As I get older, it seems that sleeping becomes more and more "difficult". Waking up three or four times in the middle of the night, opening my eyes at five o'clock in the morning and never falling asleep again, being groggy during the day and sleepy at night, the whole person's biological clock is completely out of order. Some elderly people feel that they should sleep less when they are older, and some people have to sleep for ten hours, otherwise they feel unrefreshed.

However, doctors have observed for a long time that the older you get, the more you need to rely on "feeling" but on "control" when you sleep. It's not about sleeping better or sleepy, it's about getting the body into the right state at the right time, otherwise the more you sleep, the more problems you have.

After the age of 65, the "variations" of sleep

After the age of 65, the body's circadian rhythm changes significantly. Melatonin secretion in the brain declines, and the hormone switch between day and night is no longer as accurate as it was when you were younger; The conduction velocity of the nervous system slows down, and the perception of "sleepiness" becomes dull; Reduced time in deep sleep, easy to wake up by external disturbances; Muscles and bones are more likely to feel pain or discomfort when they relax at night. These changes are not diseases, but they are enough to disrupt a person's sleep structure.

Sleeping is no longer a matter of "relaxing", but it is necessary to deliberately control the boundaries of behavior, so that the body can obtain the maximum rest effect under limited conditions. Doctors have repeatedly emphasized in studies that people over the age of 65 should pay special attention to one core problem: sleep structure disorders can induce a series of systemic problems. It is not simply a poor mental state, but it is directly related to cardiovascular rhythm, blood sugar control, and immune function.

Surveys show that if the elderly sleep time fluctuates more than 38 hours a day, the risk of hypertension and diabetes increases by 0%; Cardiac events were 0% higher in total nighttime wake-up time than those who slept relatively steadily, if the total time spent awake during the night was more than 0 minutes. These data show that sleep is not an option, but a central regulator of the functioning of the physiological system. Once the rhythm is out of order, the whole body will go wrong.

Common sleep misconceptions: the more you sleep, the more messy it gets

The most common sleep myth is "sleep when you're sleepy". Many elderly people are accustomed to sleeping when they are sleepy after eating, but as a result, the time to fall asleep at night is delayed, and coupled with frequent awakenings at night, the whole sleep is broken into several sections. In the short term, it seems to be an extra few hours of sleep, but in fact, the time of deep sleep that really has a restorative function is seriously shortened.

The deep sleep phase usually occurs in the first two hours after falling asleep, and if you fall asleep late and wake up frequently during the night, your body has no chance to enter this stage. In the long run, the brain's ability to remove metabolic waste products decreases, resulting in unresponsiveness, memory loss, anxiety and irritability. Studies have shown that older adults have a double risk of cognitive impairment when they have more than 20% reduction in deep sleep.

There is also a misconception that relies too much on naps to "catch up on sleep". Many people wake up at four or five o'clock in the morning and are groggy during the day, so they sleep for two hours after lunch, or even sleep until four o'clock in the afternoon. In this way, the body mistakenly thinks that "the night has already come once", the release of melatonin is interrupted, and at night there is no sleepiness, and I can't sleep and can only rely on TV to support the time. As a result, I woke up at two or three o'clock in the middle of the night and had complete insomnia. Doctors recommend that lunch breaks can be had, but the time should not exceed 30 minutes, and the location is preferably not in bed. Let the body know that this is a short break, not a full sleep.

Sleep Management: A "4-Step Approach" to Finding Stability

Step 1: Set your time to go to bed and wake up

Instead of "go to bed as early as possible", "go to bed at the same time every day". Even if you didn't sleep well the night before, you can't catch up until noon. Rhythm is a training consequence and is not naturally formed. Doctors recommend setting a "fixed lights-out time" for one night, even if you can't fall asleep for 20 minutes while lying down, don't pick up your phone, don't get up, and don't eat. Persist for a while, and the body will naturally form a conditioned reflex.

Step 2: Control the lighting rhythm

老年人的视网膜对光线敏感度下降，褪黑素释放机制变弱，白天不够亮、晚上不够暗，都会让身体无法准确识别“现在是白天还是黑夜”。白天一定要尽可能多接受自然光，尤其是早上7点到9点这段时间。可以不出门，但窗帘必须拉开，最好能照到脸上。晚上8点后减少灯光亮度，特别是白光和蓝光，比如手机、平板、LED台灯。这种对光的管理，会直接影响大脑的“睡眠启动”指令。

Step 3: Control your behavior before falling asleep

Many elderly people like to watch TV, play with mobile phones, and chat before going to bed, but these stimuli will activate the cerebral cortex, make the nervous system active, delay melatonin secretion, and naturally delay drowsiness. Some people eat before bed, especially high-sugar snacks, fruits, and supper, which can cause blood sugar fluctuations and trigger nocturnal awakenings. Doctors recommend not looking at screens, not eating, and not discussing emotionally intense topics within 1 hours before bedtime, so that the body knows that this is a stage of "starting to be quiet".

Step 4: Control the amount of time you spend in bed

Many people lie down early at night, thinking that lying down more will help them sleep, but in fact it is the opposite. Once the time spent in bed is much greater than the actual sleep time, the brain will confuse the difference between "lying down" and "sleeping", and over time form the memory that "the bed is a place to be awake", causing the fall of sleep to fall slower. The correct way to do this is to stay in bed as little as possible during the day and not lie in bed until bedtime at night. If you still can't fall asleep after lying down for 20 minutes, you may wish to get up and move, and then go to bed when you feel sleepy, and gradually reconstruct the connection between "bed = sleep". This approach has been consistently effective in chronic insomnia interventions and has been adopted by several sleep treatment guidelines.

Diagnosis of sleep problems: arrhythmia or functional deterioration?

Nowadays, many elderly people are using sleep aids, melatonin, and health products to solve sleep problems, but will the long-term use of these things disrupt the body's rhythm? Is there a way to tell if an elderly person's current sleep problem is "arrhythmic" or "functional"? In other words, is the problem that the sleep system is out of control, or is the body really unable to sleep? There is actually a way to judge this question. Doctors recommend looking at two indicators: "speed of initiation of drowsiness" and "ability to fall asleep after awakening at night".

If you are very sleepy at night and fall asleep easily, but wake up frequently at night and it is difficult to fall back asleep after waking up, it is most likely a rhythm disorder type; If you can't sleep at night, and you don't feel sleepy even during the day, it may be a functional degenerative type. Rhythmic sleep problems can be improved through behavioral intervention, light management, and fixed work and rest, while neurodegenerative diseases should be investigated by combining neurological assessment and EEG sleep monitoring. Treat them differently, and the direction will not be wrong.

Sleep is the "reset button" for body repair

Sleep shouldn't rely on medicine, let alone guesswork. When I fall asleep, my body really starts to repair. If you don't sleep well, don't expect to be in good shape during the day. When you are old, you are not afraid of getting old, but you are afraid of sleeping messily. Controlling sleep is not to make people sleep less, but to make sleep better. What the elderly really need is not the quantitative "eight hours of sleep", but the structural "deep enough, stable enough, and regular enough".

Sleep more but intermittently, not as well as less but complete; If you don't sleep well at night and make up for it during the day, it will only make the rhythm more and more chaotic. Many people's chronic problems, such as blood pressure fluctuations, irritability, poor appetite, and memory loss, are not rooted in the organs, but in the rhythm. Rhythm disorder, all systems are disordered, sleep, is the core of this rhythm.

Proofread by Zhuang Wu