When the world shut down in March 2020 on account of the COVID-19 pandemic, Marlene Smith’s every day routines were disrupted to the detriment of her sleep and her overall health.
Before the pandemic, Smith, 85, of Kings Mountain, North Carolina, often went out shopping and dining along with her daughter, who lives nearby. She was vigilant about keeping her house neat and tidy, which kept her lively, and followed a consistent sleeping routine.
(Courtesy of Marlene Smith)
However the forced inactivity of the COVID-19 lockdown wrecked Smith’s sleep habits.
Lack of Sleep and Strokes
“I had so many hours of doing nothing in the course of the day, I couldn’t go to sleep at night,” says Smith, a retiree from an organization that manufactures CDs. “The brain must be stimulated, and your body must be lively to sleep well. It’s like an enormous circle. Staying home all day made it harder for me to sleep.”
In February 2022, Smith suffered three transient ischemic attacks, also known as “mini-strokes.” Unlike major strokes, mini-strokes typically last a couple of minutes, and most symptoms are gone inside an hour or so, though on rare occasions they might last as long as 24 hours.
Research suggests that irregular sleep could also be a risk factor for stroke. The truth is, “abnormal sleep duration could also be a marker of chronic disease, which can itself be related to (stroke),” in response to a study published in 2018 within the Expert Review of Neurotherapeutics.
How the Pandemic Ruined Sleep
The COVID-19 pandemic has adversely affected the sleep of individuals of all ages, including older people.
“The prevalence of sleep problems in the course of the COVID-19 pandemic is high and affects about 40% of individuals from the final and health care populations,” in response to a meta-analysis of 44 papers published in 2021 within the Journal of Clinical Sleep Medicine. The research shows that individuals with lively COVID-19 appear to have higher rates of sleep issues.
Nevertheless, individuals needn’t have lively COVID-19 to experience poor sleep. Many individuals – including seniors without lively COVID-19 – are experiencing poor sleep due to disruptions in every day life and anxiety attributable to the pandemic.
“With the pandemic, we’ve seen a whole lot of changes within the regular schedules of patients,” Horvat says. “Some patients began taking naps within the afternoon and engaged in less social interaction. These are all aspects that result in changes in sleep rhythm and sleep quality.”
The interruption of many social activities essential to seniors is a key consider widespread sleep disruption amongst older people, agrees Dr. Lisa Gibbs, medical chief of geriatric medicine on the University of California, Irvine, and medical director of the SeniorHealth Center at UCI Health.
“Lockdowns caused a majority of seniors to be isolated,” Gibbs says. “Individuals who enjoyed social connections at community centers, through regular gatherings, group outings, book clubs or other activities were not in a position to have these gatherings.”
Some seniors who were homebound with paid caregivers declined to allow them to into their homes out of concerns of contracting COVID-19, she adds, resulting in gaps in care and further isolation.
These social disruptions have created loneliness and isolation amongst many seniors, which in turn contributed to anxiety and depression.
The lockdown also derailed the exercise routines of many individuals, including seniors. Getting regular exercise is very important with regards to getting good sleep, research suggests. Exercise disruptions of the sort Smith experienced is one other way the COVID-19 pandemic negatively affected the sleep of many seniors.
Research published in 2021 within the journal Sensors showed that older adults exercised significantly less after the pandemic began, which in turn led to a pointy spike in depression. The outcomes of the study demonstrated that the period of time older adults spent walking decreased by 52% and the period of time spent standing dropped by nearly 33%, which was related to a 150% increase in depression symptoms. Their findings suggests that the reduction in sleep duration also contributed to their depression.
Many individuals who haven’t previously experienced sleep disruptions don’t appreciate the importance of getting good sleep until they lose it, says Carleara Weiss, a sleep researcher on the Center for Nursing Research at State University of Latest York in Buffalo. She’s also a scientific sleep advisor for Aeroflow Sleep, an organization that sells masks and other equipment utilized by individuals with sleep apnea.
“Unfortunately, we frequently learn to operate with little or no sleep due to our busy work life,” Weiss says. “Nevertheless, our body keeps rating of sleep deprivation. Take into consideration using your automobile without changing the oil – in the end, it’s going to break.”
Poor Sleep and Health Risks
For Smith and countless other seniors – people ages 60 and above – sleep disruptions related to the pandemic are putting them in danger for an array of health problems, says Dr. Marri Horvat, a physician with the Sleep Disorders Center at Cleveland Clinic in Ohio.
Health problems related to poor sleep include:
Sleep apnea, in turn, is related to:
To treat sleep apnea, physicians typically prescribe patients a CPAP mask, which stands for continuous positive airway pressure mask. A CPAP machine sends a flow of pressurized air into the person’s mouth and nose as she her he sleeps. This helps keep the person’s airways open to permit normal respiration.
Strategies for Higher Sleep
While the pandemic has increased the prevalence of poor sleep amongst older adults, there are effective strategies that seniors can adopt to enhance their sleep hygiene, Horvat says. Sleep hygiene refers to maintaining each every day routines and a bedroom environment that promotes consistent, quality sleep.
Not only does alcohol affect aging, but consuming alcohol – especially in excess – has been linked to poor sleep quality and duration. in response to a paper published in 2022 by the Sleep Foundation. A standard sleep pattern includes 4 distinct stages. Consuming alcohol before bedtime could have a suppressive effect on REM sleep in the course of the first two sleep cycles, which might diminish overall sleep quality, in response to the paper. Dreams typically occur during REM sleep, which is restorative and is very important for cognition, learning and memory.
Regarding caffeine, research published within the journal Sleep Medicine Reviews in 2017 suggests that caffeine “typically prolonged sleep latency, reduced total sleep time and sleep efficiency, and worsened perceived sleep quality.” Caffeine stimulates the central nervous system, which might create a rush of energy. It quickly boosts alertness within the brain. These effects might be detrimental to getting good sleep.
As for nicotine’s effect on sleep, research published within the journal Nicotine & Tobacco Research in 2016 suggests an association between nicotine addiction and disrupted sleep, says Steven A. Branstetter, an associate professor of behavioral health at Penn State University and a co-author of the study. Researchers found that one key marker of nicotine addiction – the tendency to smoke soon after waking, often accompanied by waking earlier within the morning than desired – could also be a key consider the general disruption of sleep in smokers, he says.
Often, spending an excessive amount of time in bed outside of those reasons can result in difficulty falling and/or staying asleep, Horvat says. “The more time you spend in bed watching television, playing in your phone, tossing and turning while trying to go to sleep and worrying, the more it morphs your bed right into a cue for wakefulness quite than for sleep,” Horvat says. “Over time, pairing your bed with these sleep-disruptive behaviors can worsen your ability to fall and/or stay asleep.”
Using the correct mattress can improve your sleep, and selecting the correct one is a highly individual decision. Typically, medium firm mattresses are alternative for a lot of older adults. That’s because medium firm is the minimum standard for good spine alignment and luxury. Before selecting a mattress, try various models with different levels of firmness. You can even try memory foam toppers, which go on top of a mattress, for extra comfort.
Keeping your bedroom dark and freed from white light from electronic devices helps promote good sleep, says Dr. Savitha Elam-Kootil, a board-certified sleep medicine expert and internist at Kaiser Permanente in Atlanta. Should you need some dim light, amber light is best than white light or blue light.
“White or blue light interferes with secretion of the sleep hormone melatonin, greater than amber light, which in turn affects sleep onset,” she says.
Adding blackout liners to your bedroom curtains might be helpful.
Having a chosen time every night to review your day and go over what you may and couldn’t control might be a part of a rest practice that helps with sleep, Elam-Kootil says.
“Assure yourself that you just did what you may for that moment to one of the best of your ability and hence you may’t ask yourself for more,” she adds. “Assure yourself that you deserve your rest because you could be charged to similarly give your best for the following day.”
Rest practices will help your mind from feeling overly busy. Like a laptop with dozens of open tabs, Elam-Kootil explains to patients that mindfulness practices will help “close open tabs and pop-ups of their mind space,” which might prevent them from falling and staying asleep.
Practicing yoga can improve the sleep of older individuals with insomnia, research published within the journal Alternative Therapies in Health Medicine in 2014 suggests. Research published within the Indian Journal of Psychiatry in 2013 suggests that yoga improved the sleep and the standard of lifetime of 120 older people people in nine elderly group homes.
Elam-Kootil – who serves on the advisory board for MyYogaTeacher, a web based yoga platform – recommends yoga nidra, a guided meditation practice that may result in a sort of “yogic sleep” or state of deep restfulness, through which you’ve got an awareness of rest. This is simple to practice at home via online courses or audio recordings.
“It helps people to sleep seven to nine hours every day,” Elam-Kootil says.
- Child’s pose. You kneel on the yoga mat, bend forward and rest your torso in your thighs, while extending your arms uncomplicated. Allow your brow and hands to softly touch the mat. Hold the pose for one to 2 minutes.
- Butterfly pose. On this pose, you sit quasi-cross legged but allow the soles of your feet to face and touch one another. For a minute, flutter your knees up and down in order that your legs open just like the wings of a butterfly.
- Supported wall stand. On this pose, you lie down in your back together with your buttocks touching the wall while elongating your legs up the wall, perpendicular to your body, for one to 2 minutes.
Marlene Smith, the North Carolina retiree, initially began taking online yoga classes from MyYogaTeacher a couple of months within the pandemic to assist alleviate her knee pain, but she discovered that practicing yoga every day and taking nighttime meditation courses have improved her sleep and overall health.
“Since starting meditation, I have been in a position to sleep higher and stand up bright-eyed and able to go,” Smith says. “My quality of life has improved 100%.”
Yogic respiration, which is generally known as pranayama in Sanskrit, will help chill out the body and mind by stimulating the parasympathetic nervous system.
“(This) counters and balances the sympathetic nervous system, which is in overdrive in individuals with insomnia,” Elam-Kootil says.
- Bhramari pranayama. This can be a respiration technique through which you hum like a bee if you exhale. “It releases cerebral tension and helps to lower blood pressure and chill out the central nervous system,” Elam-Kootil says. “I like to recommend practice humming only while sitting upright, not while lying down, and repeat a couple of times.”
- Anuloma viloma pranayama, or alternate nostril respiration. This practice helps to balance the left and right sides of the brain, Elam-Kootil says. Slowly inhale through the left nostril, using the thumb of the correct hand to maintain the correct nostril plugged. Hold the breath for five seconds while the correct nostril stays plugged, then concurrently release the correct thumb and plug the left nostril together with your right ring finger so you may slowly exhale through the correct nostril. Repeat the slow inhale through the correct nostril while using the correct ring finger to maintain the left nostril closed, holding the breath for several seconds. Then, slowly exhale via the left nostril by releasing the ring finger and using the correct thumb to maintain the correct nostril closed. Repeat this pattern two to 5 times.
When to See Your Primary Health Care Provider
Should you’ve tried various sleep strategies and still need multiple naps in the course of the day to operate, are experiencing memory loss and/or have difficulty concentrating, see your primary care health provider, Weiss suggests. A health care provider can evaluate you and, if needed, refer you for a house or lab sleep study, which could discover specific issues, like sleep apnea.
Ultimately, sleep is critical to your overall health – from immune function, hormone regulation, considering ability and mental health.
“The excellent news is which you can spend money on sleeping higher and maintaining your health,” Weiss says. “Make sleep a pillar on your wellness journey.”
This text was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and the The Silver Century Foundation.