antidepressants, anticonvulsants, bronchodilators, corticosteroids, decongestants, high blood pressure medications, Benadryl, nicotine, caffeine and chocolate can all keep you awake.
Illustrations adapted from IMSI MasterClips CD © 1997 IMSI
Conditions that interfere with sleep include cardiovascular disease (especially atherosclerosis - hardening of the arteries - in the legs), arthritis, heart failure, depression, diabetes, chronic lung and kidney disease, neurological conditions like epilepsy, Alzheimer’s disease and migraines, heartburn (GERD: gastrointestinal reflux disease), obesity interfering with breathing, the “hot flashes” of menopause, and sleep apnea.
Snoring is more common among middle-aged and older people and overweight people. When snoring gets very loud and suddenly stops, and then starts again with gasping, that’s sleep apnea. Blood oxygen level drops - that’s dangerous. You won’t know you have it unless somebody is listening next to you. It can be treated: CPAP (constant positive airway pressure) machines, surgery, sometimes just losing weight.
“Older adults” get less deep sleep. Falling asleep takes longer. They go to bed and wake up earlier, wake up more often and tend to nap. Including naps, they still get the seven to nine hours a day they need.
How to sleep better: Get to bed and get up the same time, even on weekends. Exercise early in the day, never within three or four hours of bedtime. Use relaxing bedtime rituals: warm bath or shower, reading, light music. Avoid stress before bedtime (don’t answer the phone, pay bills or watch exciting TV shows). Create a sleep-promoting environment: not too hot or cold, quiet, dark uncluttered bedroom, comfortable mattress and pillow, light pastel colors. Turn the alarm clock so you can’t watch the time. If you’re still awake after about 20 minutes, go to another room and do something boring. Bed is for two things: sleeping and you know what.
Discussed during the question and answer period: soothing sounds and guided imagery can help. Melatonin supplements might help. Don’t treat retirement like a perpetual weekend: start your activities early in the day, and stop stressful activities at about five in the afternoon, as though you were still working.
